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Farahmand M, Moghoofei M, Dorost A, Shoja Z, Ghorbani S, Kiani SJ, Khales P, Esteghamati A, Sayyahfar S, Jafarzadeh M, Minaeian S, Khanaliha K, Naghdalipour M, Tavakoli A. Global prevalence and genotype distribution of norovirus infection in children with gastroenteritis: A meta-analysis on 6 years of research from 2015 to 2020. Rev Med Virol 2021; 32:e2237. [PMID: 33793023 DOI: 10.1002/rmv.2237] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 03/10/2021] [Accepted: 03/15/2021] [Indexed: 12/12/2022]
Abstract
In the post rotavirus vaccine era, norovirus (NoV) plays an increasingly important role in epidemic and sporadic gastroenteritis among children. This study was designed to provide an updated meta-analytic review of the prevalence of NoV among paediatric patients with gastroenteritis and to clarify the relationship between NoV infection and gastroenteritis. Systematic searches of the literature for potentially relevant studies were carried out from 1 January 2015 to 29 May 2020. The inverse variance method was chosen for weighting of the studies, and the random-effects model was used to analyse data. To determine the association between NoV infection and gastroenteritis in children, pooled odds ratio (OR) and its 95% confidence interval (CI) were computed for case-control studies. The pooled prevalence of NoV infection among 12,0531 children with gastroenteritis from 45 countries across the world was 17.7% (95% CI: 16.3%-19.2%). There were 28 studies with a case-control design, and the pooled prevalence of NoV infection among 11,954 control subjects was 6.7% (95% CI: 5.1%-8.8%). The pooled OR of the association of NoV infection and gastroenteritis was 2.7 (95% CI: 2.2-3.4). The most common NoV genotypes were GII.4 (59.3%) and GII.3 (14.9%). The highest frequency of NoV was found in the age group below 1 year. Our findings indicated a substantial burden of gastroenteritis caused by NoV globally, with GII.4 and GII.3 the major genotypes responsible for the majority of NoV-associated gastroenteritis cases among children. Younger age and male sex can be considered risk factors for NoV-associated gastroenteritis among children.
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Affiliation(s)
- Mohammad Farahmand
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohsen Moghoofei
- Department of Microbiology, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Abolfazl Dorost
- Department of Health Economics and Management, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Saied Ghorbani
- Department of Medical Virology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Jalal Kiani
- Department of Medical Virology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Pegah Khales
- Department of Medical Virology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran.,Student Research Committee, Iran University of Medical Sciences, Tehran, Iran
| | - Abdoulreza Esteghamati
- Research Center of Pediatric Infectious Diseases, Institute of Immunology and Infectious Diseases, Iran University of Medical Sciences, Tehran, Iran
| | - Shirin Sayyahfar
- Research Center of Pediatric Infectious Diseases, Institute of Immunology and Infectious Diseases, Iran University of Medical Sciences, Tehran, Iran
| | - Mehrzad Jafarzadeh
- Institute of Endocrinology and Metabolism Research and Training Center, Iran University of Medical Sciences, Tehran, Iran
| | - Sara Minaeian
- Antimicrobial Resistance Research Center, Institute of Immunology and Infectious Diseases, Iran University of Medical Sciences, Tehran, Iran
| | - Khadijeh Khanaliha
- Research Center of Pediatric Infectious Diseases, Institute of Immunology and Infectious Diseases, Iran University of Medical Sciences, Tehran, Iran
| | - Mehri Naghdalipour
- Research Center of Pediatric Infectious Diseases, Institute of Immunology and Infectious Diseases, Iran University of Medical Sciences, Tehran, Iran
| | - Ahmad Tavakoli
- Department of Medical Virology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran.,Research Center of Pediatric Infectious Diseases, Institute of Immunology and Infectious Diseases, Iran University of Medical Sciences, Tehran, Iran
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Dos Santos Zanetti A, Malheiros AF, de Matos TA, Dos Santos C, Battaglini PF, Moreira LM, Lemos LMS, Castrillon SKI, da Costa Boamorte Cortela D, Ignotti E, Espinosa OA. Diversity, geographical distribution, and prevalence of Entamoeba spp. in Brazil: a systematic review and meta-analysis. ACTA ACUST UNITED AC 2021; 28:17. [PMID: 33812449 PMCID: PMC8019558 DOI: 10.1051/parasite/2021028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 03/11/2021] [Indexed: 11/29/2022]
Abstract
The genus Entamoeba includes a variety of widely distributed species adapted to live in the digestive tracts of humans and a large variety of animals of different classes. The objective of this study was to investigate the prevalence, distribution, and molecular epidemiology of Entamoeba spp. in different classes of hosts in Brazil. Studies that analyzed hosts from several classes, including humans and domestic, wild, or captive animals, were considered. The pooled prevalence of Entamoeba spp. was calculated using the random-effects model. A total of 166 studies on humans and 16 on animals were included. The prevalence of Entamoeba spp. in the Brazilian population was 22% (95% CI: 21–24). The state with the highest prevalence was Paraiba with 72%, followed by Federal District with 53%, and Rondonia with 50%. In immunocompromized patients, the prevalence was 18%, and cancer (36%) was the most prevalent cause of immunosuppression. The prevalence of Entamoeba spp. in animal hosts was 12% (95% CI: 7–17). Captive wild animals and domestic farm animals showed the highest prevalence, with 16% and 15%, respectively. The species found more often were E. coli (86.5%), E. dispar (7.9%), and E. histolytica (3.1%). In conclusion, a high prevalence (22%) of Entamoeba spp. was found in the Brazilian population, with a prevalence of up to 50% mainly in the northern, northeastern, and central-western regions. The pathogenic species E. histolytica is distributed in most Brazilian regions, with significant prevalence percentages. Among animals, unidentified Entamoeba species were most prevalent in mammals.
