RESUMO
Overcrowding is a significant factor contributing to endemic infection with Sarcoptes scabiei in human and animal populations. However, since scabies mites from different host species are indistinguishable morphologically, it is unclear whether people can be infected from scabies-infested animals. Molecular fingerprinting was done using three S. scabiei-specific single locus hypervariable microsatellite markers, with a combined total of 70 known alleles. Multilocus analysis of 712 scabies mites from human and dog hosts in Ohio, Panama and Aboriginal communities in northern Australia now shows that genotypes of dog-derived and human-derived scabies cluster by host species rather than by geographic location. Because of the apparent genetic separation between human scabies and dog scabies, control programs for human scabies in endemic areas do not require resources directed against zoonotic infection from dogs.
Assuntos
Doenças do Cão/parasitologia , Sarcoptes scabiei/genética , Escabiose/parasitologia , Alelos , Animais , Análise por Conglomerados , DNA/química , Impressões Digitais de DNA/veterinária , Repetições de Dinucleotídeos/genética , Reservatórios de Doenças , Doenças do Cão/epidemiologia , Cães , Eletroforese/veterinária , Variação Genética , Genótipo , Humanos , Marsupiais , Havaiano Nativo ou Outro Ilhéu do Pacífico , Northern Territory/epidemiologia , Ohio/epidemiologia , Panamá/epidemiologia , Reação em Cadeia da Polimerase/veterinária , Coelhos , Escabiose/epidemiologia , Pele/parasitologia , Vitória/epidemiologia , ZoonosesRESUMO
BACKGROUND/AIMS: Among possible contributors to a progressive fall in renal perfusion and function with increasing age, some hypotheses have invoked the rise in blood pressure that occurs with age, and a high-protein diet typical of urban cultures. Kuna Amerinds residing in isolated islands off the Panamanian Coast have a very low protein intake and show no tendency for blood pressure to rise with age, thus providing an opportunity to test these hypotheses. METHODS: We measured renal plasma flow and glomerular filtration rate (PAH and inulin clearance) in 16 Kuna Indians ranging in age from 18 to 86 years (51 +/- 6 years) who have resided on Ailigandi, an isolated Panamanian island for all of their lives. Inulin and PAH were infused with a battery-driven pump for 60 min, and a metabolic clearance rate used to calculate inulin and PAH clearance. For comparison, we employed identical techniques in 29 residents of Boston, ranging in age from 19 to 79 years (52 +/- 4 years), all normotensive and free of disease or medication use. Twenty-four were Caucasian. RESULTS: The Bostonian controls showed the anticipated fall in PAH clearance with age (y = 806 - 4.9 x; r = -0.82; f = 38.0; p < 0.0001). Our hypothesis was that the absence of a blood pressure rise with age and the low protein intake would flatten the slope relating renal perfusion to Kuna age. Our finding was a numerically steeper slope relating age and renal plasma flow in the Kuna (y = 936 - 6.48x; r = -0.81; p < 0.001). Filtration fraction rose with age in both populations, and again the rise was steeper in the Kuna. GFR in the Kuna, on the other hand, was very much higher at any age (139 +/- 4 ml/min/1.73 m2) than in Bostonians (112 +/- 3 ml/min/1.73 m2; p < 0.001). CONCLUSION: The findings are not in accord with the hypothesis that age-related changes in renal perfusion and glomerular filtration rate reflect an important contribution from blood pressure rise and a high protein intake, typical of modern, urban life.
