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Martins AS, Santos SA, Lisboa CADS, Barros TF, Ribeiro TCM, Da Costa-Ribeiro H, Mattos ÂPD, Almeida Mendes PSD, Mendes CMC, Souza EL, Moreno Amor AL, Soares NM, Aquino Teixeira MC. Infectious etiology and indicators of malabsorption or intestinal injury in childhood diarrhea. BIOMEDICA : REVISTA DEL INSTITUTO NACIONAL DE SALUD 2024; 44:80-91. [PMID: 38648349 DOI: 10.7705/biomedica.6913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Accepted: 02/20/2024] [Indexed: 04/25/2024]
Abstract
INTRODUCTION The multifactorial etiology of gastroenteritis emphasizes the need for different laboratory methods to identify or exclude infectious agents and evaluate the severity of diarrheal disease. OBJECTIVE To diagnose the infectious etiology in diarrheic children and to evaluate some fecal markers associated with intestinal integrity. MATERIALS AND METHODS The study group comprised 45 children with diarrheal disease, tested for enteropathogens and malabsorption markers, and 76 children whose feces were used for fat evaluation by the traditional and acid steatocrit tests. RESULTS We observed acute diarrhea in 80% of the children and persistent diarrhea in 20%. Of the diarrheic individuals analyzed, 40% were positive for enteropathogens, with rotavirus (13.3%) and Giardia duodenalis (11.1%) the most frequently diagnosed. Among the infected patients, occult blood was more evident in those carrying pathogenic bacteria (40%) and enteroviruses (40%), while steatorrhea was observed in infections by the protozoa G. duodenalis (35.7%). Children with diarrhea excreted significantly more lipids in feces than non-diarrheic children, as determined by the traditional (p<0.0003) and acid steatocrit (p<0.0001) methods. Moreover, the acid steatocrit method detected 16.7% more fecal fat than the traditional method. CONCLUSIONS Childhood diarrhea can lead to increasingly severe nutrient deficiencies. Steatorrhea is the hallmark of malabsorption, and a stool test, such as the acid steatocrit, can be routinely used as a laboratory tool for the semi-quantitative evaluation of fat malabsorption in diarrheic children.
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Affiliation(s)
- Adson Santos Martins
- Programa de Pós-Graduação em Farmácia, Universidade Federal da Bahia, Salvador, Brasil
| | - Samara Alves Santos
- Programa de Pós-Graduação em Farmácia, Universidade Federal da Bahia, Salvador, Brasil
| | | | - Tânia Fraga Barros
- Programa de Pós-Graduação em Farmácia, Universidade Federal da Bahia, Salvador, Brasil; Faculdade de Farmácia, Universidade Federal da Bahia, Salvador, Brasil
| | | | - Hugo Da Costa-Ribeiro
- Hospital Universitário Professor Edgard Santos - HUPES, Universidade Federal da Bahia, Salvador, Brasi
| | - Ângela Peixoto de Mattos
- Hospital Universitário Professor Edgard Santos - HUPES, Universidade Federal da BahiaHospital Universitário Professor Edgard Santos - HUPES, Universidade Federal da Bahia, Salvador, Brasi
| | | | | | - Edna Lúcia Souza
- aculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Brasil
| | - Ana Lúcia Moreno Amor
- Centro de Ciências da Saúde, Universidade Federal do Recôncavo da Bahia, Santo Antônio de Jesus, Brasil
| | - Neci Matos Soares
- Programa de Pós-Graduação em Farmácia, Universidade Federal da Bahia, Salvador, Brasil; Faculdade de Farmácia, Universidade Federal da Bahia, Salvador, Brasil
| | - Márcia Cristina Aquino Teixeira
- Programa de Pós-Graduação em Farmácia, Universidade Federal da Bahia, Salvador, Brasil; Faculdade de Farmácia, Universidade Federal da Bahia, Salvador, Brasil
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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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Calegar DA, Monteiro KJL, Bacelar PAA, Evangelista BBC, Almeida MM, Dos Santos JP, Boia MN, Coronato-Nunes B, Jaeger LH, Carvalho-Costa FA. Epidemiology, species composition and genetic diversity of tetra- and octonucleated Entamoeba spp. in different Brazilian biomes. Parasit Vectors 2021; 14:160. [PMID: 33731176 PMCID: PMC7968159 DOI: 10.1186/s13071-021-04672-y] [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: 12/01/2020] [Accepted: 03/05/2021] [Indexed: 11/16/2022] Open
Abstract
