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Objetivo: Conhecer o perfil do imigrante que utiliza a atenção primária de Florianópolis. Métodos: Estudo transversal de base populacional com dados cadastrais de estrangeiros moradores de Florianópolis, que utilizaram a Atenção Primária à Saúde entre os anos de 2014 e 2016. As variáveis utilizadas foram: nacionalidade, sexo, idade, nível de escolaridade, raça, endereço de moradia e tipos de serviços utilizados. Resultados: Um total de 10.108 estrangeiros utilizaram a atenção básica em Florianópolis no período do estudo, com predomínio de adultos, brancos, com ensino médio ou superior, predominância de argentinos, uruguaios e haitianos, utilizando predominantemente serviços da farmácia e consultas médicas, distribuídos em todas unidades de saúde da capital. Houve maior nível de escolaridade e maior proporção de crianças e idosos na população provinda de países desenvolvidos, além de uma menor utilização dos serviços. Discussão: Estudo pioneiro no Brasil. O perfil dos imigrantes estudados é comparável à população de estudos europeus, com predomínio de latino-americanos e caribenhos, com faixa etária prevalecendo população economicamente ativa, utilizando consultas médicas e com alta escolaridade entre imigrantes de países desenvolvidos.

Objective: To know the immigrant's profile who use primary care in Florianopolis. Methods: Cross-sectional populational-based study with register data from foreigners who used Primary Health Care in Florianopolis between 2014 and 2016. The variables were nationality, sex, age, level of education, race and service used. Results: A total of 10,108 immigrants accessed primary care in Florianopolis during the study period, with a predominance profile of adults, Caucasian, with medium/high level of education, Latin Americans, mainly using pharmacy and medical consultations, distributed in all primary care units at Florianopolis. We observed a higher level of schooling and a greater proportion of children and elderly people in the population coming from developed countries, in addition to a lower use of services. Discussion: The profile of immigrants in the study population is comparable to the immigrant population in some European studies, with a predominance of Latin Americans and Caribbean, with a high frequency of economically active age group, using medical consultations and high education among immigrants from developed countries.

Objetivo: Conocer el perfil del inmigrante que utiliza la atención primaria a la salud de Florianópolis. Métodos: Estudio transversal de base poblacional con datos de registro de extranjeros que utilizaron la Atención Primaria a la Salud de Florianópolis entre los años 2014 y 2016. Las variables utilizadas fueron: nacionalidad, sexo, edad, nivel de escolaridad, raza, dirección de vivienda y residencia tipos de servicios utilizados. Resultados: Total de 10.108 inmigrantes utilizaron la atención básica en Florianópolis en el período del estudio, con un perfil de predominio de adultos, blancos, con enseñanza media o superior de escolaridad, predominio de argentinos, uruguayos y haitianos, utilizando predominantemente servicios de la farmacia y consultas médicos, distribuidos en todas las unidades de salud de la capital. Se observó un mayor nivel de escolaridad y mayor proporción de niños y ancianos en la población proveniente de países desarrollados, además de una menor utilización de los servicios. Discusión: Estudio pionero en Brasil, el perfil de los inmigrantes en la población del estudio es comparable a la población de estudios europeos, con predominio de latinoamericanos y caribeños, con rango de edad prevaleciendo población económicamente activa, utilizando consultas médicas y con alta escolaridad entre inmigrantes de países desarrollados.

