RESUMO
OBJETIVO: investigar a epidemia de nefrite por Streptococcus zooepidemicus em Monte Santo de Minas, Minas Gerais, Brasil. MÉTODOS: realizou-se estudo de caso-controle e tentativa de isolamento do agente, no período de janeiro a abril de 2013, utilizando-se dados clínicos, laboratoriais, de entrevistas e de inspeções. RESULTADOS: houve 417 casos notificados e 175 (42,0%) confirmados, dos quais 90,9% residiam no município e 67,4% eram do sexo feminino, com idade mediana de 36 anos; 24% dos casos foram hospitalizados; três sorveterias do município utilizavam leite do laticínio A; houve associação significativa entre adoecimento e consumo do leite A (odds ratio [OR]=4,16/IC95%: 1,55;11,18), um dos sorvetes feito com esse leite (OR=3,09/IC95%: 1,39;6,86) e milk shake de leite não industrializado (OR=3,25/IC95%: 1,13;9,36); não se detectou a bactéria em propriedades rurais. CONCLUSÃO: a epidemia de nefrite por Streptococcus zooepidemicus foi associada ao consumo de leite e derivados.
OBJECTIVE: to investigate an outbreak of nephritis by Streptococcus zooepidemicus in Monte Santo de Minas, Minas Gerais State, Brazil. METHODS: a case-control study and attempt to isolate the bacterial agent were carried out from January to April 2013, using clinical and laboratory data, interviews and inspections. RESULTS: 417 suspected cases were reported, of which 175 (42.0%) were confirmed; 90.9% lived in that municipality, of which 67.4% were female, with median age of 36 years; 24% of cases were hospitalized; three ice cream shops in the municipality used type A milk; there was significant association between the illness and the consumption of type A milk (odds ratio [OR]=4.16/95%CI: 1.55;11.18), one of the ice cream made with this milk (OR=3.09/95%CI: 1.39;6.86) and milk shake of non-processed milk (OR=3.25/95%CI: 1.13;9.36); the bacterium was not detected in rural properties. CONCLUSION: the outbreak of nephritis by Streptococcus zooepidemicus was associated with the consumption of milk and dairy products.
OBJETIVO: investigar la epidemia de nefritis por Streptococcus zooepidemicus en Monte Santo de Minas, Minas Gerais, Brasil. MÉTODOS: fue realizado un estudio de casos y controles e intento de aislamiento del agente, entre enero y abril de 2013, con datos clínicos y de laboratorio, entrevistas e inspecciones. RESULTADOS: fueron notificados 417 casos sospechoso, de los cuales, 175 confirmados; 90,9% eran residentes del municipio, 67,4% de sexo femenino, con mediana de edad de 36 años; 24% casos fueron hospitalizados; tres heladerías del municipio utilizaban leche del lacticinio A; encontramos asociación significativa entre la enfermedad y el consumo de leche A (odds ratio [OR]=4,16/IC95%: 1,55;11,18), en helados hechos con leche (OR=3,09/IC95%: 1,39;6,86) y milk shake de leche no industrializada (OR=3,25/IC95%: 1,13;9,36); la bactéria no fue aislada en zonas rurales. CONCLUSIÓN: la epidemia de nefritis por Streptococcus zooepidemicus se asoció con el consumo de leche y derivados.
Assuntos
Humanos , Masculino , Feminino , Streptococcus equi , Leite , Nefrite/epidemiologia , Monitoramento EpidemiológicoRESUMO
OBJECTIVE: to investigate an outbreak of nephritis by Streptococcus zooepidemicus in Monte Santo de Minas, Minas Gerais State, Brazil. METHODS: a case-control study and attempt to isolate the bacterial agent were carried out from January to April 2013, using clinical and laboratory data, interviews and inspections. RESULTS: 417 suspected cases were reported, of which 175 (42.0%) were confirmed; 90.9% lived in that municipality, of which 67.4% were female, with median age of 36 years; 24% of cases were hospitalized; three ice cream shops in the municipality used type A milk; there was significant association between the illness and the consumption of type A milk (odds ratio [OR]=4.16/95%CI: 1.55;11.18), one of the ice cream made with this milk (OR=3.09/95%CI: 1.39;6.86) and milk shake of non-processed milk (OR=3.25/95%CI: 1.13;9.36); the bacterium was not detected in rural properties. CONCLUSION: the outbreak of nephritis by Streptococcus zooepidemicus was associated with the consumption of milk and dairy products.
