RESUMO
In Peru, new cases of asymptomatic HCV infection are reported with certain frequency in patients with or without antecedents of blood transfusion. Although serologic screening has improved notoriously in the last years, there is still a population of polytransfused patients with high HCV risk (e.g. hemodialyzed patients), making up a major reservoir. Based on this premise, we decided to study the risk of the health worker population in Peru as another major HCV risk group. A total of 2,769 health workers from 7 Public Hospitals and 2 Private Hospitals in the City of Lima and from 7 Public Hospitals in 4 major/main cities of Peru (Chiclayo, Trujillo, Arequipa, and Cusco) were studied. All those workers, who due to their area of work had higher contact with blood and/or blood derivatives (Surgery, ICU, Traumatology, Gynecology, Gastroenterology, Hemodialysis and Laboratories-Blood Banks) were studied. The studied population accounts for 30% of the total health worker population in these services. All serums underwent the EIA-3 test (HCV-Cobas-Core, Lab. Roche, USA). The positive results were confirmed by RT-HCV (Ampiclor, Roche). The positive serums were confirmed by PCR and the positive results with high viral load underwent HCV genotyping (AMPICLOR-Roche Diagnostic, IGEN Diagnostic USA). Of the 2,769 health workers studied in Peru, 32 were positive for HCV antibodies (1.16% of the total number). Lima showed a prevalence slightly higher than the provinces: 26 out of 2,112 vs. 6 out of 657, or 1.23% vs. 0.91%, respectively. The higher risk is assumed by professional with higher level of contact with blood: 2 physicians (Hemodialysis), 5 nurses (HD) and Lab-Blood Bank technicians. The physicians and nurses share the same risk. If we segregate Lima from provinces, it can be seen that the highest risk is in Lima (1.34% compared to 1.07% in provinces). There is a major risk in health workers and the figures are slightly above those that were suspected for Peru (between 0.4 and 1.0). Finally, we can conclude that the group with the highest HCV risk among health workers is the group specialized in hemodialysis, followed by laboratory (1.79%), surgery (1.40%), and gastroenterology (0.8%). This is the first report at national level of HCV sero-prevalence in Peru.
Assuntos
Hepatite C/epidemiologia , Recursos Humanos em Hospital , Adolescente , Adulto , Idoso , Portador Sadio , Feminino , Gastroenterologia , Genótipo , Unidades Hospitalares de Hemodiálise , Hepacivirus/genética , Anticorpos Anti-Hepatite C/análise , Humanos , Técnicas Imunoenzimáticas , Laboratórios , Masculino , Pessoa de Meia-Idade , Peru/epidemiologia , Reação em Cadeia da Polimerase , Fatores de Risco , Estudos Soroepidemiológicos , Centro Cirúrgico HospitalarRESUMO
Se reporta el hallazgo de fasciola hepatica en el colédoco de una mujer de 61 años, procedente de Contumazá (Cajamarca), que ingresó con dolor abdominal en el cuadrante superior derecho de dos semanas de evolución, acompañado de escalofríos, fiebre, ictericia, coluria y prurito generalizado. En el examen físico se constató leve ictericia y dolor en el hipocondrio derecho. Presentó eosinofilia leve, hematocrito 43 por ciento, bilirrubinas totales 1.25 mg/dl, bilirrubina directa 0.99 mg/dl, bilirrubina indirecta 0.26 mg/dl. fosfatasa alcaloma elevada. El examen ecográfico informó de un cálculo en el tercio distal del colédoco. fue sometida a colecistectomía con el diagnóstico preoperatorio de coledocolitiasis; sin embargo, se halló la vesícula normal; no se encontraron cálculos; se hallaron dos especímenes de fasciola hepatica en el colédoco. La paciente recibió praziquantel. La fasciolasis hepática es una zoonosis cuya prevalencia es de alrededor de 2 por ciento en países como Perú, Bolivia y Chile.