Assuntos
Envelhecimento/fisiologia , Indígenas Centro-Americanos , Rim/fisiologia , Circulação Renal/fisiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Pressão Sanguínea/fisiologia , Creatinina/urina , Dieta , Feminino , Taxa de Filtração Glomerular/fisiologia , Humanos , Testes de Função Renal , Masculino , Pessoa de Meia-Idade , Panamá , População Rural , Caracteres Sexuais , População UrbanaRESUMO
The indigenous Kuna who live on islands in the Panamanian Caribbean were among the first communities described with little age-related rise in blood pressure or hypertension. Our goals in this study were to ascertain whether isolated island-dwelling Kuna continue to show this pattern, whether migration to Panama City and its environs changed the patterns, and whether the island-dwelling Kuna have maintained their normal blood pressure levels despite partial acculturation, reflected in an increased salt intake. We enrolled 316 Kuna participants who ranged in age from 18 to 82 years. In 50, homogeneity was confirmed by documentation of an O+ blood group. In 92 island dwellers, diastolic hypertension was not identified and blood pressure levels were as low in volunteers over 60 years of age as in those between 20 and 30 years of age. In Panama City, conversely, hypertension prevalence was 10.7% and exceeded 45% in those over 60 years of age (P < .01), blood pressure levels were higher in the elderly, and there was a statistically significant positive relationship between age and blood pressure (P < .01). In Kuna Nega, a Panama City suburb designed to maintain a traditional Kuna lifestyle but with access to the city, all findings were intermediate. Sodium intake and excretion assessed in 50 island-dwelling Kuna averaged 135 +/- 15 mEq/g creatinine per 24 hours, exceeding substantially other communities free of hypertension and an age-related rise in blood pressure. Despite partial acculturation, the island-dwelling Kuna Indians are protected from hypertension and thus provide an attractive population for examining alternative mechanisms.
Assuntos
Aculturação , Envelhecimento/fisiologia , Hipertensão/epidemiologia , Indígenas Centro-Americanos , Cloreto de Sódio na Dieta/administração & dosagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Pressão Sanguínea/fisiologia , Humanos , Hipertensão/etiologia , Magnésio/administração & dosagem , Pessoa de Meia-Idade , Panamá/epidemiologia , Panamá/etnologia , Potássio/administração & dosagem , Potássio/urina , Sódio/urina , Cloreto de Sódio na Dieta/metabolismoRESUMO
For 18 years treatment with lindane or crotamiton products has failed to stem the epidemic of scabies among the Kuna Indians in the San Blas islands of the Republic of Panama. Permethrin 5% cream was introduced as the only treatment in a programme to control scabies on an island of 756 inhabitants and involving workers recruited locally. Prevalence fell from 33% to less than 1% after every person was treated. As long as continued surveillance and treatment of newly introduced cases was maintained, prevalence of scabies remained below 1.5% for over 3 years. When supply of medication was interrupted for 3 weeks, prevalence rose to 3.6%. When control was lost after the US invasion of Panama, prevalence rose to 12% within 3 months. Bacterial skin infections decreased dramatically when scabies was controlled. Permethrin is safe and effective even in areas where this disease has become resistant to lindane.
Assuntos
Serviços de Saúde Comunitária/organização & administração , Piretrinas/uso terapêutico , Escabiose/prevenção & controle , Administração Tópica , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Feminino , Seguimentos , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Pomadas , Panamá/epidemiologia , Permetrina , Projetos Piloto , Prevalência , Avaliação de Programas e Projetos de Saúde , Piretrinas/administração & dosagem , Recidiva , Escabiose/epidemiologiaRESUMO
Permethrin 5% cream (Elimite) was approved as a treatment for scabies by the U.S. Food and Drug Administration in September 1989. In a double-blinded, randomized study, it was compared with crotamiton 10% cream (Eurax) for the treatment of scabies in children 2 months to 5 years of age. Two weeks after a single overnight treatment, 14 (30%) of 47 children were cured with permethrin 5% cream, in contrast to only 6 of 47 (13%) of subjects treated with Eurax. Four weeks after treatment the figures were 89% and 60% cured for the two agents, respectively. In 10 of the 19 patients whose treatment failed, the condition became worse after therapy. The difference in efficacy in favor of permethrin was significant (P = 0.002). That agent also demonstrated greater effectiveness in reducing pruritus and secondary bacterial infections. Elimite offers a safe, efficacious, and cosmetically elegant alternative to Eurax in the treatment of scabies in children.