Assuntos
Surtos de Doenças , Nefrite/epidemiologia , Infecções Estreptocócicas/epidemiologia , Streptococcus equi/isolamento & purificação , Adolescente , Adulto , Animais , Brasil/epidemiologia , Estudos de Casos e Controles , Criança , Pré-Escolar , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Leite/microbiologia , Nefrite/microbiologia , Infecções Estreptocócicas/microbiologia , Adulto JovemRESUMO
Objective The objective of this study was to assess outcomes of childhood systemic lupus erythematosus (cSLE) in three different age groups evaluated at last visit: group A early-onset disease (<6 years), group B school age (≥6 and <12 years) and group C adolescent (≥12 and <18 years). Methods An observational cohort study was performed in ten pediatric rheumatology centers, including 847 cSLE patients. Results Group A had 39 (4%), B 395 (47%) and C 413 (49%). Median disease duration was significantly higher in group A compared to groups B and C (8.3 (0.1-23.4) vs 6.2 (0-17) vs 3.3 (0-14.6) years, p < 0.0001). The median Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SLICC/ACR-DI) (0 (0-9) vs 0 (0-6) vs 0 (0-7), p = 0.065) was comparable in the three groups. Further analysis of organ/system damage revealed that frequencies of neuropsychiatric (21% vs 10% vs 7%, p = 0.007), skin (10% vs 1% vs 3%, p = 0.002) and peripheral vascular involvements (5% vs 3% vs 0.3%, p = 0.008) were more often observed in group A compared to groups B and C. Frequencies of severe cumulative lupus manifestations such as nephritis, thrombocytopenia, and autoimmune hemolytic anemia were similar in all groups ( p > 0.05). Mortality rate was significantly higher in group A compared to groups B and C (15% vs 10% vs 6%, p = 0.028). Out of 69 deaths, 33/69 (48%) occurred within the first two years after diagnosis. Infections accounted for 54/69 (78%) of the deaths and 38/54 (70%) had concomitant disease activity. Conclusions This large multicenter study provided evidence that early-onset cSLE group had distinct outcomes. This group was characterized by higher mortality rate and neuropsychiatric/vascular/skin organ damage in spite of comparable frequencies of severe cumulative lupus manifestations. We also identified that overall death in cSLE patients was an early event mainly attributed to infection associated with disease activity.
Assuntos
Anemia Hemolítica Autoimune/complicações , Lúpus Eritematoso Sistêmico/complicações , Nefrite/complicações , Trombocitopenia/complicações , Adolescente , Idade de Início , Anemia Hemolítica Autoimune/diagnóstico , Anemia Hemolítica Autoimune/patologia , Brasil/epidemiologia , Criança , Pré-Escolar , Estudos de Coortes , Feminino , Humanos , Imunossupressores/uso terapêutico , Lactente , Lúpus Eritematoso Sistêmico/tratamento farmacológico , Lúpus Eritematoso Sistêmico/epidemiologia , Lúpus Eritematoso Sistêmico/mortalidade , Mortalidade , Nefrite/diagnóstico , Nefrite/epidemiologia , Nefrite/mortalidade , Gravidez , Estudos Retrospectivos , Índice de Gravidade de Doença , Trombocitopenia/diagnóstico , Trombocitopenia/patologia , Resultado do TratamentoRESUMO
In dogs, diseases of the urinary tract are common and can be caused by disorders of varied etiology. The objective of this study was to classify qualitatively and quantitatively urinary tract lesions of 363 dogs, which were classified according to its anatomical distribution and etiology. The data was obtained from the revision of 36 years of protocols from the Regional Laboratory of Diagnosis (LRD/UFPel) and it represents 4.0% of diagnoses from a total of 8980 for that period and species. Renal injury accounted for 93.1% of cases, with 309 being primary kidney lesions; from which the main lesions were the tubulointerstitial nephritis (142 cases) often associated with Leptospirosis (47). Injuries of lower urinary tract accounted for 6.9% of the cases where acute cystitis stands out (19). In this study, renal failure, acute or chronic, represented an important cause of death in dogs.(AU)
