RESUMO
A locally sustainable system of prenatal screening of Trypanosoma cruzi infection has been implemented in rural health care centers of endemic areas in Paraguay A total of 61.091 women from Paraguari and Cordillera Departments were serologically evaluated, where 7.802 (12,7%) resulted to be anti-T. cruzi IgG positive. A total of 1,865 infants born to seropositive mothers were examined by parasitological techniques, such as direct microscopic observation and polymerase chain reaction, and serologically by ELISA, ELISA-SAPA and IFI. 104 infected babies were detected and treated with benznidazole. The recovery of babies born to seropositive mothers performing a single examination at the age of 6 months was significantly higher, as compared with the recommended method involving two examinations, both at birth and after 6 months of age. Although at 6 months of age in 7% of the infants maternal IgG was still detected. PCR was the most sensitive technique for early detection of T. cruzi infection in babies, but we do not recommend it use for diagnosis in high endemic areas, considering that for the screening of 815 babies, 2000 reactions were needed. We propose a strategy to detect congenital transmission of Chagas disease, based on a large-scale study, where the shortcomings of the different serological and parasitological techniques are discussed.
Assuntos
Humanos , Animais , Feminino , Recém-Nascido , Lactente , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Gravidez , Atenção Primária à Saúde/organização & administração , Diagnóstico Pré-Natal/normas , Doença de Chagas/congênito , Doença de Chagas/diagnóstico , Doenças Endêmicas , Triagem Neonatal/normas , Anticorpos Antiprotozoários/sangue , Doença de Chagas/epidemiologia , Ensaio de Imunoadsorção Enzimática , Imunoglobulina G/sangue , Biomarcadores/sangue , Paraguai/epidemiologia , População Rural , Estudos Soroepidemiológicos , Trypanosoma cruzi/imunologiaRESUMO
Group A rotavirus infections were detected in 93 of 410 fecal samples from children with acute diarrhea, admitted in three main hospitals of Asunción, Paraguay, from August 1998 to August 2000. Most of the rotavirus-infected patients were admitted during the winter season in the three epidemic years. The rotavirus infection rate was highest in infants from 6 to 23 months of age. In the 93 samples examined, 10 different rotavirus electropherotypes were recognized, but two of them largely predominated. Only one sample showed a short electropherotype pattern, thus indicating a minor involvement of the rotavirus subgroup I in rotaviral acute diarrhea in the area and the time during which the survey was carried out.
Assuntos
Diarreia/epidemiologia , Surtos de Doenças , Infecções por Rotavirus/epidemiologia , Rotavirus/classificação , Doença Aguda , Pré-Escolar , Diarreia/virologia , Eletroforese em Gel de Poliacrilamida/métodos , Fezes/virologia , Humanos , Lactente , Paraguai/epidemiologia , RNA Viral/análise , Rotavirus/isolamento & purificação , Infecções por Rotavirus/virologiaRESUMO
For the diagnosis of Chagas' disease, the trans-sialidase inhibition assay was able to resolve the results for samples with borderline results, to detect as positive 60% of samples that were negative by conventional serology, and to discriminate idiopathic from chagasic megaviscera or cardiopathy. No cross-reaction with sera from patients with other diseases was observed.
Assuntos
Anticorpos Antiprotozoários/sangue , Antígenos de Protozoários/imunologia , Doença de Chagas/diagnóstico , Glicoproteínas/antagonistas & inibidores , Neuraminidase/antagonistas & inibidores , Animais , Anticorpos Antiprotozoários/imunologia , Doenças Autoimunes/sangue , Doenças Autoimunes/imunologia , Brasil/epidemiologia , Doença de Chagas/sangue , Doença de Chagas/epidemiologia , Doença de Chagas/imunologia , Reações Cruzadas , Glicoproteínas/imunologia , Humanos , Leishmaniose Cutânea/sangue , Leishmaniose Cutânea/imunologia , Malária/sangue , Malária/imunologia , Neuraminidase/imunologia , Testes de Neutralização/métodos , Paraguai/epidemiologia , Sensibilidade e Especificidade , Sífilis/sangue , Sífilis/imunologia , Trypanosoma cruzi/imunologiaRESUMO
Presenta un estudio alos niños menores de 5 años de edad, de ambo sexos, que consultan al servicio de urgencias de la cátedra de pediatría del hospital de clínicas e internados en la sala de lactantes, por cuadros de diarrea aguda siendo la causa más importante los los rotavirus
Assuntos
Rotavirus , Diarreia , ParaguaiRESUMO
In 1991 and 1992, a prenatal screening of Trypanosoma cruzi infection was carried out using ELISA and indirect immunofluorescence techniques. A total of 840 blood samples from pregnant women, obtained at the Maternity Ward of the Hospital de Clínicas, National University of Asunción (Asunción, Paraguay), and 1,022 samples from the Regional Hospital of the San Pedro Department of Paraguay were examined. It was observed that 7.7% and 10.5%, respectively, of the pregnant women were serologically positive for infection with T. cruzi. When blood samples obtained from newborns on the day of birth or, at the most, on the first few days afterwards were examined by direct microscopic observation, an incidence of congenital transmission of 3% was found. These results are consistent with those of neighboring countries. When a serologic follow-up was conducted on the newborns until six months of age, the incidence of congenital transmission reached 10%. The same incidence rate was obtained when the samples collected during the first days after birth were examined by the polymerase chain reaction (PCR). Fifty-eight infants born to seropositive mothers were followed-up, two of which were positive by direct microscopic observation at birth, and four who were PCR-positive, but microscopy-negative at birth. None of the infants were positive for IgM at birth. The infected babies were treated with benznidazole and were followed-up by serology and PCR for four years. We conclude that the PCR has a clear advantage over conventional techniques for the early detection of congenital transmission of T. cruzi infection, and for monitoring infants undergoing chemotherapy.