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BACKGROUND: Toxocara canis and T. cati are parasites of dogs and cats, respectively, that infect humans and cause human toxocariasis. Infection may cause asthma-like symptoms but is often asymptomatic and is associated with a marked eosinophilia. Previous epidemiological studies indicate that T. canis infection may be associated with the development of atopy and asthma. OBJECTIVES: To investigate possible associations between Toxocara spp. seropositivity and atopy and childhood wheezing in a population of children living in non-affluent areas of a large Latin American city. METHODS: The study was conducted in the city of Salvador, Brazil. Data on wheezing symptoms were collected by questionnaire, and atopy was measured by the presence of aeroallergen-specific IgE (sIgE). Skin prick test (SPT), total IgE and peripheral eosinophilia were measured. Toxocara seropositivity was determined by the presence of anti-Toxocara IgG antibodies, and intestinal helminth infections were determined by stool microscopy. FINDINGS: Children aged 4 to 11 years were studied, of whom 47% were seropositive for anti-Toxocara IgG; eosinophilia >4% occurred in 74.2% and >10% in 25.4%; 59.6% had elevated levels of total IgE; 36.8% had sIgE≥0.70 kU/L and 30.4% had SPT for at least one aeroallergen; 22.4% had current wheezing symptoms. Anti-Toxocara IgG was positively associated with elevated eosinophils counts, total IgE and the presence of specific IgE to aeroallergens but was inversely associated with skin prick test reactivity. CONCLUSION: The prevalence of Toxocara seropositivity was high in the studied population of children living in conditions of poverty in urban Brazil. Toxocara infection, although associated with total IgE, sIgE and eosinophilia, may prevent the development of skin hypersensitivity to aeroallergens, possibly through increased polyclonal IgE and the induction of a modified Th2 immune reaction.

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BACKGROUND: The current epidemic of asthma and atopy has been explained by alterations in immune responses related to reduction in childhood infections. However, the findings of epidemiologic studies investigating the association between infection with atopy and asthma have been inconsistent. OBJECTIVE: We sought to investigate the effect of single or multiple infections (pathogen burden) on atopy and wheeze in urban children from Latin America. METHODS: Specific IgE against aeroallergens (sIgE) and skin prick test (SPT) reactivity for the most common local allergens were measured in 1128 children aged 4 to 11 years. Data on wheezing and potential confounders were collected by questionnaire. Infections by 8 pathogens were assessed by using serology and stool examination. Associations of wheeze and atopic outcomes with single and multiple infections were analyzed by means of logistic regression. RESULTS: Negative results for Toxoplasma gondii were associated with a higher prevalence of sIgE (≥0.70 kU/L), whereas negative results for Ascaris lumbricoides, T gondii, herpes simplex virus, and EBV were associated with a higher prevalence of SPT reactivity. Children with 3 or fewer infection markers had a higher prevalence of sIgE and SPT reactivity compared with those with 4 or more infection markers. However, isolated infections or pathogen burden were not associated with the prevalence of atopic or nonatopic wheeze. CONCLUSION: The findings provide support for the idea that the hygiene hypothesis is operating in an urban Latin American context, but its expression is thus far restricted to the atopic status of patients and not the perceived asthma symptoms.

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INTRODUCTION: Larva migrans visceral is caused by Toxocara sp and has never been studied in Bahia. This work investigated the prevalence and risk factors for infection by Toxocara canis in individuals from Salvador, State of Bahia. METHODS: Three hundred and thirty-eight individuals were investigated for the presence of serum IgG anti-T. canis. RESULTS: IgG anti-T. canis was higher in individuals from lower social classes who had more contact with dogs and cats, indicating that these variables are factors risk for this infection. CONCLUSIONS: The prevalence of T. canis infection was high. The risk factors for this infection identified are in agreement with in the literature.

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INTRODUÇÃO: Larva migrans visceral é causada por Toxocara sp e nunca foi estudada na Bahia. Neste trabalho, investigou-se a prevalência e fatores de risco de infecção por Toxocara canis, em indivíduos de Salvador. MÉTODOS: Trezentos e trinta e oito indivíduos foram investigados para presença de anticorpos IgG séricos anti-T. canis. RESULTADOS: IgG anti-T. canis foi mais alta em indivíduos de classe social baixa com maior contato com cães e gatos, indicando que estas variáveis são fatores de risco para esta infecção. CONCLUSÕES: A prevalência de infecção por T. canis foi alta. Os fatores de risco desta infecção encontrados estão de acordo com a literatura.

INTRODUCTION: Larva migrans visceral is caused by Toxocara sp and has never been studied in Bahia. This work investigated the prevalence and risk factors for infection by Toxocara canis in individuals from Salvador, State of Bahia. METHODS: Three hundred and thirty-eight individuals were investigated for the presence of serum IgG anti-T. canis. RESULTS: IgG anti-T. canis was higher in individuals from lower social classes who had more contact with dogs and cats, indicating that these variables are factors risk for this infection. CONCLUSIONS: The prevalence of T. canis infection was high. The risk factors for this infection identified are in agreement with in the literature.