Em cães, as doenças do trato urinário são frequentes e podem ser causadas por desordens de etiologia variada. O objetivo deste trabalho foi classificar qualitativa e quantitativamente lesões do trato urinário de 363 cães, as quais foram classificadas de acordo com a distribuição anatômica e etiologia. Os dados foram obtidos em uma revisão de protocolos de 36 anos do LRD/UFPel e corresponderam a 4,0% do total de 8980 diagnósticos realizados no período para a espécie. As lesões renais representaram 93,1%, sendo 309 primárias do rim; dentre as principais lesões, está a nefrite tubulo-intersticial (142 casos), geralmente associada à Leptospirose (47). O trato urinário inferior representou 6,9% dos casos, destacando-se cistite aguda (19). Neste estudo, a insuficiência renal, aguda ou crônica, representou importante causa mortis em cães.(AU)
Assuntos
Animais , Cães , Sistema Urinário/lesões , Sistema Urinário/patologia , Rim/lesões , Nefrite/epidemiologia , Nefrite/etiologia , Nefrite/patologia , Nefrite/veterinária , Métodos Epidemiológicos/veterinária , Cistite/veterinária , Leptospirose/veterináriaRESUMO
OBJECTIVE: The aim of this multicenter study in a large childhood-onset systemic lupus erythematosus (cSLE) population was to assess the herpes zoster infection (HZI) prevalence, demographic data, clinical manifestations, laboratory findings, treatment, and outcome. METHODS: A retrospective multicenter cohort study (Brazilian cSLE group) was performed in ten Pediatric Rheumatology services in São Paulo State, Brazil, and included 852 cSLE patients. HZI was defined according to the presence of acute vesicular-bullous lesions on erythematous/edematous base, in a dermatomal distribution. Post-herpetic neuralgia was defined as persistent pain after one month of resolution of lesions in the same dermatome. Patients were divided in two groups for the assessment of current lupus manifestations, laboratory findings, and treatment: patients with HZI (evaluated at the first HZI) and patients without HZI (evaluated at the last visit). RESULTS: The frequency of HZI in cSLE patients was 120/852 (14%). Hospitalization occurred in 73 (61%) and overlap bacterial infection in 16 (13%). Intravenous or oral aciclovir was administered in 113/120 (94%) cSLE patients at HZI diagnosis. None of them had ophthalmic complication or death. Post-herpetic neuralgia occurred in 6/120 (5%). After Holm-Bonferroni correction for multiple comparisons, disease duration (1.58 vs 4.41 years, p < 0.0001) was significantly lower in HZI cSLE patients compared to those without HZI. Nephritis (37% vs 18%, p < 0.0001), lymphopenia (32% vs 17%, p < 0.0001) prednisone (97% vs 77%, p < 0.0001), cyclophosphamide (20% vs 5%, p < 0.0001) and SLE Disease Activity Index 2000 (6.0 (0-35) vs 2 (0-45), p < 0.0001) were significantly higher in the former group. The logistic regression model showed that four independent variables were associated with HZI: disease duration < 1 year (OR 2.893 (CI 1.821-4.597), p < 0.0001), lymphopenia <1500/mm(3) (OR 1.931 (CI 1.183-3.153), p = 0.009), prednisone (OR 6.723 (CI 2.072-21.815), p = 0.002), and cyclophosphamide use (OR 4.060 (CI 2.174-7.583), p < 0.0001). CONCLUSION: HZI is an early viral infection in cSLE with a typical dermatomal distribution. Lymphopenia and immunosuppressive treatment seem to be major factors underlying this complication in spite of a benign course.
