RESUMEN

Giardia duodenalis genotypes A and B have been reported in Colombia. The population consisted of 235 schoolchildren whose ages ranged from 2 to 10 yr of age from the municipalities of Soledad and Galapa in the department of Atlántico, Colombia. Fecal samples were obtained and then analyzed in triplicate using the sedimentation in formalin-ether (Ritchie's method) and direct examination techniques. Of the 235 fecal samples, 35 samples were positive for G. duodenalis; positive samples were concentrated in a sucrose gradient and sonicated for 3 cycles of 20 sec. DNA extraction was performed, and the parasites were genotyped by conventional PCR amplifying a region of the ß-giardin gene. A general prevalence of G. duodenalis of 13.2% was found, and of these genotyped samples, 13 (56.7%) and 7 (20%) corresponded to genotype A, 1 (4.3%), and 3 (25%) corresponded to genotype B, and 9 (39.1%) and 2 (16.7%) were not defined, in the municipalities Soledad and Galapa, respectively. Additionally, 23 children were diagnosed with symptomatologic giardiasis, and 12 were asymptomatic; the most relevant symptoms were abdominal pain (7, 20%) and diarrhea (13, 56.7%). The nutritional status of children with Giardia genotypes A and B were as follows: 3 in a state of malnutrition (10%), 10 normal (33.3%), and 6 overweight and obese (20%) with genotype A, and 1 in a state of malnutrition (3.3%) and 3 normal (10%) with genotype B. The genotypes found in G. duodenalis did not show an association with nutritional status or with the clinical manifestations evaluated in schoolchildren.

Asunto(s)

Giardia lamblia/clasificación , Giardiasis/parasitología , Desnutrición/complicaciones , Estado Nutricional/fisiología , Niño , Preescolar , Colombia , Genotipo , Técnicas de Genotipaje , Giardia lamblia/genética , Giardiasis/complicaciones , Giardiasis/fisiopatología , Humanos , Desnutrición/parasitología

RESUMEN

Protein malnutrition is a risk factor for developing visceral leishmaniasis. Because we previously demonstrated that protein malnutrition and infection with Leishmania infantum disrupts the splenic microarchitecture in BALB/c mice, alters T cell-subsets and increases splenic parasite load, we hypothesize that splenic microenvironment is precociously compromised in infected animals that suffered a preceding malnutrition. To evaluate this, we characterized the abundance of proteins secreted in the splenic interstitial fluid (IF) using an iTRAQ-based quantitative proteomics approach. In addition, local levels of pro-inflammatory and proliferation molecules were analyzed. Whereas well-nourished infected animals showed increased IL-1ß and IL-2 levels, malnourished-infected mice displayed significant reduction of these cytokines. Remarkably, a two-weeks infection with L. infantum already modified protein abundance in the splenic IF of well-nourished mice, but malnourished animals failed to respond to infection in the same fashion. Malnutrition induced significant reduction of chemotactic and pro-inflammatory molecules as well as of proteins involved in nucleic acid and amino acid metabolism, indicating an impaired proliferative microenvironment. Accordingly, a significant decrease in Ki67 expression was observed, suggesting that splenocyte proliferation is compromised in malnourished animals. Together, our results show that malnutrition compromises the splenic microenvironment and alters the immune response to the parasite in malnourished individuals. SIGNIFICANCE: Protein malnutrition is recognized as an important epidemiological risk factor for developing visceral leishmaniasis (VL). Locally secreted factors present in the interstitial fluid have important roles in initiating immune responses and in regulating fluid volume during inflammation. However, the regulation of secreted factors under pathological conditions such as malnutrition and infection are widely unknown. To analyze how protein malnutrition alters secreted proteins involved in the immune response to L. infantum infection we evaluated the proteomic profile of the interstitial fluid of the spleen in malnourished BALB/c mice infected with L. infantum. Our work revealed new elements that contribute to the understanding of the immunopathological events in the spleen of malnourished animals infected with L. infantum and opens new pathways for consideration of other aspects that could improve VL treatment in malnourished individuals.