Background Entamoeba species harbored by humans have different degrees of pathogenicity. The present study explores the intra- and interspecific diversity, phylogenetic relationships, prevalence and distribution of tetra- and octonucleated cyst-producing Entamoeba in different Brazilian regions. Methods Cross-sectional studies were performed to collect fecal samples (n = 1728) and sociodemographic data in communities located in four Brazilian biomes: Atlantic Forest, Caatinga, Cerrado, and Amazon. Fecal samples were subjected to molecular analysis by partial small subunit ribosomal DNA sequencing (SSU rDNA) and phylogenetic analysis. Results Light microscopy analysis revealed that tetranucleated cysts were found in all the studied biomes. The highest positivity rates were observed in the age group 6–10 years (23.21%). For octonucleated cysts, positivity rates ranged from 1 to 55.1%. Sixty SSU rDNA Entamoeba sequences were obtained, and four different species were identified: the octonucleated E. coli, and the tetranucleated E. histolytica, E. dispar, and E. hartmanni. Novel haplotypes (n = 32) were characterized; however, new ribosomal lineages were not identified. The Entamoeba coli ST1 subtype predominated in Atlantic Forest and Caatinga, and the ST2 subtype was predominant in the Amazon biome. E. histolytica was detected only in the Amazon biome. In phylogenetic trees, sequences were grouped in two groups, the first containing uni- and tetranucleated and the second containing uni- and octonucleated cyst-producing Entamoeba species. Molecular diversity indexes revealed a high interspecific diversity for tetra- and octonucleated Entamoeba spp. (H ± SD = 0.9625 ± 0.0126). The intraspecific diversity varied according to species or subtype: E. dispar and E. histolytica showed lower diversity than E. coli subtypes ST1 and ST2 and E. hartmanni. Conclusions Tetra- and octonucleated cyst-producing Entamoeba are endemic in the studied communities; E. histolytica was found in a low proportion and only in the Amazon biome. With regard to E. coli, subtype ST2 was predominant in the Amazon biome. The molecular epidemiology of Entamoeba spp. is a field to be further explored and provides information with important implications for public health. ![]()
Supplementary Information The online version contains supplementary material available at 10.1186/s13071-021-04672-y.
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Affiliation(s)
- Deiviane Aparecida Calegar
- Laboratório de Epidemiologia e Sistemática Molecular, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil.
| | - Kerla Joeline Lima Monteiro
- Centro/Norte, Escritório Técnico Regional - Fundação Oswaldo Cruz, Piauí, Rua Magalhães Filho, 519, Teresina, Piauí, Brazil
| | - Polyanna Araújo Alves Bacelar
- Laboratório de Epidemiologia e Sistemática Molecular, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil.,Centro/Norte, Escritório Técnico Regional - Fundação Oswaldo Cruz, Piauí, Rua Magalhães Filho, 519, Teresina, Piauí, Brazil
| | - Brenda Bulsara Costa Evangelista
- Laboratório de Epidemiologia e Sistemática Molecular, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil.,Centro/Norte, Escritório Técnico Regional - Fundação Oswaldo Cruz, Piauí, Rua Magalhães Filho, 519, Teresina, Piauí, Brazil
| | - Mayron Morais Almeida
- Laboratório de Epidemiologia e Sistemática Molecular, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | - Jéssica Pereira Dos Santos
- Laboratório de Epidemiologia e Sistemática Molecular, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil.,Centro/Norte, Escritório Técnico Regional - Fundação Oswaldo Cruz, Piauí, Rua Magalhães Filho, 519, Teresina, Piauí, Brazil
| | - Márcio Neves Boia
- Laboratório de Biologia e Parasitologia de Mamíferos Silvestres Reservatórios, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | - Beatriz Coronato-Nunes
- Laboratório de Epidemiologia e Sistemática Molecular, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil.,Faculdade de Medicina de Petrópolis (FMP)/Faculdade Arthur Sá Earp Neto (FASE), Rua Machado Fagundes, 326, Cascatinha, Petrópolis, Rio de Janeiro, Brazil
| | - Lauren Hubert Jaeger
- Laboratório de Epidemiologia e Sistemática Molecular, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil.,Faculdade de Farmácia, Universidade Federal de Juiz de Fora, Rua José Lourenço Kelmer, s/n - Campus Universitário, Bairro São Pedro, Juiz de Fora, Minas Gerais, Brazil
| | - Filipe Anibal Carvalho-Costa
- Laboratório de Epidemiologia e Sistemática Molecular, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
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Braz AS, Andrade CAFD, Mota LMHD, Lima CMBL. Recomendações da Sociedade Brasileira de Reumatologia sobre diagnóstico e tratamento das parasitoses intestinais em pacientes com doenças reumáticas autoimunes. REVISTA BRASILEIRA DE REUMATOLOGIA 2015; 55:368-80. [DOI: 10.1016/j.rbr.2014.10.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2014] [Revised: 10/01/2014] [Accepted: 10/17/2014] [Indexed: 01/22/2023] Open
