Parasitismo por Cryptosporidium sp. em crianças com diarréia aguda

Abstract

No período de agosto de 1987 a julho de 1990, examinaram-se, na Seção de Enteroparasitoses do Instituto Adolfo Lutz, 241 amostras de fezes de crianças, com idade variável entre 1 e 48 meses, que apresentavam episódio agudo de diarréia e foram atendidas no Instituto da Criança do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. Quarenta e duas (17,43%) amostras revelaram a presença de Cryptosporidium sp. após coloração por fucsina-carbólica. O achado de oocistos de Cryptosporidium sp. foi mais freqüente no período compreendido pelos meses de março a maio. Os autores discutem as associações entre Cryptosporidium sp. e outros agentes diarréicos.

Intra-familial and extra-familial risk factors associated with Cryptosporidium parvum infection among children hospitalized for diarrhea in Goiânia, Goiás, Brazil.

“…3,6,8,10,29 Our study similarly found a significant association between the odds of C. parvum infection and the occurrence of rain (Figure 1). Similar trends were also observed in other regions of Brazil, and in Indonesia and Zambia.…”

“…7,23 The reported range of cryptosporidial infection in Brazil has varied from 1.1% to 17.4%. 3,[8][9][10][11] Such prevalences were generated by less sensitive diagnostic tests compared with the direct immunofluorescent assay used in our study, [14][15][16][17] but differences in the age distribution of the study population, combined with differences in exposure to risk factors, likely contribute to the inter-study differences in the observed prevalence of infection among Brazilian children. Our adjusted prevalence of 18.7%, which was based on sensitivity data from a gold standard of immunomagnetic separation in combination with immunofluorescent microscopy, 13 was similar to that observed for urban Zambian children 6 and lower than the 29.6% reported for the State of Puebla, Mexico.…”

“…This age-associated pattern of young children being at highest risk of infection was similar to that found in the city of São Paulo. 10 When the analysis was adjusted for the age of the child, boys were at higher risk of C. parvum infection compared with girls. This was similar to patterns observed in Guinea-Bissau 2 and among Bedouin infants in Israel.…”

“…Similar trends were also observed in other regions of Brazil, and in Indonesia and Zambia. 3,6,10,29 The biologic source(s) for C. parvum infection and the exact routes of transmission during these wetter months have not been well described, but the impact of rainfall has been shown to mobilize and transport C. parvum oocysts out of fresh fecal material and fecal slurries and across vegetated soil surfaces and through soil columns. [30][31][32][33] Increased numbers of cases of C. parvum infection in Fortaleza and Lusaka during the rainy season were associated with contaminated drinking water supplied to these population, 3,6 but source of drinking water and mode of water disinfection were not associated with the odds of C. parvum infection among our study population.…”

“…[8][9][10][11] Several studies have been conducted in urban populations among diarrheic children in Brazil, but the majority of this work did not examine preventable risk factors associated with clinical cryptosporidiosis or based the conclusions on univariate associations that were susceptible to confounding. [8][9][10] A study conducted in children residing within a Brazilian urban slum or "favela" determined that low birth weight and geographic location were risk factors for acquisition of symptomatic infection with Cryptosporidium. 3 The ability of breastfeeding to protect against early childhood cryptosporidiosis has been inconclusive.…”