Asunto(s)

Proliferación Celular , Líquido Extracelular/metabolismo , Perfilación de la Expresión Génica , Leishmania infantum/metabolismo , Leishmaniasis Visceral/metabolismo , Desnutrición/metabolismo , Proteómica , Bazo/metabolismo , Animales , Líquido Extracelular/parasitología , Inflamación/metabolismo , Inflamación/parasitología , Inflamación/patología , Leishmaniasis Visceral/patología , Masculino , Desnutrición/parasitología , Desnutrición/patología , Ratones , Ratones Endogámicos BALB C , Bazo/parasitología , Bazo/patología

RESUMEN

Detrimental effects of malnutrition on immune responses to pathogens have long been recognized and it is considered a main risk factor for various infectious diseases, including visceral leishmaniasis (VL). Thymus is a target of both malnutrition and infection, but its role in the immune response to Leishmania infantum in malnourished individuals is barely studied. Because we previously observed thymic atrophy and significant reduction in cellularity and chemokine levels in malnourished mice infected with L. infantum, we postulated that the thymic microenvironment is severely compromised in those animals. To test this, we analyzed the microarchitecture of the organ and measured the protein abundance in its interstitial space in malnourished BALB/c mice infected or not with L. infantum. Malnourished-infected animals exhibited a significant reduction of the thymic cortex:medulla ratio and altered abundance of proteins secreted in the thymic interstitial fluid. Eighty-one percent of identified proteins are secreted by exosomes and malnourished-infected mice showed significant decrease in exosomal proteins, suggesting that exosomal carrier system, and therefore intrathymic communication, is dysregulated in those animals. Malnourished-infected mice also exhibited a significant increase in the abundance of proteins involved in lipid metabolism and tricarboxylic acid cycle, suggestive of a non-proliferative microenvironment. Accordingly, flow cytometry analysis revealed decreased proliferation of single positive and double positive T cells in those animals. Together, the reduced cortical area, decreased proliferation, and altered protein abundance suggest a dysfunctional thymic microenvironment where T cell migration, proliferation, and maturation are compromised, contributing for the thymic atrophy observed in malnourished animals. All these alterations could affect the control of the local and systemic infection, resulting in an impaired response to L. infantum infection.

Asunto(s)

Interacciones Huésped-Patógeno/inmunología , Leishmania infantum/inmunología , Leishmaniasis Visceral/inmunología , Desnutrición/inmunología , Linfocitos T/inmunología , Timo/inmunología , Animales , Transporte Biológico , Movimiento Celular , Proliferación Celular , Ciclo del Ácido Cítrico/genética , Ciclo del Ácido Cítrico/inmunología , Exosomas/inmunología , Exosomas/metabolismo , Exosomas/parasitología , Líquido Extracelular/inmunología , Líquido Extracelular/metabolismo , Líquido Extracelular/parasitología , Galectina 1/genética , Galectina 1/inmunología , Regulación de la Expresión Génica , Interacciones Huésped-Patógeno/genética , Inmunidad Innata , Leishmania infantum/crecimiento & desarrollo , Leishmaniasis Visceral/genética , Leishmaniasis Visceral/metabolismo , Leishmaniasis Visceral/parasitología , Metabolismo de los Lípidos , Masculino , Desnutrición/genética , Desnutrición/metabolismo , Desnutrición/parasitología , Ratones , Ratones Endogámicos BALB C , Plasminógeno/genética , Plasminógeno/inmunología , Proteoma/genética , Proteoma/inmunología , Linfocitos T/parasitología , Timo/metabolismo , Timo/parasitología