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Affiliation(s)
- Andernice Dos Santos Zanetti
- Post-Graduation Program in Environmental Science, Faculty of Agricultural and Biological Sciences, State University of Mato Grosso (UNEMAT), Tancredo Neves Ave., 1095 - Cavalhada II, Caceres, 78217-042 Mato Grosso, Brazil
| | - Antonio Francisco Malheiros
- Post-Graduation Program in Environmental Science, Faculty of Agricultural and Biological Sciences, State University of Mato Grosso (UNEMAT), Tancredo Neves Ave., 1095 - Cavalhada II, Caceres, 78217-042 Mato Grosso, Brazil
| | - Tatiane Amorim de Matos
- Post-Graduation Program in Environmental Science, Faculty of Agricultural and Biological Sciences, State University of Mato Grosso (UNEMAT), Tancredo Neves Ave., 1095 - Cavalhada II, Caceres, 78217-042 Mato Grosso, Brazil
| | - Carolina Dos Santos
- Post-Graduation Program in Environmental Science, Faculty of Agricultural and Biological Sciences, State University of Mato Grosso (UNEMAT), Tancredo Neves Ave., 1095 - Cavalhada II, Caceres, 78217-042 Mato Grosso, Brazil
| | - Paula Franciene Battaglini
- Residency in Infectious Diseases, Júlio Miller University Hospital, Federal University of Mato Grosso, Luis Philippe Pereira Leite St., Alvorada, Cuiabá, 78048-902 Mato Grosso, Brazil
| | - Luciana Melhorança Moreira
- Faculty of Agricultural and Biological Sciences, State University of Mato Grosso (UNEMAT), Tancredo Neves Ave., 1095 - Cavalhada II, 78217-042 Caceres, Mato Grosso, Brazil
| | - Larissa Maria Scalon Lemos
- Department of Nursing, Faculty of Health Sciences, State University of Mato Grosso (UNEMAT), Tancredo Neves Ave., 1095 - Cavalhada II, Caceres, 78217-042 Mato Grosso, Brazil
| | - Solange Kimie Ikeda Castrillon
- Post-Graduation Program in Environmental Science, Faculty of Agricultural and Biological Sciences, State University of Mato Grosso (UNEMAT), Tancredo Neves Ave., 1095 - Cavalhada II, Caceres, 78217-042 Mato Grosso, Brazil
| | - Denise da Costa Boamorte Cortela
- Department of Medicine, Faculty of Health Sciences, State University of Mato Grosso (UNEMAT), Tancredo Neves Ave., 1095 - Cavalhada II, 78217-042 Caceres, Mato Grosso, Brazil
| | - Eliane Ignotti
- Post-Graduation Program in Environmental Science, Faculty of Agricultural and Biological Sciences, State University of Mato Grosso (UNEMAT), Tancredo Neves Ave., 1095 - Cavalhada II, Caceres, 78217-042 Mato Grosso, Brazil
| | - Omar Ariel Espinosa
- Faculty Estacio of Pantanal (Estacio FAPAN), São Luís, 2522 St - Cidade Nova, Caceres, 78201-000 Mato Grosso, Brazil
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Ferreira ALDC, Carvalho FFD, Nihei OK, Nascimento IA, Shimabuku Junior RS, Fernandes RD, Moreira NM. Prevalence of intestinal parasites in children from public preschool in the Triple Border Brazil, Argentina, and Paraguay. ABCS HEALTH SCIENCES 2021. [DOI: 10.7322/abcshs.2019136.1401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Introduction: The prevalence of parasitosis in children from Brazilian border cities is unknown. Objective: To identify the prevalence of intestinal parasites in children from public pre-school on the Brazilian border and their socioeconomic and health profile. Methods: Fecal samples were obtained from 178 children from public early childhood educational center (CMEI) in Brazilian border municipalities in Foz do Iguaçu, Brazil. Samples were processed by Hoffman sedimentation and zinc sulfate centrifugation and flotation methods. A questionnaire was administered to children´s parents or guardians regarding parasitic diseases, socioeconomic status, and sanitary habits. Results: The prevalence of