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Silva MTN, Santana JV, Bragagnoli G, Marinho AMDN, Malagueño E. Prevalence of Entamoeba histolytica/Entamoeba dispar in the city of Campina Grande, in northeastern Brazil. Rev Inst Med Trop Sao Paulo 2015; 56:451-4. [PMID: 25229229 PMCID: PMC4172120 DOI: 10.1590/s0036-46652014000500015] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2012] [Accepted: 03/19/2014] [Indexed: 11/22/2022] Open
Abstract
There is a clear need to perform epidemiological studies to find the
true prevalence of Entamoeba histolytica around the world. The
evaluation of this prevalence has been hindered by the existence of two
different species which are morphologically identical, but genetically
different, namely E. histolytica, which causes amebiasis, and
E. dispar, which is non-pathogenic. In Brazil, the
E. dispar has been detected in communities in the
Southeastern (SE) and Northeastern (NE) regions with poor
sanitation. However, individuals infected with E. histolytica
have been identified in other regions. There is an absence of reports on the
prevalence of these parasites in the state of Paraíba, which also has areas
with poor sanitary conditions where a high prevalence of the E.
histolytica/E. dispar complex has been detected in children
from urban slums. The present study evaluated the prevalence of E.
histolytica and E. dispar in 1,195 asymptomatic
children between two and 10 years of age, living in a sprawling urban slum in
Campina Grande, in the state of Paraíba, in Northeastern Brazil. These
children were examined and their feces samples were analyzed microscopically. A
total of 553 children tested positive for the E. histolytica/E.
dispar complex, and 456 of the positive samples were tested with
the E. histolytica II® ELISA kit. All 456 samples were
negative for the presence of the adhesin E. histolytica
specific antigen. The evidence suggests that in this community E.
histolytica is absent and E. dispar is the
dominant species.
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Affiliation(s)
| | - José Valfrido Santana
- Laboratório de Imunopatologia Keizo Asami (LIKA), Universidade Federal de Pernambuco, Recife, Brazil
| | - Gérson Bragagnoli
- Centro de Ciências Biológicas e da Saúde, Universidade Federal de Campina Grande, Paraíba, Brazil
| | | | - Elizabeth Malagueño
- Laboratório de Imunopatologia Keizo Asami (LIKA), Universidade Federal de Pernambuco, Recife, Brazil
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Pereira VV, Conceição ADS, Maximiano LHS, Belligoli LDQG, Silva ESD. Laboratory diagnosis of amebiasis in a sample of students from southeastern Brazil and a comparison of microscopy with enzyme-linked immunosorbent assay for screening of infections with Entamoeba sp. Rev Soc Bras Med Trop 2014; 47:52-6. [PMID: 24603737 DOI: 10.1590/0037-8682-0214-2013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2013] [Accepted: 01/29/2014] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Epidemiological studies on amebiasis have been reassessed since Entamoeba histolytica and E. dispar were first recognized as distinct species. Because the morphological similarity of these species renders microscopic diagnosis unreliable, additional tools are required to discriminate between Entamoeba species. The objectives of our study were to compare microscopy with ELISA kit (IVD®) results, to diagnose E. histolytica infection, and to determine the prevalence of amebiasis in a sample of students from southeastern Brazil. METHODS In this study, diagnosis was based on microscopy due to its capacity for revealing potential cysts/trophozoites and on two commercial kits for antigen detection in stool samples. RESULTS For 1,403 samples collected from students aged 6 to 14 years who were living in Divinópolis, Minas Gerais, Brazil, microscopy underestimated the number of individuals infected with E. histolytica/E. dispar (5.7% prevalence) compared with the ELISA kit (IVD®)-based diagnoses (15.7% for E. histolytica/E. dispar). A comparison of the ELISA (IVD®) and light microscopy results returned a 20% sensitivity, 97% specificity, low positive predictive value, and high negative predictive value for microscopy. An ELISA kit (TechLab®) that was specific for E. histolytica detected a 3.1% (43/1403) prevalence for E. histolytica infection. CONCLUSIONS The ELISA kit (IVD®) can be used as an alternative screening tool. The high prevalence of E. histolytica infection detected in this study warrants the implementation of actions directed toward health promotion and preventive measures.