RESUMEN

Background: Cryptosporidium species are enteric protozoa that cause significant morbidity and mortality in children worldwide. We characterized the epidemiology of Cryptosporidium in children from 8 resource-limited sites in Africa, Asia, and South America. Methods: Children were enrolled within 17 days of birth and followed twice weekly for 24 months. Diarrheal and monthly surveillance stool samples were tested for Cryptosporidium by enzyme-linked immunosorbent assay. Socioeconomic data were collected by survey, and anthropometry was measured monthly. Results: Sixty-five percent (962/1486) of children had a Cryptosporidium infection and 54% (802/1486) had at least 1 Cryptosporidium-associated diarrheal episode. Cryptosporidium diarrhea was more likely to be associated with dehydration (16.5% vs 8.3%, P < .01). Rates of Cryptosporidium diarrhea were highest in the Peru (10.9%) and Pakistan (9.2%) sites. In multivariable regression analysis, overcrowding at home was a significant risk factor for infection in the Bangladesh site (odds ratio, 2.3 [95% confidence interval {CI}, 1.2-4.6]). Multiple linear regression demonstrated a decreased length-for-age z score at 24 months in Cryptosporidium-positive children in the India (ß = -.26 [95% CI, -.51 to -.01]) and Bangladesh (ß = -.20 [95% CI, -.44 to .05]) sites. Conclusions: This multicountry cohort study confirmed the association of Cryptosporidium infection with stunting in 2 South Asian sites, highlighting the significance of cryptosporidiosis as a risk factor for poor growth. We observed that the rate, age of onset, and number of repeat infections varied per site; future interventions should be targeted per region to maximize success.

Asunto(s)

Criptosporidiosis/epidemiología , Diarrea/epidemiología , Áreas de Pobreza , África/epidemiología , Asia/epidemiología , Preescolar , Estudios de Cohortes , Aglomeración , Cryptosporidium/aislamiento & purificación , Diarrea/parasitología , Heces/parasitología , Femenino , Trastornos del Crecimiento/parasitología , Humanos , Lactante , Recién Nacido , Masculino , Desnutrición/parasitología , Análisis de Regresión , Factores de Riesgo , Factores Socioeconómicos , América del Sur/epidemiología , Encuestas y Cuestionarios

RESUMEN

Schistosomiasis and malnutrition are often overlapped in poor communities, resulting in disproportionately high mortality rates. Currently, fragmented data make it difficult to define the relationship between diet and schistosomiasis. Thus, we systematically review the preclinical evidence on the impact of diet in Schistosoma mansoni infection. From a structured search, we recovered 27 original articles. All studies used mice and most of them investigated hypoproteic (70.37%), hyperlipidic (22.22%) or vitamin-deficient (7.41%) diets. Diets based on carbohydrate, zinc or milk supplementation were investigated at a reduced frequency (3.70% each). Hypoproteic diets attenuated parasitic load and granulomatous inflammation, but also reduced host resistance to S. mansoni infection, determining higher mortality rates. By stimulating steatohepatitis, parasitic load and granulomatous inflammation, hyperlipidic diets increase organ damage and mortality in infected animals. Although a high-sugar diet and vitamin restriction potentiate and zinc supplementation attenuates S. mansoni infection, the current evidence for these diets remains inconclusive. Analysis of methodological quality indicated that the current evidence is at high risk of bias due to incomplete characterization of the experimental design, diet composition and treatment protocols. From the bias analysis, we report methodological limitations that should be considered to avoid systematic reproduction of inconsistent and poorly reproducible experimental designs.

Asunto(s)

Dieta , Desnutrición/parasitología , Esquistosomiasis mansoni/fisiopatología , Animales , Dieta Alta en Grasa , Humanos , Inflamación/patología , Hígado/parasitología , Ratones , Ratas , Esquistosomiasis mansoni/prevención & control , Vitaminas/administración & dosificación , Zinc/administración & dosificación