Assuntos
Ciclofosfamida/efeitos adversos , Herpes Zoster/epidemiologia , Imunossupressores/efeitos adversos , Lúpus Eritematoso Sistêmico/complicações , Prednisona/efeitos adversos , Aciclovir/administração & dosagem , Adolescente , Adulto , Idade de Início , Antivirais/administração & dosagem , Brasil/epidemiologia , Criança , Pré-Escolar , Feminino , Herpes Zoster/tratamento farmacológico , Hospitalização/estatística & dados numéricos , Humanos , Lactente , Modelos Logísticos , Lúpus Eritematoso Sistêmico/tratamento farmacológico , Linfopenia/epidemiologia , Masculino , Nefrite/epidemiologia , Estudos Retrospectivos , Índice de Gravidade de Doença , Adulto JovemAssuntos
Humanos , Masculino , Feminino , Adulto , Nefrologia , Nefrite/diagnóstico , Nefrite/epidemiologia , Nefrite , Saúde do Adulto , AdultoRESUMO
INTRODUÇÃO: As doenças glomerulares são uma causa frequente de doença renal crônica, sobretudo nos países em desenvolvimento. OBJETIVO: O objetivo deste estudo foi determinar o perfil destas glomerulopatias em um hospital público da cidade de Brasília, Distrito Federal. MÉTODOS: Foram realizadas 121 biopsias renais pela equipe de nefrologia do Hospital Regional da Asa Norte (HRAN) entre agosto de 2005 e maio de 2009. Foram excluídas oito biopsias realizadas em pacientes transplantados renais e analisados os prontuários dos 113 pacientes restantes. Dados analisados: sexo, idade, exames laboratoriais, síndrome glomerular, diagnóstico clínico, grau de fibrose intersticial, uso de imunossupressores, necessidade de diálise e desfecho clínico. RESULTADOS: A média de idade foi 34,9 ± 16,2 anos, com predomínio masculino (51,3 por cento). As principais síndromes glomerulares foram: síndrome nefrótica (41,6 por cento) e glomerulonefrite rapidamente progressiva (35,4 por cento). Entre as glomerulopatias primárias, houve predomínio da glomeruloesclerose segmentar e focal (26,9 por cento) e da nefropatia por IgA (25 por cento) e entre as secundárias a nefrite lúpica (50 por cento) e a glomerulonefrite proliferativa exsudativa difusa (34,2 por cento). A maioria dos pacientes fez uso de imunossupressores (68,1 por cento) e quase um terço deles (29,2 por cento) necessitou de diálise durante a internação. Evoluíram para terapia dialítica crônica 13,3 por cento dos pacientes e 10,6 por cento evoluíram a óbito. CONCLUSÃO: Este estudo poderá contribuir para melhor entendimento epidemiológico das doenças glomerulares no Distrito Federal, orientando na adoção de políticas públicas visando permitir rápido diagnóstico e manejo clínico das mesmas.
INTRODUCTION: Glomerular diseases are a frequent etiology of chronic kidney disease, especially in the developing countries. OBJECTIVE: To determine the profile of such glomerulopathies in a public hospital located in the city of Brasilia, Federal District. METHODS: 121 renal biopsies in different patients were performed by the Renal Division of Hospital Regional da Asa Norte (HRAN) between August 2005 and May 2009. Eight renal biopsies in renal-transplant patients were excluded and the medical records of 113 remaining patients were analyzed. Analyzed data: sex, age, laboratory exams, glomerular syndrome, clinical diagnosis, degree of interstitial fibrosis, immunosuppressants use, need for dialysis and clinical outcome. RESULTS: The age average was 34.9 ± 16.2 years-old, a predominance of male patients (51.3 percent). Major glomerular syndromes were: nephrotic syndrome (41.6 percent) and the rapidly- progressive glomerulonephritis (35.4 percent). Among primary glomerulopathies focal glomerulosclerosis (26.8 percent) followed by IgA nephropathy (25 percent) were predominant; and among the most prevalent secondary glomerulopathies we had lupus nephritis (50 percent) and diffuse exudative proliferative glomerulonephritis (34.2 percent).The majority of the patients used immunosuppressants (68.1 percent) and almost one third of them (29.2 percent) needed dialysis during their hospitalization. Progressed to chronic dialysis therapy 13.3 percent of the patients and 10.6 percent died. CONCLUSION: This study may contribute to better epidemiological understanding of glomerular diseases in the Federal District, guiding the adoption of public policies aiming the quick clinical treatment of such diseases.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Glomerulonefrite por IGA/epidemiologia , Glomerulonefrite/epidemiologia , Glomerulosclerose Segmentar e Focal/epidemiologia , Nefrite Lúpica/epidemiologia , Nefrite/epidemiologia , Nefropatias/epidemiologia , Falência Renal Crônica/epidemiologiaRESUMO
BACKGROUND: Outbreaks of nephritis have been rare since the 1970s. From December, 1997, to July, 1998, 253 cases of acute nephritis were identified in Nova Serrana, Brazil. Seven patients required dialysis, and three patients died. We did a case-control study to investigate the cause of the outbreak. METHODS: Using a matched cluster design, we examined seven recent patients, their family members (n=23), and members of neighbourhood-matched control households (n=22). We subsequently interviewed 50 patients and 50 matched controls about exposure to various dairy products. We also cultured dairy foods and took udder-swab and milk samples from cows. FINDINGS: Throat cultures indicated that nephritis was associated with group C Streptococcus equi subspecies zooepidemicus, a cause of bovine mastitis. S. zooepidemicus was detected in four of seven case households (six of 30 people) and no control households (p=0.09). Patients were more likely than matched controls to have consumed a locally produced cheese called queijo fresco (matched odds ratio 2.1, p=0.05). The nephritis attack rate was 4.5 per 1000 in Nova Serrana but 18 per 1000 in the village Quilombo do Gaia (p=0.003). The largest supplier of unpasteurized queijo fresco was a farm in Quilombo do Gaia. S. zooepidemicus was not detected in food samples or in swabs collected from cows in August, 1998, although mastitis was evident among cows on the suspected farm. Throat cultures of the two women who prepared cheese on this farm yielded the outbreak strain of S. zooepidemicus. After the cheese was removed from the distribution system, no further cases were reported. INTERPRETATION: A large outbreak of glomerulonephritis was attributed to S. zooepidemicus in unpasteurised cheese. This outbreak highlights the dangers of consuming unpasteurized dairy products and need for global efforts to promote food safety.