intestinal parasites was 26.9% (n=48). A high prevalence of Giardia duodenalis was found (16.3%), followed by Endolimax nana (8.4%), Enterobius vermiculares (1.7%), Ascaris lumbricoides, and Entamoeba coli (0.5%). Forty-seven children (26.4%) presented monoparasitism. The percentage of parasitosis was significantly higher among male children (33.7% - p<0.036) who exhibited weight loss (50.0%), were from low-income families (35.4%- p=0.05), and had mothers with a low education (54.0%-p=0.0001). The highest percentage of Giardia was in children who exhibited weight loss (42.9% - p<0.05) and had mothers with low education (35.0%- p=0.0001). Multivariate analysis indicated that in the variable gender (male gender), weight loss and low maternal education contributed to the variability of parasitosis in children from the surveyed MCEC. Conclusion: The higher prevalence of Giardia was due to child and family variables. The detection of Enterobius vermiculares and Ascaris lumbricoides, despite the low frequency, indicates the need for better basic sanitation policies. Keywords: child; parasites; prevalence; border areas; giardiasis.
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Pacheco FTF, de Carvalho SS, Santos SA, das Chagas GMT, Santos MC, Santos JGS, da Costa-Ribeiro H, Ribeiro TCM, de Mattos ÂP, Gomes MA, Soares NM, Teixeira MCA. Specific IgG and IgA Antibody Reactivities in Sera of Children by Enzyme-Linked Immunoassay and Comparison With Giardia duodenalis Diagnosis in Feces. Ann Lab Med 2021; 40:382-389. [PMID: 32311851 PMCID: PMC7169635 DOI: 10.3343/alm.2020.40.5.382] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Revised: 01/05/2020] [Accepted: 03/31/2020] [Indexed: 01/03/2023] Open
Abstract
Background Giardia duodenalis is conventionally diagnosed in fecal samples using parasitological methods. However, sensitivity is poor when only a single sample is analyzed, due to intermittent excretion of cysts in feces. Alternatively, the serum antibodies to G. duodenalis can be used for parasite diagnosis and epidemiological studies to determine previous exposure. We compared the rate of G. duodenalis infection between serum anti-Giardia IgG and IgA antibodies and fecal examination in Brazilian children. Methods Fecal and serum samples were tested from 287 children at a clinical laboratory and from 187 children at daycare centers. Fecal samples were processed using conventional parasitological methods and coproantigen detection for Giardia diagnosis. Serum samples were tested using an in-house ELISA for detection of anti-Giardia IgG and IgA. Results G. duodenalis was found in 8.2% (N=39) of the 474 children analyzed. The sensitivity and specificity of ELISA were 80.0% and 90.0% for IgG and 80.0% and 83.3% for IgA, respectively. The total positivity rate of anti-Giardia IgG and IgA in the sera was 13.9% (N=66) and 23.6% (N=112). The agreement between the positivity of specific antibodies and the detection of G. duodenalis in feces was moderate for ELISA-IgG, kappa index (95% CI)=0.543 (0.422–0.664), and mild for ELISA-IgA, kappa index (95% CI)=0.283 (0.162–0.404). Among the children infected with other enteroparasites, 11.6% (N=10) and 24.4% (N=21) showed reactivity to anti-Giardia IgG and to IgA, respectively. This cross-reactivity was more frequent in samples from children infected with Endolimax nana and Entamoeba coli. Conclusions The higher frequency of specific antibody reactivity compared with G. duodenalis diagnosis in feces could reflect continuous exposure of children to G. duodenalis infection, resulting in long-lasting immunological memory and/or cross-reactivity with other intestinal amoebas.