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Toxocara canis is a highly prevalent worldwide canine nematode responsible for enzootic and zoonotic infections. It is considered to be one of the main agents of human visceral and ocular larva migrans. False negative diagnosis may occur because adult infected dogs with "dormant" larvae may have negative fecal test results since they usually do not shed parasite eggs in their stools. During pregnancy, the larvae become active and infect the offspring through the placenta. A serological test can distinguish infected animals, thus increasing the accuracy of the diagnosis for epidemiological studies and prophylactic purposes. In the present work a serological investigation was carried out to study the risk factors for the acquisition of this infection in 301 dogs inhabiting the city of Salvador, northeast Brazil. A validated questionnaire was applied to the donors and caretakers to assess animal management practices. All dogs were submitted to clinical evaluation and blood collection. Serum samples were analyzed for IgG antibodies against excretory-secretory products of T. canis larvae, used as antigens, by indirect ELISA. The overall seroprevalence of anti-T. canis IgG antibodies was 82.7%. Risk factors for T. canis infection included sex, area of origin within the city, homemade leftover food intake, failure to receive regular vaccination against infectious diseases and lack of preventive anti-helminthic treatment. Most of these risk factors suggest a lack of veterinary care and poverty. The high frequency of seropositivity found for toxocariasis in dogs suggests that results based on parasitological fecal examination could underestimate the actual prevalence of the infection.

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BACKGROUND: The prevalence of allergic diseases has increased over recent decades in affluent countries, but remains low in rural populations and some non-affluent countries. An explanation for these trends is that increased exposure to infections may provide protection against the development of allergy. In this work we investigated the association between exposure to viral infections in children living in urban Brazil and the prevalence of atopy and asthma. METHODS: School age children living in poor neighborhoods in the city of Salvador were studied. Data on asthma symptoms and relevant risk factors were obtained by questionnaire. Skin prick tests (SPTs) were performed to seven aeroallergens, and specific IgE was measured to four of these. Viral infections were determined by the presence of specific IgG in serum to Herpes simplex (HSV), Herpes zoster (HZV), Epstein-Barr (EBV), and Hepatitis A (HAV) viruses. RESULTS: A total of 644 (49.7%) children had at least one allergen-specific IgE> 0.35 kU/L and 489 (37.7%) had specific IgE> 0.70 kU/L. A total of 391 (30.2%) children were skin test positive (SPT+), and 295 (22.8%) children were asthmatic. The seroprevalence of viral infections was 88.9% for EBV, 55.4% for HSV, 45.5% for VZV and 17.5% for HAV. Negative associations were observed between SPT+ and HSV (OR = 0.64, CI = 0.51, 0.82) and EBV (OR = 0.63, CI = 0.44, 0.89) infections, but no associations were seen between viral infections and the presence of allergen-specific IgE or asthma. CONCLUSION: These data do not support previous data showing a protective effect of HAV against atopy, but did show inverse associations between SPT+ (but not specific IgE+) and infections with HSV and EBV. These findings suggest that different viral infections may protect against SPT+ in different settings and may indicate an immunoregulatory role of such infections on immediate hypersensitivity responses. The data provide no support for a protective effect of viral infections against asthma in this population.

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BACKGROUND: Helicobacter pylori infection has been proved to be of great relevance to public health in unindustrialized countries, especially in low socioeconomic groups. Poor hygiene, deficient sanitation, and crowded conditions have been reported as risk factors for this infection. In this work, we investigated whether social and demographic characteristics were associated with anti-H. pylori IgG antibodies in 1104 children aged 4-11 years old from Salvador, a large city located in northeastern Brazil. METHODS: Standardized questionnaires were used to obtain social, demographic, and environmental data for the studied population in two periods of time (from 1997 to 2003 and in 2005). Anti-H. pylori IgG antibodies were assessed by indirect enzyme-linked immunosorbent assay in 2005. RESULTS: Anti-H. pylori IgG antibody was present in 28.7% of the children. Among the studied variables, the following were positively associated with the presence of anti-H. pylori antibodies in multivariable analyses: age above 8 years old (OR = 1.72, 95% CI = 1.23-2.40), a larger sibling number (OR = 1.66, 95% CI = 1.26-2.18), nursery attendance (OR = 1.49, 95% CI = 1.04-2.12), location of the house at an unpaved street (OR = 2.03, 95% CI = 1.44-2.87) and absence of a flush toilet (OR = 1.32, 95% CI = 1.00-1.74). CONCLUSION: Our data show that H. pylori infection in children from a major Brazilian city is associated with variables indicative of a crowded environment and deficient sanitation/habitation conditions, leading to the conclusion that improvements in hygiene and social conditions may protect children against this infection.