RESUMEN

Protein malnutrition, the most deleterious cause of malnutrition in developing countries, has been considered a primary risk factor for the development of clinical visceral leishmaniasis (VL). Protein malnutrition and infection with Leishmania infantum leads to lymphoid tissue disorganization, including changes in cellularity and lymphocyte subpopulations in the thymus and spleen. Here we report that protein malnutrition modifies thymic chemotactic factors by diminishing the CCL5, CXCL12, IGF1, CXCL9 and CXCL10 protein levels in infected animals. Nevertheless, T cells preserve their migratory capability, as they were able to migrate ex vivo in response to chemotactic stimuli, indicating that malnutrition may compromise the thymic microenvironment and alter in vivo thymocyte migration. Decrease in chemotactic factors protein levels was accompanied by an early increase in the parasite load of the spleen. These results suggest that the precondition of malnutrition is affecting the cell-mediated immune response to L. infantum by altering T cell migration and interfering with the capacity of protein-deprived animals to control parasite spreading and proliferation. Our data provide evidence for a disturbance of T lymphocyte migration involving both central and peripheral T-cells, which likely contribute to the pathophysiology of VL that occurs in malnourished individuals.

Asunto(s)

Movimiento Celular , Leishmania infantum/patogenicidad , Leishmaniasis Visceral/complicaciones , Leishmaniasis Visceral/inmunología , Desnutrición/complicaciones , Desnutrición/inmunología , Linfocitos T/patología , Timo/patología , Animales , Apoptosis , Atrofia , Peso Corporal , Quimiotaxis , Citocinas/sangre , Factor I del Crecimiento Similar a la Insulina/metabolismo , Leishmaniasis Visceral/sangre , Leishmaniasis Visceral/parasitología , Leptina/sangre , Ligandos , Macrófagos/metabolismo , Macrófagos/patología , Desnutrición/sangre , Desnutrición/parasitología , Ratones Endogámicos BALB C , Carga de Parásitos , Parásitos/patogenicidad , Receptores CXCR3/metabolismo , Bazo/parasitología , Timocitos/patología

RESUMEN

Techniques for Giardia diagnosis based on microscopy are usually applied as routine laboratory testing; however, they typically exhibit low sensitivity. This study aimed to evaluate Giardia duodenalis and other intestinal parasitic infections in different pediatric groups, with an emphasis on the comparison of Giardia diagnostic techniques. Feces from 824 children from different groups (diarrheic, malnourished, with cancer and from day care) were examined by microscopy and ELISA for Giardia, Cryptosporidium sp. and Entamoeba histolytica coproantigen detection. Giardia-positive samples from day-care children, identified by either microscopy or ELISA, were further tested by PCR targeting of the ß-giardin and Gdh genes. Statistically significant differences (P<0.05) were observed when comparing the frequency of each protozoan among the groups. Giardia duodenalis was more frequent in day-care children and Cryptosporidium sp. in diarrheic and malnourished groups; infections by Entamoeba histolytica were found only in children with diarrhea. Considering positivity for Giardia by at least one method, ELISA was found to be more sensitive than microscopy (97% versus 55%). To examine discrepancies among the diagnostic methods, 71 Giardia-positive stool samples from day-care children were tested by PCR; of these, DNA was amplified from 51 samples (77.4%). Concordance of positivity between microscopy and ELISA was found for 48 samples, with 43 confirmed by PCR. Parasite DNA was amplified from eleven of the 20 Giardia samples (55%) identified only by ELISA. This study shows the higher sensitivity of ELISA over microscopy for Giardia diagnosis when a single sample is analyzed and emphasizes the need for methods based on coproantigen detection to identify this parasite in diarrheic fecal samples.

Asunto(s)

Criptosporidiosis/diagnóstico , Entamebiasis/diagnóstico , Ensayo de Inmunoadsorción Enzimática/métodos , Giardiasis/diagnóstico , Parasitosis Intestinales/diagnóstico , Microscopía/métodos , Niño , Guarderías Infantiles , Criptosporidiosis/parasitología , Cryptosporidium/aislamiento & purificación , Proteínas del Citoesqueleto/genética , ADN Protozoario/genética , Diarrea/parasitología , Entamoeba histolytica/aislamiento & purificación , Entamebiasis/parasitología , Heces/parasitología , Femenino , Giardia lamblia/aislamiento & purificación , Giardiasis/parasitología , Humanos , Parasitosis Intestinales/parasitología , Masculino , Desnutrición/parasitología , Proteínas Protozoarias/genética , Sensibilidad y Especificidad , Deshidrogenasas del Alcohol de Azúcar/genética