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Affiliation(s)
- Flávia Thamiris Figueiredo Pacheco
- Department of Clinical and Toxicological Analysis, Pharmacy College, Salvador, Brazil.,Hospital Professor Edgard Santos, Federal University of Bahia, Salvador, Brazil
| | | | - Samara Alves Santos
- Department of Clinical and Toxicological Analysis, Pharmacy College, Salvador, Brazil
| | | | | | | | | | | | | | - Maria Aparecida Gomes
- Department of Parasitology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Neci Matos Soares
- Department of Clinical and Toxicological Analysis, Pharmacy College, Salvador, Brazil
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Duarte JL, Diaz-Quijano FA, Batista AC, Duarte AF, Melchior LAK, Giatti LL. Climate variability and hospitalizations due to infectious diarrheal diseases in a municipality of the Western Brazilian Amazon Region. CIENCIA & SAUDE COLETIVA 2019; 24:2959-2970. [PMID: 31389543 DOI: 10.1590/1413-81232018248.21232017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Accepted: 10/27/2017] [Indexed: 11/22/2022] Open
Abstract
Morbimortality due to infectious diarrheal diseases still is a serious health issue in Brazil and is highly related to factors such as weather, environment, and people's life conditions. This study aimed to analyze the relationship between hospitalization rates due to infectious diarrheal diseases among the population of the municipality of Rio Branco (AC), Brazil and precipitation, river level, humidity and temperature between 2000 and 2013. Data were retrieved from the Hospital Information System of the SUS (Unified Health System), the National Institute of Meteorology and the National Water Agency. Multiple Poisson and negative binomial regression models were adjusted. Results showed that there is a positive association between hospitalization due to infectious diarrheal diseases and the level of the Acre river (RR: 1.07; CI 95%: 1.04 to 1.1); these hospitalization rates fell 14% between 2000 and 2013 (RR: 0.86; CI 95%: 0.85 to 0.87). The most vulnerable group was the age group of less than 1 year of age. This study showed the vulnerability of an Amazonian city to climate variability and its respective epidemiological influence on the incidence of hospitalizations due to infectious diarrheal diseases.
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Affiliation(s)
- Juliana Lúcia Duarte
- Departamento de Saúde Ambiental, Faculdade de Saúde Pública, Universidade de São Paulo (USP). Av. Dr. Arnaldo 715, Cerqueira Cesar. 01246-904 São Paulo SP Brasil.
| | | | - Antônio Carlos Batista
- Departamento de Ciências Florestais, Setor de Ciências Agrárias, Universidade Federal do Paraná. Curitiba PR Brasil
| | | | | | - Leandro Luiz Giatti
- Departamento de Saúde Ambiental, Faculdade de Saúde Pública, Universidade de São Paulo (USP). Av. Dr. Arnaldo 715, Cerqueira Cesar. 01246-904 São Paulo SP Brasil.
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Oishi CY, Klisiowicz DDR, Seguí R, Köster PC, Carmena D, Toledo R, Esteban JG, Muñoz-Antoli C. Reduced prevalence of soil-transmitted helminths and high frequency of protozoan infections in the surrounding urban area of Curitiba, Paraná, Brazil. Parasite Epidemiol Control 2019; 7:e00115. [PMID: 31660444 PMCID: PMC6807289 DOI: 10.1016/j.parepi.2019.e00115] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 05/14/2019] [Accepted: 06/17/2019] [Indexed: 12/20/2022] Open
Abstract
Human populations living in the surrounding urban areas of large Brazilian cities have increased vulnerability to intestinal parasites. However, the epidemiological scenario of soil-transmitted helminths (STH) in Curitiba, Paraná's main city, remains largely unknown. To bridge this gap of knowledge, this study aims to determine the prevalence of intestinal parasites and to investigate potential transmission pathways of the most prevalent species detected. We conducted a cross-sectional epidemiological study between July and September 2014 among schoolchildren in urban and peri-urban (deprived) areas of the municipality of Campo do Tenente, Curitiba. A total of 549 stool samples were used for coproparasitological diagnosis. Microscopy-positive samples of the most common species found were re-assessed by PCR and sequencing methods at the small subunit rRNA gene. Prevalence of infection by any given enteroparasite was 24.8%, but soil-transmitted helminths were only detected in 3.5% of the examined samples. Frequency of protozoan infections reached 90% and 97.8% in single and multiple infections, respectively. Blastocystis sp. (38.9%) was the most frequently species found in the surveyed schoolchildren population. A total of 41 Blastocystis-positive samples were unambiguously typed as ST1 (36.4%), ST2 (21.2%), ST3 (39.4%), and ST1 + ST3 mixed infection (3.0%). These results indicate that Blastocystis transmission is primarily anthroponotic in origin. This data highlights the importance of maintaining the anthelminthic control programs currently in place and of improving sanitary disposal of human excreta in poor-resource settings.