Assuntos
Surtos de Doenças , Nefrite/epidemiologia , Infecções Estreptocócicas/epidemiologia , Streptococcus equi/isolamento & purificação , Adolescente , Adulto , Animais , Brasil/epidemiologia , Estudos de Casos e Controles , Bovinos , Feminino , Microbiologia de Alimentos , Humanos , Masculino , Nefrite/microbiologia , Infecções Estreptocócicas/microbiologiaRESUMO
Over one hundred patients diagnosed with vascular purpura at the National Institute of Pediatrics between 1979 and 1988 were retrospectively studied. Frequency was similar for both sexes. 82% were between the ages of six months and 11 years old. The extrarenal clinical manifestations were: petechias in 98%; abdominal pain 78% arthralgias 45%; melena 39%; and arthritis in 19% of the cases, 49 patients had nephropathy of different degrees and they did differently, 32 had hematuria with or without proteinuria within a nephrotic range, seven suffered from a nephrotic syndrome, one with a nephritic syndrome and nine others had a combination of two or three syndromes (nephritic/nephrotic/renal failure) with an unfavorable evolution towards terminal renal failure in eight of them; on the other hand, this was not seen in the remaining patients. Thirteen renal biopsies were taken from patients with more severe clinical manifestations, finding in them mesangial proliferation or endo- and extracapillary proliferation. These findings suggest that the initial clinical presentation of the illness allows for the prediction of the future.
Assuntos
Vasculite por IgA/complicações , Nefropatias/diagnóstico , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Vasculite por IgA/epidemiologia , Lactente , Nefropatias/epidemiologia , Nefropatias/etiologia , Masculino , México/epidemiologia , Nefrite/diagnóstico , Nefrite/epidemiologia , Nefrite/etiologia , Síndrome Nefrótica/diagnóstico , Síndrome Nefrótica/epidemiologia , Síndrome Nefrótica/etiologia , Prognóstico , Estudos RetrospectivosRESUMO
Se realiza un estudio bacteriano y sérico a toda la población de una comunidad rural. Se informa que se habían presentado 12 niños con cuadros clínicos compatibles con la nefritis aguda, durante un período de 4 meses. Se señala que es el primer estudio realizado en nuestro país, donde se analiza un brote de nefritis de manera multidisciplinaria. Se indica que se aislaron estreptococos hemolíticos grupo A, del 143 de los individuos estudiados. Los serotipos predominates fueron los M 49 y los M 12; también se aislaron estreptococos grupo A, del 25 de los niños que padecieron nefritis; del 13,1 de los convivientes, y del 13 de la población general. Se expresa que los títulos medios geométricos de antiestreptolisina O, resultaron elevados y similares en todos los grupos estudiados (portadores de estreptococos o no y nefríticos, convivientes y población general)
Assuntos
Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Humanos , Masculino , Feminino , Nefrite/epidemiologia , Streptococcus pyogenes/isolamento & purificação , Infecções Estreptocócicas/complicações , Nefrite/complicaçõesRESUMO
We studied a group of 114 persons living together with children admitted in the hospital because of poststreptococcal glomerulonephritis; minute count of the urinary sediment, antistreptolysin 0 and throat culture were done. An increased was found in the urinary excretion of erythrocytes in 31% of the population studied; 71% showed a rise of serum antistreptolysin 0 and 9% showed beta hemolytic streptococci in their throat culture. It is important to search for these asymptomatic patients among relatives and follow their course; there is a possibility that some will developed chronic nephritis. It is also important to erradicate the streptococcal infection.