Assuntos
Piretrinas/uso terapêutico , Escabiose/tratamento farmacológico , Toluidinas/uso terapêutico , Administração Tópica , Pré-Escolar , Método Duplo-Cego , Feminino , Humanos , Lactente , Masculino , Pomadas , Panamá , Permetrina , Piretrinas/administração & dosagem , Ensaios Clínicos Controlados Aleatórios como Assunto , Toluidinas/administração & dosagemAssuntos
Dermatopatias Infecciosas , Administração Tópica , Animais , Antibacterianos/administração & dosagem , Antibacterianos/uso terapêutico , Clima , Cricetinae , Modelos Animais de Doenças , Métodos Epidemiológicos , Humanos , Higiene , Militares , Pele/microbiologia , Dermatopatias Infecciosas/complicações , Dermatopatias Infecciosas/tratamento farmacológico , Dermatopatias Infecciosas/epidemiologia , Dermatopatias Infecciosas/microbiologia , Dermatopatias Infecciosas/prevenção & controle , América do Sul , Infecções Estafilocócicas/epidemiologia , Staphylococcus/isolamento & purificação , Infecções Estreptocócicas/epidemiologia , Streptococcus pyogenes/isolamento & purificação , Estados Unidos , VietnãRESUMO
A skin infection survey of 1,084 people was carried out in two jungle villages in eastern Panama. Bacterial pyoderma was the most prevalent infection, affecting 25% of boys, 15% of girls, and 11% of those over 10 years of age. Streptococcus pyogenes and Staphylococcus aureus were recovered from 84% of pyodermas cultured. Nearly 60% of the cutaneous staphylococcal isolates were resistant to penicillin. Hippelates flies were seen feeding on purulent skin lesions and may have been important in transmission. Scabies, ringworm, candidiasis, and cutaneous leishmaniasis were in comparison with pyoderma involving less than 1% of the population each. All of the ringworm infections were caused by Trichophyton rubrum.
Assuntos
Dermatopatias Infecciosas/epidemiologia , Adolescente , Adulto , Negro ou Afro-Americano , Fatores Etários , Infecções Bacterianas/epidemiologia , Candidíase/epidemiologia , Criança , Pré-Escolar , Clima , Feminino , Humanos , Indígenas Sul-Americanos , Lactente , Leishmaniose Mucocutânea/epidemiologia , Masculino , Panamá , População , Pioderma/epidemiologia , Escabiose/epidemiologia , Fatores Sexuais , Dermatopatias Infecciosas/microbiologia , Infecções Estafilocócicas/epidemiologia , Infecções Estreptocócicas/epidemiologia , Tinha/epidemiologiaAssuntos
Clima , Higiene , Pioderma/epidemiologia , Infecções Estreptocócicas/epidemiologia , Doença Aguda , Adolescente , Adulto , Altitude , Criança , Pré-Escolar , Colômbia , Feminino , Glomerulonefrite/epidemiologia , Humanos , Umidade , Lactente , Masculino , Pioderma/etiologia , Febre Reumática/epidemiologia , Cardiopatia Reumática/epidemiologia , Fatores Socioeconômicos , Staphylococcus/isolamento & purificação , Streptococcus/isolamento & purificaçãoRESUMO
Streptococcal surveys in foreign countries or remote areas may be greatly enhanced by the use of calcium alginate swabs desiccated in sterile silica gel. Delays of up to 4 weeks before return to a base laboratory are feasible, and the need for fresh media or laboratory facilities in the field may be eliminated. Comparison of direct plating on crystal violet blood agar versus delayed silica gel preservation during surveys in Uganda, Haiti, Colombia, and Miami, Fla., showed no significant loss of positive cultures from skin lesions and suggests that desiccated swabs increase the recovery of bacitracin-sensitive Streptococcus pyogenes (presumptive group A) from throats.