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Affiliation(s)
- Camila Yumi Oishi
- Post-Graduate Program in Microbiology and Pathology, Department of Basic Pathology, Biological Sciences Area, Paraná Federal University, Curitiba, Brazil
| | - Débora do Rocio Klisiowicz
- Post-Graduate Program in Microbiology and Pathology, Department of Basic Pathology, Biological Sciences Area, Paraná Federal University, Curitiba, Brazil
| | - Raimundo Seguí
- Departamento Farmacia y Tecnología Farmacéutica y Parasitología, Área Parasitología, Facultat Farmàcia, Universitat València, Spain
| | - Pamela C Köster
- Parasitology Reference and Research Laboratory, National Centre for Microbiology, Majadahonda, Madrid, Spain
| | - David Carmena
- Parasitology Reference and Research Laboratory, National Centre for Microbiology, Majadahonda, Madrid, Spain
| | - Rafael Toledo
- Departamento Farmacia y Tecnología Farmacéutica y Parasitología, Área Parasitología, Facultat Farmàcia, Universitat València, Spain
| | - José Guillermo Esteban
- Departamento Farmacia y Tecnología Farmacéutica y Parasitología, Área Parasitología, Facultat Farmàcia, Universitat València, Spain
| | - Carla Muñoz-Antoli
- Departamento Farmacia y Tecnología Farmacéutica y Parasitología, Área Parasitología, Facultat Farmàcia, Universitat València, Spain
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Ignacio CF, Silva MECD, Handam NB, Alencar MDFL, Sotero-Martins A, Barata MMDL, Moraes AHAD. Socioenvironmental conditions and intestinal parasitic infections in Brazilian urban slums: a cross-sectional study. Rev Inst Med Trop Sao Paulo 2017; 59:e56. [PMID: 28793024 PMCID: PMC5553943 DOI: 10.1590/s1678-9946201759056] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Accepted: 03/31/2017] [Indexed: 02/06/2023] Open
Abstract
Methods A cross-sectional study covering an agglomeration of urban slums was conducted between 2015 and 2016 using participants observation, a socioeconomic survey, and the spontaneous sedimentation method with three slides per sample to analyze fresh stool specimens ( n =595) searching for intestinal parasites. Results Endolimax nana ( n =95, 16.0%) and Entamoeba coli ( n =65, 10.9%) were the most frequently identified agents, followed by Giardia intestinalis ( n =24, 4.0%) and Ascaris lumbricoides ( n =11, 1.8%). Coinfections caused by E. nana and E. histolytica/dispar and by Entamoeba coli/A. lumbricoides were significant. The use of piped water as drinking water, the presence of A. lumbricoides , and contamination with coliform bacteria and Escherichia coli were more common in major area (MA) 1. Children (0-19 years) had a greater chance of living in poverty (OR 3.36; 95% CI: 2.50- 4.52; p <0.001) which was pervasive. The predominance of protozoa parasites suggests that a one-size-fits-all approach focusing on preventive chemotherapy for soil-transmitted helminths is not appropriate for all communities in developing countries. It is important that both residents and health professionals consider the socioenvironmental conditions of urban slums when assessing intestinal parasitic infections for disease control and health promotion initiatives.
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Affiliation(s)
- Caroline Ferraz Ignacio
- Fundação Oswaldo Cruz, Instituto Oswaldo Cruz, Laboratório de Inovações em Terapias, Ensino e Bioprodutos, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Milena Enderson Chagas da Silva
- Fundação Oswaldo Cruz, Instituto Oswaldo Cruz, Laboratório de Inovações em Terapias, Ensino e Bioprodutos, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Natasha Berendonk Handam
- Fundação Oswaldo Cruz, Escola Nacional de Saúde Pública Sérgio Arouca, Departamento de Saneamento e Saúde Ambiental, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Maria de Fatima Leal Alencar
- Fundação Oswaldo Cruz, Instituto Oswaldo Cruz, Laboratório de Inovações em Terapias, Ensino e Bioprodutos, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Adriana Sotero-Martins
- Fundação Oswaldo Cruz, Escola Nacional de Saúde Pública Sérgio Arouca, Departamento de Saneamento e Saúde Ambiental, Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Antonio Henrique Almeida de Moraes
- Fundação Oswaldo Cruz, Instituto Oswaldo Cruz, Laboratório de Inovações em Terapias, Ensino e Bioprodutos, Rio de Janeiro, Rio de Janeiro, Brazil
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Faria CP, Zanini GM, Dias GS, Sousa MDC. Associations of Giardia lamblia assemblages with HIV infections and symptomatology: HIV virus and assemblage B were they born to each other? Acta Trop 2017; 172:80-85. [PMID: 28456597 DOI: 10.1016/j.actatropica.2017.04.026] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 04/20/2017] [Accepted: 04/22/2017] [Indexed: 12/13/2022]
Abstract
Giardia lamblia is an intestinal parasite that has an extensive genetic variation among isolates. This species is divided into eight different assemblages (A-H), but only assemblages A and B have been associated with human infections. Studies on the associations of G. lamblia assemblages and symptoms have been done but were inconclusive. The aim of this study was to correlate G. lamblia assemblages with symptoms in patients with and without HIV/AIDS and its association with the CD4T cell count. The cross-sectional survey was conducted among patients attending the Evandro Chagas National Institute of Infectious Diseases (INI/FIOCRUZ) in Rio de Janeiro from January 2011 to February 2015. Thirty-eight of 65 microscopically positive stool samples for G. lamblia were from HIV positive patients and 27 were from HIV negative patients. Of the HIV infected patients, 19 (55.9%) were genotyped as assemblage B of which 9 (47.4%) had a CD4Tcell count below 200cells/mm3. In addition, we found a greater number of samples belonging to assemblage B in symptomatic cases (11 of 19; 57.9%). Our data suggest that assemblage B is very likely to be found in HIV infected patients and probably the lower CD4T count gives advantages for assemblage B replication. Furthermore, assemblage B seems to be associated with symptomatology, particularly abdominal pain, asthenia, diarrhea, fever, headache and myalgia. This study provides information on G. lamblia assemblages and symptoms in patients with and without HIV/AIDS virus and their association with CD4Tcell counts.