RESUMEN

Visceral leishmaniasis (VL) is a parasitic infectious disease that causes significant morbidity and mortality in the tropical and subtropical regions of the world. Although infections with visceralizing Leishmania may be asymptomatic, factors such as undernutrition increase the likelihood of progressing to clinical disease. Protein malnutrition, the most deleterious cause of malnutrition in developing countries, has been considered as a primary risk factor for the development of clinical VL. However, data regarding the immunological basis of this association are scarce. With the aim to analyze the effects of protein malnutrition on Leishmania infantum infection, we used BALB/c mice subjected to control or low protein isocaloric diets. Each animal group was divided into two subgroups and one was infected with L. infantum resulting in four study groups: animals fed 14% protein diet (CP), animals fed 4% protein diet (LP), animals fed 14% protein diet and infected (CPi), and animals fed 4% protein diet and infected (LPi).The susceptibility to L. infantum infection and immune responses were assessed in terms of body and lymphoid organ weight, parasite load, lymphocyte subpopulations, and cytokine expression. LPi mice had a significant reduction of body and lymphoid organ weight and exhibited a severe decrease of lymphoid follicles in the spleen. Moreover, LPi animals showed a significant decrease in CD4+CD8+ T cells in the thymus, whereas there was an increase of CD4+ and CD8+ T cells percentages in the spleen. Notably, the cytokine mRNA levels in the thymus and spleen of protein malnourished-infected animals were altered compared to the CP mice. Protein malnutrition results in a drastic dysregulation of T cells and cytokine expression in the thymus and spleen of L. infantum-infected BALB/c mice, which may lead to defective regulation of the thymocyte population and an impaired splenic immune response, accelerating the events of a normal course of infection.

Asunto(s)

Citocinas/metabolismo , Leishmania infantum/inmunología , Leishmaniasis Visceral/inmunología , Desnutrición/inmunología , Desnutrición/parasitología , Bazo/inmunología , Linfocitos T/inmunología , Timo/inmunología , Animales , Peso Corporal , Dieta con Restricción de Proteínas , Líquido Extracelular/metabolismo , Leishmaniasis Visceral/parasitología , Hígado/inmunología , Hígado/parasitología , Hígado/patología , Ratones Endogámicos BALB C , Tamaño de los Órganos , Carga de Parásitos , Bazo/parasitología , Bazo/patología , Timo/patología

RESUMEN

Undernourished mice infected (UI) submitted to low and long-lasting infections by Schistosoma mansoni are unable to develop the hepatic periportal fibrosis that is equivalent to Symmers’ fibrosis in humans. In this report, the effects of the host’s nutritional status on parasite (worm load, egg viability and maturation) and host (growth curves, biology, collagen synthesis and characteristics of the immunological response) were studied and these are considered as interdependent factors influencing the amount and distribution of fibrous tissue in hepatic periovular granulomas and portal spaces. The nutritional status of the host influenced the low body weight and low parasite burden detected in UI mice as well as the number, viability and maturation of released eggs. The reduced oviposition and increased number of degenerated or dead eggs were associated with low protein synthesis detected in deficient hosts, which likely induced the observed decrease in transformation growth factor (TGF)-β1 and liver collagen. Despite the reduced number of mature eggs in UI mice, the activation of TGF-β1 and hepatic stellate cells occurred regardless of the unviability of most miracidia, due to stimulation by fibrogenic proteins and eggshell glycoproteins. However, changes in the repair mechanisms influenced by the nutritional status in deficient animals may account for the decreased liver collagen detected in the present study.

