[The serum markers in the pregnant population of the basic health area of El Natahoyo (Gijón)]

OBJECTIVES

To find the prevalence of markers of rubeola, Toxoplasma, lues, HIV and hepatitis A, B and C viruses in the pregnant women of a health district; and these markers' correlations with epidemiological and socio-demographic antecedents.

PATIENTS

129 pregnant women from the 5.3 Health District in Asturias with birth predicted for between August 1994 and October 1995. A descriptive study of epidemiological, socio-demographic and serological data; statistical calculation with RSigma.

RESULTS

109 pregnant women (84.5%) were assessed, average age 28.6, including 9 abortions with path. analysis in the first three months. HIV was tested in 15 cases, all negative. Toxoplasma was positive in 46 cases, with no association with other variables. Rubeola was negative in 6 cases, all > 25 years old, with overall vaccination coverage of 42.2% and 64.7% for < 26-year-olds. One case of lues was found. The HC test was negative in all the pregnant women, with 4% of HBsAg+, related to being gypsy and to AF of hepatopathy. HA IgG was positive in 52 cases (52%) and more common among gypsies vs. the rest. In the latter group there was increasing prevalence according to age.

CONCLUSIONS

1) HIV screening is not common. 2) There is a high percentage of pregnant women with no immunity to Toxoplasma. 3) Low rubeola vaccination coverage among women under 26 was found. 4) There is a higher percentage of HBsAg+ cases in comparison with other areas, but not with the HC virus. 5) A high percentage of cases had no previous contact with the HA virus.

[The prevalence of markers for the hepatitis A and B viruses in the population of Gijón between 6 and 25 years old]

BACKGROUND

The aim of this study was to know the prevalence of previous infection markers for hepatitis A and B viruses in a pediatric-juvenile population from Gijón, Spain.

PATIENTS AND METHODS

A representative (according to the census) transversal randomized sample of a population from 6 to 25 years in age from Gijón, Spain, was included in the study analyzing demographic, epidemiologic and clinical variables, liver tests, anti-HAV IgG and anti-HBc.

RESULTS

Of the 630 individuals selected a demographic error was detected in 28 (4.4%) and 453 subjects were studied (71.9%) in whom the anti-HAV IgG was positive in 37 cases (8.75% of prevalence adjusted for age), with 4.4% (12/271) (CI 95% 2.3%-7.6%) for the younger cases and 13.7% (25/182) (CI 95% 9.1%-19.6%) in the group ranging from 18 to 25 years in age (p < 0.001). No anti-HAV IgG positive case was detected in the population under the age of 10 years. Among the young adults the prevalence of anti-HAV IgG positive cases was higher in those born in the south of Spain (2/6, 33.3%) (CI 95% 4.3%-77.7%) with respect to those from the northern regions of Spain (9/259, 3.5%) (CI 95% 1.6%-6.4%). (p = 0.02). With respect to HBV markers, of the 433 unvaccinated cases, 6 (1.4%) presented markers of past infection and 2 (0.46%) HBsAg positivity. Both had normal serum ALT without viral replication. Six cases of hypertransaminasemia levels (1.3%) were detected all being related with obesity or alcoholism. All the cases with previous acute clinical hepatitis were found to be anti-HAV IgG positive and anti-HBc negative.

CONCLUSIONS

The current prevalence of anti-HAV IgG in the population from 6 to 25 years from Gijón, Spain is very low and given the high degree of susceptibility (86%) for HAV infection in the young adult population (18-25 years) the implementation of vaccination programs is recommended even without previous serologic screening. The low prevalence of anti-Hbc would also undervalue its use as prevaccination screening against HB in this geographical area.

[Ascitic peritonitis due to Candida albicans]

We report a case of spontaneous peritonitis due to Candida albicans, in a diabetic patient with alcoholic liver cirrhosis, ascites, gastrointestinal bleeding from esophageal varices, sepsis, renal failure and encephalopathy. These factors, added to prolonged antibiotic therapy and instrumental manipulations, could have resulted in the colonization by Candida, usually described in secondary peritonitis, but perhaps underdiagnosed in cirrhotic patients with spontaneous peritonitis and severe multiorgan failure.