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As enteroparasitoses vêm sendo exaustivamente estudadas ao longo do século em diversas comunidades no Brasil. Porém, estudos que envolvam comunidades remanescentes quilombolas ainda são escassos. Este trabalho teve como objetivo investigar a frequência de parasitos intestinais e possíveis fatores de risco para estas infecções em uma amostra de crianças e adolescentes (2 a 14 anos) residentes em uma área de remanescentes quilombolas da Bahia. Foram examinados 348 indivíduos e aplicado um questionário sobre suas características socioeconômicas e sanitárias. Dentre os 348 examinados, a frequência de resultados positivos para pelo menos um protozoário ou helminto foi de 276 (79,3 por cento). Quanto aos aspectos socioeconômicos e sanitários, das 180 famílias entrevistadas 122 (67 por cento) informaram viver com renda média de meio salário mínimo mensal, mais da metade (61 por cento) não consomem água tratada, 51 por cento não possuem banheiros em suas residências e a falta de rede de esgoto prevaleceu em 96 por cento dos domicílios. Estes resultados evidenciaram um quadro de alta frequência de enteroparasitos nesta população, uma vez que está exposta a precárias condições higiênico-sanitárias. Este quadro exige das autoridades governamentais medidas de controle e educação para melhorar a qualidade de vida desta comunidade.

Intestinal parasites have been exhaustively studied in different communities in Brazil throughout the years although data concerning remaining “quilombolas”(descendants of former black slaves that escaped to hiding places, the quilombos) communities are poor. The current study aimed to investigate the frequency of intestinal parasites and potential risk factors for these infections in children and teenagers (2-14 years old), living in a remaining quilombola community in Bahia. Stool samples were collected and standardized questionnaires were applied to 348subjects. 276 (79.3%) were infected by protozoa or helminth parasites. In relation to socioeconomic characteristics, of 180 interviewed families, 122 (67%) reported to live with a half minimum salary, most of them (61%) have no treated water, 51% have no toilet in their houses. Sewage system was absent in 96.6% of the houses. These results show the high frequency of intestinal parasites in this population, once they live in precarious socioeconomic and environmental conditions, highlighting the immediate need of governmental interventions on this community.

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BACKGROUND: Environmental factors are likely to have profound effects on the development of host immune responses, with serious implications for infectious diseases and inflammatory disorders such as asthma. OBJECTIVE: This study was designed to investigate the effects of environmental exposures on the cytokine profile of children. METHODS: The study involved measurement of T helper (Th) 1 (interferon-gamma), 2 [interleukin (IL)-5 and IL-13], and the regulatory cytokine IL-10 in unstimulated peripheral blood leukocytes from 1,376 children 4-11 years of age living in a poor urban area of the tropics. We also assessed the impact of environmental exposures in addition to biological characteristics recorded at the time of blood collection and earlier in childhood (0-3 years before blood collection). RESULTS: The proportion of children producing IL-10 was greater among those without access to drinking water [p < 0.05, chi-square test, odds ratio (OR) = 1.67]. The proportion of children producing IL-5 and IL-10 (OR = 10.76) was significantly greater in households that had never had a sewage system (p < 0.05, trend test). CONCLUSIONS: These data provide evidence for the profound effects of environmental exposures in early life as well as immune homeostasis in later childhood. Decreased hygiene (lack of access to clean drinking water and sanitation) in the first 3 years of life is associated with higher spontaneous IL-10 production up to 8 years later in life.

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