Asunto(s)

Animales , Ratones , Colágeno/biosíntesis , Cirrosis Hepática/parasitología , Hígado/patología , Desnutrición/parasitología , Schistosoma mansoni/inmunología , Factor de Crecimiento Transformador beta1 , Reacción de Fase Aguda/etiología , Enfermedad Crónica , Modelos Animales de Enfermedad , Huevos/análisis , Técnica del Anticuerpo Fluorescente , Granuloma de Cuerpo Extraño/parasitología , Intestinos/parasitología , Hígado/parasitología , Desnutrición/complicaciones , Estado Nutricional , Oviposición/inmunología , Cultivo Primario de Células , Parasitemia/parasitología , Esquistosomiasis mansoni/complicaciones , Esquistosomiasis mansoni/patología

RESUMEN

Undernourished mice infected (UI) submitted to low and long-lasting infections by Schistosoma mansoni are unable to develop the hepatic periportal fibrosis that is equivalent to Symmers' fibrosis in humans. In this report, the effects of the host's nutritional status on parasite (worm load, egg viability and maturation) and host (growth curves, biology, collagen synthesis and characteristics of the immunological response) were studied and these are considered as interdependent factors influencing the amount and distribution of fibrous tissue in hepatic periovular granulomas and portal spaces. The nutritional status of the host influenced the low body weight and low parasite burden detected in UI mice as well as the number, viability and maturation of released eggs. The reduced oviposition and increased number of degenerated or dead eggs were associated with low protein synthesis detected in deficient hosts, which likely induced the observed decrease in transformation growth factor (TGF)-ß1 and liver collagen. Despite the reduced number of mature eggs in UI mice, the activation of TGF-ß1 and hepatic stellate cells occurred regardless of the unviability of most miracidia, due to stimulation by fibrogenic proteins and eggshell glycoproteins. However, changes in the repair mechanisms influenced by the nutritional status in deficient animals may account for the decreased liver collagen detected in the present study.

Asunto(s)

Colágeno/biosíntesis , Cirrosis Hepática/parasitología , Hígado/patología , Desnutrición/parasitología , Schistosoma mansoni/inmunología , Factor de Crecimiento Transformador beta1/metabolismo , Reacción de Fase Aguda/etiología , Animales , Enfermedad Crónica , Modelos Animales de Enfermedad , Huevos/análisis , Técnica del Anticuerpo Fluorescente , Granuloma de Cuerpo Extraño/parasitología , Intestinos/parasitología , Hígado/parasitología , Desnutrición/complicaciones , Ratones , Ratones Endogámicos C57BL , Estado Nutricional , Oviposición/inmunología , Parasitemia/parasitología , Cultivo Primario de Células , Esquistosomiasis mansoni/complicaciones , Esquistosomiasis mansoni/patología

RESUMEN

BACKGROUND: Children in rural areas experience the interrelated problems of poor growth, anemia and parasitic infections. We investigated the prevalence of and associations between intestinal helminth and protozoan infections, malnutrition and anemia in school-age Venezuelan children. METHODS: This cross-sectional study was conducted in 390 children aged 4-16 years from three rural areas of Venezuela: the Amazon Region, Orinoco Delta and Carabobo State. Stool samples were collected for direct parasitic examinations. Anthropometric indicators of chronic (height-for-age Z score) and acute (weight-for-height and Body Mass Index (BMI)-for-age Z score in respectively children under 5 years of age and children aged 5 years and above) malnutrition were calculated. Multivariate linear and logistic regression models were built to determine factors associated with nutritional status and polyparasitism. RESULTS: Hookworm and Strongyloides stercoralis prevalences were highest in children from the Amazon rainforest (respectively 72% and 18%) while children from the Orinoco Delta and Carabobo State showed higher rates of Ascaris lumbricoides (respectively 28% and 37%) and Trichuris trichiura (40% in both regions). The prevalence of Giardia lamblia infection was not significantly different between regions (average: 18%). Anemia prevalence was highest in the Amazon Region (24%). Hemoglobin levels were significantly decreased in children with a hookworm infection. Malnutrition was present in respectively 84%, 30% and 13% of children from the Amazon Region, Orinoco Delta and Carabobo State. In multivariate analysis including all regions, G. lamblia and helminth infections were significantly and negatively associated with respectively height-for-age and weight-for-height/BMI-for-age Z scores. Furthermore, hemoglobin levels were positively associated with the height-for-age Z score (0.11, 95% CI 0.02 - 0.20). CONCLUSIONS: In rural populations in Venezuela helminthiasis and giardiasis were associated with acute and chronic nutritional status respectively. These data highlight the need for an integrated approach to control transmission of parasites and improve the health status of rural Venezuelan children.