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Affiliation(s)
- Valeriana Valadares Pereira
- Campus Centro-Oeste Dona Lindu, Universidade Federal de São João del-Rei, DivinópolisMG, Campus Centro-Oeste Dona Lindu, Universidade Federal de São João del-Rei, Divinópolis, MG
| | - Abiqueila da Silva Conceição
- Campus Centro-Oeste Dona Lindu, Universidade Federal de São João del-Rei, DivinópolisMG, Campus Centro-Oeste Dona Lindu, Universidade Federal de São João del-Rei, Divinópolis, MG
| | - Leandro Henrique Silva Maximiano
- Campus Centro-Oeste Dona Lindu, Universidade Federal de São João del-Rei, DivinópolisMG, Campus Centro-Oeste Dona Lindu, Universidade Federal de São João del-Rei, Divinópolis, MG
| | - Leonardo de Queiroz Gomes Belligoli
- Campus Centro-Oeste Dona Lindu, Universidade Federal de São João del-Rei, DivinópolisMG, Campus Centro-Oeste Dona Lindu, Universidade Federal de São João del-Rei, Divinópolis, MG
| | - Eduardo Sergio da Silva
- Campus Centro-Oeste Dona Lindu, Universidade Federal de São João del-Rei, DivinópolisMG, Campus Centro-Oeste Dona Lindu, Universidade Federal de São João del-Rei, Divinópolis, MG
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Gomes TDS, Garcia MC, de Souza Cunha F, Werneck de Macedo H, Peralta JM, Peralta RHS. Differential diagnosis of Entamoeba spp. in clinical stool samples using SYBR green real-time polymerase chain reaction. ScientificWorldJournal 2014; 2014:645084. [PMID: 24693242 PMCID: PMC3944400 DOI: 10.1155/2014/645084] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2013] [Accepted: 12/29/2013] [Indexed: 11/17/2022] Open
Abstract
Amoebiasis, a disease caused by Entamoeba histolytica, is usually diagnosed by microscopic examination, which does not differentiate the morphologically identical species of the E. histolytica/E. dispar complex. Furthermore, morphologically similar species such as Entamoeba hartmanni contribute to misidentification. Therefore, there is a need for more sensitive and specific methods. This study standardized a multiplex real-time PCR system for E. histolytica and E. dispar and a single real-time PCR for E. hartmanni. The multiplex protocol detected up to 0.0143 pg of E. histolytica DNA and 0.5156 pg of E. dispar DNA, and the average melting temperature (T(m)) was 73 °C and 70 °C, respectively. For E. hartmanni, the T(m) was 73 °C and the amplification was successful down to 0.03 fg of plasmid DNA. Negative controls and other intestinal parasites presented no amplification. Among the 48 samples tested, E. dispar DNA was detected in 37; none exhibited E. histolytica DNA and 11 were negative in the multiplex protocol. In 4 of these 11 samples, however, E. hartmanni DNA was amplified. SYBR Green is demonstrated to be an interesting option and these combined PCR reactions can improve laboratory diagnosis of amoebiasis in developing countries.
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Affiliation(s)
- Thiago dos Santos Gomes
- Departamento de Doenças Infecciosas e Parasitárias, Faculdade de Medicina, Universidade Federal do Rio de Janeiro, 21941-902 Rio de Janeiro, RJ, Brazil
| | - Mariana Coimbra Garcia
- Instituto de Microbiologia Prof. Paulo de Góes, Universidade Federal do Rio de Janeiro, 21941-590 Rio de Janeiro, RJ, Brazil
| | - Flavia de Souza Cunha
- Departamento de Doenças Infecciosas e Parasitárias, Faculdade de Medicina, Universidade Federal do Rio de Janeiro, 21941-902 Rio de Janeiro, RJ, Brazil
| | | | - José Mauro Peralta
- Instituto de Microbiologia Prof. Paulo de Góes, Universidade Federal do Rio de Janeiro, 21941-590 Rio de Janeiro, RJ, Brazil
| | - Regina Helena Saramago Peralta
- Faculdade de Medicina, Universidade Federal Fluminense, 24030-210 Niterói, RJ, Brazil
- Departamento de Patologia, Hospital Universitário Antônio Pedro, Rua Marquês do Paraná 303, Prédio Principal, 4° andar, Centro, 24030-210 Niterói, RJ, Brazil
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Santos FLN, Gonçalves MDS, Soares NM. Validation and utilization of PCR for differential diagnosis and prevalence determination of Entamoeba histolytica/Entamoeba dispar in Salvador City, Brazil. Braz J Infect Dis 2011. [DOI: 10.1016/s1413-8670(11)70156-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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