Assuntos
Glomerulonefrite/microbiologia , Nefrite Hereditária , Infecções Estreptocócicas/complicações , Doença Aguda , Adolescente , Adulto , Criança , Pré-Escolar , Meio Ambiente , Feminino , Glomerulonefrite/epidemiologia , Glomerulonefrite/genética , Humanos , Masculino , México , Nefrite/epidemiologia , Nefrite/transmissão , Infecções Estreptocócicas/epidemiologia , Infecções Estreptocócicas/genéticaAssuntos
Púrpura , Doença Aguda , Aspirina/uso terapêutico , Criança , Pré-Escolar , Avaliação de Medicamentos , Humanos , Hidroxizina/uso terapêutico , Lactente , Nefrite/epidemiologia , Nefrite/etiologia , Prednisona/uso terapêutico , Prognóstico , Púrpura/complicações , Púrpura/tratamento farmacológico , Púrpura/epidemiologiaRESUMO
We have been looking for differentiating aspects of the streptococcal infections associated with acute rheumatic fever (ARF) and acute alonerulonephritis (AGN) in Trinidad since November 1969. At this meeting last year, we reported our first 10 months' observation which were made during a period when AGN was endemic. Since then an outbreak of scabies accompanied by a major epidemic of AGN has occurred which afforded an excellent opportunity to study and compare the related streptococcal infections. Observations to be reported presently include the following: (1) While the number of cases of AGN increased nearly 10-fold to over 150 in both August and September, ARF increased only to less than 20 cases a month during the height of the epidemic of AGN. (2) The scabies epidemic was associated with AGN while skin lesions continued to be relatively rare in patients with ARF. (3) The streptococcal strains isolated from patients with AGN and ARF were not the same, the epidemic M-type 55 being associated with AGN but not ARF while M-type 11 strains were found in many patients with ARF and in none with AGN, (4) Antibody titres were similar in the two groups of patients as reflected by ASO and AH titres; the former continued to be low, while the latter continued to be increased. Thus, we conclude that although the antibody responses of patients with ARF and AGN are similar in Trinidad, skin infections are associated with AGN but not with ARF and the nephritogenic and rheumatogenic streptococcal strains are different (AU)
Assuntos
Humanos , Febre Reumática , Escabiose/epidemiologia , Nefrite/epidemiologia , Infecções Estreptocócicas/epidemiologia , Trinidad e Tobago/epidemiologiaRESUMO
Two hundred and ninety-seven patients were admitted to the San Fernando General Hospital with acute glomerulonephritis from September 1964 to February 1965. Only a small number of the patients gave a history of sore throat and many patients had septic skin lesions one to four weeks before the onset of oedema, the presenting symptom in all the cases. Children between the ages of 3 and 9 years were most commonly affected. There were 46 children under the age of 3 years. 57 percent of the patients were male. The concentration of cases occurred in the rural areas within a radius of 10 miles from San Fernando, and 76 percent of the patients were Indians. Group A beta Haemolytic streptococci were isolated from the skin and throat of a representative sample of nephritic patients. A pilot streptococcal survey was also conducted among normal school-children in both "nephritic" and "non-nephritic" districts. 66 percent of 50 normal children selected at random from the three schools in Dede (nephritic district) had Group A beta haemolytic streptococci either in the throat or skin. 44 percent of 50 normal school-children from the two school in Tortuga (non-nephritic) had Group A beta haemolytic streptococci. The epidemic is on the wane. The present epidemic was compared with the 1958-1959 epidemic of acute nephritis in South Trinidad (AU)
Assuntos
Humanos , Criança , Masculino , Nefrite/epidemiologia , Trinidad e Tobago/epidemiologia , Infecções EstreptocócicasRESUMO
Over a period of 6 months a remarkable increase was seen in the incidence of acute nephritis among children in South Trinidad, and 263 cases were admitted to a general hospital. The patients were found to differ in their age, sex, and geographic distribution. The disease was associated with respiratory infection rather than skin infection, the form usually seen here, and the appearance of desquamation in many of the children suggested that the underlying organism was one capable of producing scarlet fever. The disease was mild. Only five children (1.9 percent) died, all from cardiac failure. Recovery appears so far to be complete in all but one of the survivors. (Summary)