Asunto(s)

Etnicidad/estadística & datos numéricos , Intestinos/parasitología , Desnutrición/etnología , Desnutrición/epidemiología , Adolescente , Anemia/complicaciones , Niño , Preescolar , Estudios Transversales , Femenino , Humanos , Modelos Lineales , Masculino , Desnutrición/complicaciones , Desnutrición/parasitología , Análisis Multivariante , Venezuela/epidemiología , Venezuela/etnología

RESUMEN

Giardia intestinalis infection is prevalent throughout the world and widely distributed in developing countries. In general, children display serious consequences to their state of health, including slow height-weight development; therefore, the main aim of this study was to determine the association between Giardia infection and the nutritional status of children who participate in the program of complementary feeding (Mejoramiento Alimentario y Nutricional de Antioquia (MANA) - Instituto Colombiano de Bienestar Familiar (ICBF)). A cross-sectional study examining the association of giardiasis with nutritional status was conducted. A total of 2035 children aged eight months to six years-old were studied. Data were collected using structured questionnaires, anthropometric measurements and laboratory analysis of blood and stool samples. Analysis of the results showed that 27.6% of children were infected with G. intestinalis, while 8.1% and 1.9% were mildly and significantly underweight, respectively, and 14.1% presented stunting. Giardiasis was statistically identified as a strong predictor of stunting in this study population.

Asunto(s)

Heces/parasitología , Servicios de Alimentación , Giardiasis/epidemiología , Desnutrición/epidemiología , Programas Nacionales de Salud , Niño , Preescolar , Colombia/epidemiología , Métodos Epidemiológicos , Femenino , Giardiasis/complicaciones , Humanos , Lactante , Masculino , Desnutrición/parasitología , Factores Socioeconómicos

RESUMEN

Giardia intestinalis infection is prevalent throughout the world and widely distributed in developing countries. In general, children display serious consequences to their state of health, including slow height-weight development; therefore, the main aim of this study was to determine the association between Giardia infection and the nutritional status of children who participate in the program of complementary feeding (Mejoramiento Alimentario y Nutricional de Antioquia (MANA) - Instituto Colombiano de Bienestar Familiar (ICBF)). A cross-sectional study examining the association of giardiasis with nutritional status was conducted. A total of 2035 children aged eight months to six years-old were studied. Data were collected using structured questionnaires, anthropometric measurements and laboratory analysis of blood and stool samples. Analysis of the results showed that 27.6% of children were infected with G. intestinalis, while 8.1% and 1.9% were mildly and significantly underweight, respectively, and 14.1% presented stunting. Giardiasis was statistically identified as a strong predictor of stunting in this study population.

---

A infecção pela Giardia intestinalis está amplamente distribuída no mundo apresentando a maior prevalência nos países em desenvolvimento. Em crianças, esta parasitose pode ter conseqüências graves no estado geral de saúde assim como no ganho de peso e estatura. O objetivo desta pesquisa foi estabelecer a associação entre a infecção com Giardia e o estado nutricional das crianças beneficiárias do programa de complementação alimentar - MANA. Um estudo de corte no qual foram avaliadas 2035 crianças entre os oito meses e os seis anos de idade foi realizado. A informação foi obtida a partir de questionários estruturados, medições antropométricas e exame de fezes. Os resultados mostraram que 27,6% das crianças estavam infectadas com Giardia intestinalis, das quais 8,1% apresentaram desnutrição moderada, 1,9% desnutrição grave e 14,1% franca queda no crescimento. Em conclusão, nesta população a Giardíase foi indicador de desnutrição grave.