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Affiliation(s)
- Clarissa Perez Faria
- CNC - Center for Neurosciences and Cell Biology, University of Coimbra, 3030-548 Coimbra, Portugal; Faculty of Pharmacy, University of Coimbra, 3030-548 Coimbra, Portugal; Laboratory of Parasitology, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, 21040-900, Brazil
| | - Graziela Maria Zanini
- Laboratory of Parasitology, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, 21040-900, Brazil
| | - Gisele Silva Dias
- Laboratory of Parasitology, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, 21040-900, Brazil
| | - Maria do Céu Sousa
- CNC - Center for Neurosciences and Cell Biology, University of Coimbra, 3030-548 Coimbra, Portugal; Faculty of Pharmacy, University of Coimbra, 3030-548 Coimbra, Portugal.
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Faria CP, Zanini GM, Dias GS, da Silva S, de Freitas MB, Almendra R, Santana P, Sousa MDC. Geospatial distribution of intestinal parasitic infections in Rio de Janeiro (Brazil) and its association with social determinants. PLoS Negl Trop Dis 2017; 11:e0005445. [PMID: 28273080 PMCID: PMC5358884 DOI: 10.1371/journal.pntd.0005445] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 03/20/2017] [Accepted: 03/01/2017] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Intestinal parasitic infections remain among the most common infectious diseases worldwide. This study aimed to estimate their prevalence and provide a detailed analysis of geographical distribution of intestinal parasites in the metropolitan region of Rio de Janeiro, considering demographic, socio-economic, and epidemiological contextual factors. METHODS/PRINCIPAL FINDINGS The cross-section survey was conducted among individuals attending the Evandro Chagas National Institute of Infectious Diseases (FIOCRUZ, RJ) during the period from April 2012 to February 2015. Stool samples were collected and processed by sedimentation, flotation, Kato-Katz, Baermann-Moraes and Graham methods, iron haematoxylin staining and safranin staining. Of the 3245 individuals analysed, 569 (17.5%) were infected with at least one parasite. The most common protozoa were Endolimax nana (28.8%), Entamoeba coli (14.8%), Complex Entamoeba histolytica/Entamoeba dispar (13.5%), Blastocystis hominis (12.7%), and Giardia lamblia (8.1%). Strongyloides stercoralis (4.3%), Schistosoma mansoni (3.3%), Ascaris lumbricoides (1.6%), and hookworms (1.5%) were the most frequent helminths. There was a high frequency of contamination by protozoa (87%), and multiple infections were observed in 141 participants (24.8%). A positive association between age (young children) and gender (male) with intestinal parasites was observed. Geospatial distribution of the detected intestinal parasitic infections was not random or homogeneous, but was influenced by socioeconomic conditions (through the material deprivation index (MDI)). Participants classified in the highest levels of deprivation had higher risk of having intestinal parasites. CONCLUSIONS/SIGNIFICANCE This study provides the first epidemiological information on the prevalence and distribution of intestinal parasitic infections in the Rio de Janeiro metropolitan area. Intestinal parasites, especially protozoa, are highly prevalent, indicating that parasitic infections are still a serious public health problem. MDI showed that intestinal parasites were strongly associated with the socioeconomic status of the population, thus making it possible to identify social vulnerable areas.