Asunto(s)

Niño , Preescolar , Femenino , Humanos , Lactante , Masculino , Servicios de Alimentación , Heces/parasitología , Giardiasis/epidemiología , Desnutrición/epidemiología , Programas Nacionales de Salud , Colombia/epidemiología , Métodos Epidemiológicos , Giardiasis/complicaciones , Desnutrición/parasitología , Factores Socioeconómicos

RESUMEN

OBJECTIVE: To investigate the nutritional status of individuals from a rural area of Brazil, and associations with helminth infections in an age-stratified sample. METHOD: A total of 1113 individuals aged from 6 months to 83 years from the rural community of Americaninhas in Minas Gerais were investigated. Assessments comprised anthropometric measurements of weight, height and body composition, examining faecal samples for helminth eggs, and peripheral blood assays for albumin, haemoglobin and ferritin concentrations. RESULTS: Ten percent of the participants were underweight, 12.8% were overweight and 28.3% of the children and adolescents were stunted. 11.6% had low lean body mass and 28.8% had low fat body mass. Hypoalbuminaemia was seen in 5.5%, anaemia in 12.5% and iron deficiency in 13.1%, although the prevalence of these two indices increased with age. Multivariate analysis showed that, after controlling for age, sex and socio-economic status, stunting was significantly associated with Ascaris lumbricoides infection among children and adolescents, whereas low body mass was significantly associated with hookworm infection among adults and the elderly. CONCLUSIONS: Helminth infections are associated with undernutrition in endemic populations, with important differences between the effects of hookworm and A. lumbricoides on age-related nutritional status.

Asunto(s)

Ascariasis/epidemiología , Tamaño Corporal , Infecciones por Uncinaria/epidemiología , Parasitosis Intestinales/epidemiología , Desnutrición/epidemiología , Estado Nutricional , Adolescente , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Anemia Ferropénica/epidemiología , Anemia Ferropénica/parasitología , Animales , Ascaris lumbricoides , Brasil/epidemiología , Niño , Preescolar , Femenino , Ferritinas/deficiencia , Humanos , Hipoalbuminemia/epidemiología , Hipoalbuminemia/parasitología , Lactante , Masculino , Desnutrición/parasitología , Persona de Mediana Edad , Salud Rural

RESUMEN

A patologia da esquistossomose e inicialmente devido a inflamação granulomatosa ao redor dos ovos depositados pelo S. mansoni com subsequente formação de fibrose. 0 presente estudo examinou as possíveis repercussões da desnutrição no hospedeiro e nos parasitos. Os camundongos desnutridos mostraram uma baixa resposta granulomatosa, caracterizada por granulomas pequenos e esparsos no tecido hepatico, sem formação de fibrose periportal. Os animais eutróficos apresentaram uma intensa resposta inflamatória com maior número de granulomas e maior percentual de tecido fibroso. A resposta imune humoral específica para SEA mostrou-se alterada em animais desnutridos, que apresentaram níveis de anticorpos IgG1, IgG2b e IgG3 específicos contra SEA de 2 a 4 vezes mais baixos do que os níveis de camundongos eutróficos. Não foram observadas diferenças na produção de citocinas (IFN-y, IL-4 e IL-5) e na proliferação celular por esplenócitos obtidos dos dois grupos experimentais. Estes achados indicam que os camundongos desnutridos apresentam um perfil de resposta imune semelhante aos animais alimentados com dieta normoproteica, contudo os níveis de anticorpos mostraram-se estatisticamente inferiores nos animais alimentados com dieta hipoproteica. Alterações no desenvolvimento dos parasitos oriundos de hospedeiros desnutridos foram evidenciadas no sistema reprodutor dos machos, bem como na oviposição das femeas (redução). Estes resultados, permitem inferir que a baixa fecundidade dos parasitos e a presença de possíveis distúrbios na maturação desses ovos, decorrentes da deficiencia proteica, sao fundamentais na reação granulomatosa pouco intensa sem progressão para a fibrose periportal, observada nos animais desnutridos.

Asunto(s)

Animales , Ratones , Desnutrición/parasitología , Desnutrición/patología , Esquistosomiasis mansoni/inmunología , Esquistosomiasis mansoni/patología , Modelos Animales