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Affiliation(s)
- Clarissa Perez Faria
- Center for Neurosciences and Cell Biology (CNC), University of Coimbra, Coimbra, Portugal
- Faculty of Pharmacy, University of Coimbra, Coimbra, Portugal
- Evandro Chagas National Institute of Infectious Diseases (INI), Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Graziela Maria Zanini
- Evandro Chagas National Institute of Infectious Diseases (INI), Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Gisele Silva Dias
- Evandro Chagas National Institute of Infectious Diseases (INI), Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Sidnei da Silva
- Evandro Chagas National Institute of Infectious Diseases (INI), Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | | | - Ricardo Almendra
- Centre of Studies on Geography and Spatial Planning (CEGOT), Department of Geography and Tourism, University of Coimbra, Coimbra, Portugal
| | - Paula Santana
- Centre of Studies on Geography and Spatial Planning (CEGOT), Department of Geography and Tourism, University of Coimbra, Coimbra, Portugal
| | - Maria do Céu Sousa
- Center for Neurosciences and Cell Biology (CNC), University of Coimbra, Coimbra, Portugal
- Faculty of Pharmacy, University of Coimbra, Coimbra, Portugal
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10
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Faria CP, Zanini GM, Dias GS, da Silva S, Sousa MDC. Molecular Characterization of Giardia lamblia: First Report of Assemblage B in Human Isolates from Rio de Janeiro (Brazil). PLoS One 2016; 11:e0160762. [PMID: 27517469 PMCID: PMC4982690 DOI: 10.1371/journal.pone.0160762] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Accepted: 07/25/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Despite the high prevalence of giardiasis, the genetic characterization of Giardia lamblia has been poorly documented in Brazil and molecular epidemiology research has only been conducted in the last few years. The aim of this study was to determine the prevalence of different G. lamblia assemblages and detect mixed infections among patients with giardiasis. METHODS AND PRINCIPAL FINDINGS The cross-section survey was conducted among patients attending the FIOCRUZ in Rio de Janeiro. In order to discriminate the genetic assemblages/sub-assemblages, G. lamblia isolates were characterized by PCR-RFLP and qPCR using four loci genes (bg, gdh, tpi and orfC4). Of the 65 positive samples, 41 (63.1%) were successfully amplified by nested-PCR of bg and gdh genes. Among them, 16 were typed as sub-assemblage AII, 7 as BIII, 4 as BIV and 8 as a mixture of BIII and BIV. After the analysis by qPCR assay, a total of 55 (84.6%) samples were amplified using at least one locus: bg gene was amplified in 38 (58.5%) samples, gdh in 41 (63.1%), tpi in 39 (60%), and orfC4 in 39 (60%). Multilocus genotyping results showed that 29 (52.7%) samples belonged to Assemblage A and 26 (47.3%) samples belonged to Assemblage B. In 2011 and 2012, 20 (74.1%) samples belonged to Assemblage A and 7 (25.9%) belonged to Assemblage B. In subsequent years (2013-2015) there was a predominance of Assemblage B, 19 (67.9%) versus 9 (32.1%) Assemblage A. CONCLUSIONS This is the first time that Assemblage B of G. lamblia was reported in human clinical samples from Rio de Janeiro (Brazil) and is the first report about genetic characterization using four genes. The qPCR assemblage-specific showed no mixed infections by Assemblages A and B. A switch in genetic profile over the years was observed, firstly predominance of Assemblage A and lastly of Assemblage B.
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Affiliation(s)
- Clarissa Perez Faria
- CNC - Center for Neurosciences and Cell Biology, University of Coimbra, Coimbra, Portugal
- Faculty of Pharmacy, University of Coimbra, Coimbra, Portugal
- Laboratory of Parasitology, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Graziela Maria Zanini
- Laboratory of Parasitology, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Gisele Silva Dias
- Laboratory of Parasitology, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Sidnei da Silva
- Laboratory of Parasitology, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Maria do Céu Sousa
- CNC - Center for Neurosciences and Cell Biology, University of Coimbra, Coimbra, Portugal
- Faculty of Pharmacy, University of Coimbra, Coimbra, Portugal
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11
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Genotyping of Giardia duodenalis isolates in asymptomatic children attending daycare centre: evidence of high risk for anthroponotic transmission. Epidemiol Infect 2015; 144:1418-28. [DOI: 10.1017/s0950268815002514] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
SUMMARYGiardia duodenalis is a common intestinal parasite infecting children attending daycare centres. This study aimed to verify Giardia occurrence and the genotypes of isolates infecting children aged 0–6 years and workers at a daycare centre in the state of São Paulo, Brazil. The families of children who tested positive for Giardia, were asked to provide stool samples from household members and their dogs. Samples (123 children, 14 centre employees, 44 household members, 19 children after treatment, and 20 dogs) were examined for intestinal parasites using concentration methods. DNA extracted from all samples was submitted for polymerase chain reaction (PCR) testing and the amplicons generated were used for multilocus sequence typing of beta-giardin (bg), triose phosphate isomerase (tpi) and glutamate dehydrogenase (gdh) genes. Giardia was detected in 15·9% and 28·6% of the 220 samples by microscopy and PCR, respectively. Analysis of sequences retrieved from 29 isolates revealed both assemblages A (31%) and B (69%). Sub-assemblages AII, BIII and BIV were identified and the alignment of the bg, gdh and tpi sequences revealed the presence of some single nucleotide polymorphisms, especially in assemblage B sequences. The higher predominance of assemblage B and the identification of the AII type support the view that anthroponotic transmission appears to be an important route of transmission in environments that concentrate children at an age when poor hygiene practices make them more vulnerable to such infection.
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Wang X, Wang J, Sun H, Xia S, Duan R, Liang J, Xiao Y, Qiu H, Shan G, Jing H. Etiology of Childhood Infectious Diarrhea in a Developed Region of China: Compared to Childhood Diarrhea in a Developing Region and Adult Diarrhea in a Developed Region. PLoS One 2015; 10:e0142136. [PMID: 26528820 PMCID: PMC4631449 DOI: 10.1371/journal.pone.0142136] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Accepted: 10/16/2015] [Indexed: 01/22/2023] Open
Abstract
In China, great differences in economy, social characteristics and hygiene exist between developing and developed regions. A comparative study of infectious diarrhea between two regions was needed. Three groups of diarrheal patients were collected: children ≤5 year-olds from Beijing (developed region) and Henan Province (developing region), and adults over 18 year-olds from Beijing. A questionnaire was used to survey and feces samples were examined for 16 enteropathogens. We enrolled 1422 children and 1047 adults from developed region and 755 children from developing region. Virus positive rates were 32.98% for children and 23.67% for adults in developed region. The most prevalent pathogen for children was rotavirus whereas for adults was norovirus. Bacterial isolation rates were 13.92% for children from developed region, while 29.14% for children from the developing regions. For the greatest difference, Shigella accounted for 50.79% and was the dominant pathogen in the developing region, whereas in the developed region it was only 1.45%. There was no significant relationship between the local levels of development with diarrheogenic Escherichia coli (DEC) categories. But it was seen the notable differences between the population with different age: enteropathogenic E.coli (EPEC) and enteroaggregative E.coli (EAggEC) were the primary classes of DEC in children from both regions, whereas it was enterotoxigenic E.coli (ETEC) in adults. The symptoms of Shigella and Salmonella infection, such as bloody stools, white blood cells (WBC) and red blood cells (RBC) positivity and fever were similar in children, which may lead to the misidentification. Yersinia enterocolitica and shiga toxin-producing E.coli (STEC) infections were firstly reported in Beijing. There was a large difference in etiology of bacterial diarrhea between children in developing and developed regions of China.
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Affiliation(s)
- Xin Wang
- Institute of Basic Medicine Science, Chinese Academy of Medicine Sciences, School of Basic Medicine, Peking Union Medicine College, Beijing, China
- National Institute for Communicable Disease Control and Prevention, Chinese Centre for Disease Control and Prevention, State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Beijing, China
| | - Jing Wang
- Department of Infectious Disease, Dongcheng Centre for Disease Control and Prevention, Beijing, China
| | - Hao Sun
- Department of Infectious Disease, Dongcheng Centre for Disease Control and Prevention, Beijing, China
| | - Shengli Xia
- Department of Infectious Disease, Henan Provincial Centre for Disease Control and Prevention, Zhengzhou, China
| | - Ran Duan
- National Institute for Communicable Disease Control and Prevention, Chinese Centre for Disease Control and Prevention, State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Beijing, China
| | - Junrong Liang
- National Institute for Communicable Disease Control and Prevention, Chinese Centre for Disease Control and Prevention, State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Beijing, China
| | - Yuchun Xiao
- National Institute for Communicable Disease Control and Prevention, Chinese Centre for Disease Control and Prevention, State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Beijing, China
| | - Haiyan Qiu
- National Institute for Communicable Disease Control and Prevention, Chinese Centre for Disease Control and Prevention, State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Beijing, China
| | - Guangliang Shan
- Institute of Basic Medicine Science, Chinese Academy of Medicine Sciences, School of Basic Medicine, Peking Union Medicine College, Beijing, China
- * E-mail: (HJ); (GS)
| | - Huaiqi Jing
- National Institute for Communicable Disease Control and Prevention, Chinese Centre for Disease Control and Prevention, State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Beijing, China
- * E-mail: (HJ); (GS)
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