Background Giardia duodenalis infects humans and other mammals by ingestion of cysts in contaminated water or food, or directly in environments with poor hygiene. Eight assemblages, designated A–H, are described for this species.Methodology/Principal FindingsWe investigated by microscopy or by direct immunofluorescence technique the occurrence of G. duodenalis in 380 humans, 34 animals, 44 samples of water and 11 of vegetables. G. duodenalis cysts present in samples were genotyped through PCR-RFLP of β giardin and glutamate dehydrogenase (gdh) genes and sequencing of gdh. The gdh gene was amplified in 76.5% (26/34) of the human faeces samples with positive microscopy and in 2.9% (1/34) of negative samples. In 70.4% (19/27) of the positive samples were found BIV assemblage. In two samples from dogs with positive microscopy and one negative sample, assemblages BIV, C, and D were found. Cysts of Giardia were not detected in water samples, but three samples used for vegetable irrigation showed total coliforms above the allowed limit, and Escherichia coli was observed in one sample. G. duodenalis BIV was detected in two samples of Lactuca sativa irrigated with this sample of water. BIV was a common genotype, with 100% similarity, between different sources or hosts (humans, animals and vegetables), and the one most often found in humans.Conclusions/SignificanceThis is the first study in Brazil that reports the connection among humans, dogs and vegetables in the transmission dynamics of G. duodenalis in the same geographic area finding identical assemblage. BIV assemblage was the most frequently observed among these different links in the epidemiological chain.

SUMMARYToxocariasis is a worldwide public-health problem that poses major risks to children who may accidentally ingest embryonated eggs of Toxocara. The objectives of this study were to investigate the occurrence of anti-Toxocara spp. antibodies in children and adolescents and the variables that may be involved, as well as environmental contamination by Toxocara spp. eggs, in urban recreation areas of north central mesoregion, Paraná State, Brazil. From June 2005 to March 2007. a total of 376 blood samples were collected by the Public Health Service from children and adolescents one to 12 years old, of both genders. Samples were analyzed by the indirect ELISA method for detection of anti-Toxocara antibodies. Serum samples were previously absorbed with Ascaris suum antigens, and considered positive with a reagent reactivity index ≥1. Soil samples from all of the public squares and schools located in the four evaluated municipalities that had sand surfaces (n = 19) or lawns (n = 15) were analyzed. Of the 376 serum samples, 194 (51.6%) were positive. The seroprevalence rate was substantially higher among children aging one to five years (p = 0.001) and six to eight years (p = 0.022). The clinical signs and symptoms investigated did not show a statistical difference between seropositive and seronegative individuals (p > 0.05). In 76.5% of the investigated recreation places, eggs of Toxocara were detected in at least one of the five collected samples. Recreation areas from public schools were 2.8 times more contaminated than from public squares. It is important to institute educational programs to inform families and educators, as well as to improve sanitary control of animals and cleaning of the areas intended for recreation in order to prevent toxocariasis.

BackgroundThere is no published information about the use of different protocols to administer a highly diluted medication.Evaluate the effect of different protocols for treatment with biotherapic T. cruzi 17 dH (BIOTTc17dH) on clinical/parasitological evolution of mice infected with T. cruzi-Y strain.MethodsA blind, randomized controlled trial was performed twice, using 60 28-day-old male Swiss mice infected with T. cruzi-Y strain, in five treatment groups: CI - treated with a 7% ethanol-water solution, diluted in water (10 μL/mL) ad libitum; BIOTPI - treated with BIOTTc17dH in water (10 μL/mL) ad libitum during a period that started on the day of infection; BIOT4DI - treated with BIOTTc17dH in water (10 μL/mL) ad libitum beginning on the 4th day of infection; BIOT4-5–6 - treated with BIOTTc17dH by gavage (0.2 mL/ animal/day) on the 4th, 5th and 6th days after infection; BIOT7-8–9 - treated with BIOTTc17dH by gavage (0.2 mL/ animal/day) on the 7th, 8th and 9th days after infection. We evaluated: parasitemia; total parasitemia (Ptotal); maximum peak of parasites; prepatent period (PPP) - time from infection to detection of the parasite in blood; patent period (PP) - period when the parasitemia can be detected in blood; clinical aspects; and mortality.ResultsParasitological parameters in the BIOTPI and mainly in the BIOT4PI group showed better evolution of the infection compared to the control group (CI), with lower Ptotal, lower maximum peak of parasites, higher PPP, lower PP and longer survival times. These animals showed stable body temperature and higher weight gain and water consumption, with more animals having normal-appearing fur for longer periods. In contrast, groups BIOT4-5–6 and BIOT7-8–9 showed worse evolution of the infection compared to the control group, considering both parasitological and clinical parameters. The correlation analysis combined with the other data from this study indicated that the prepatent period is the best parameter to evaluate the effect of a medication in this model.ConclusionsThe BIOT4DI group showed the best clinical and parasitological evolution, with lower parasitemia and a trend toward lower mortality and a longer survival period. The prepatent period was the best parameter to evaluate the effect of a medication in this model.

Abstract. The question of whether Chlamydia trachomatis (Ct) is a cofactor for human Papillomavirus (HPV) in cervical carcinogenesis is still controversial. We conducted a molecular detection study of both infections in 622 Brazilian women, including 252 women with different grades of abnormal cervical cytology and cervical cancer (CC; cases) and 370 women with normal cytology (controls). Although Ct infection did not seem related to CC carcinogenicity, women with abnormal cytology had a significant high rate of Ct infection. Therefore, it is important to adopt protocols for diagnosis and treatment of this bacterium in conjunction with screening for CC in this population.At present, cervical cancer (CC) is the second leading cause of cancer affecting women, 1,2 preceded only by breast cancer; it develops over a long period through precursor lesions that can be detected by cytological screening.3 Its frequency varies in different regions of the world, and it is much higher in underdeveloped or developing than developed countries.1 In Brazil, CC is the third most common cancer among women, with 17,000-18,000 new cases annually. 4 It is well-established that persistent infection by high-risk (HR) human Papillomavirus (HPV) is a necessary but not sufficient cause of CC.5 Considering that a small proportion of HR-HPV-infected women actually develop CC, 6 additional risk factors that may be involved in the development of the disease have been investigated.Among other sexually transmitted infections (STIs) that can increase the risk of CC, Chlamydia trachomatis (Ct) is among the leading factors. Some investigators have proposed that Ct infection could affect HPV acquisition and persistence, increase the rate of transformation to early precursor lesions, and also increase the likelihood that precursor lesions lead to CC.7 However, the association of Ct as a cofactor for HPV in cervical carcinogenesis is still controversial. 8 This information directly affects the adoption of efforts to control CC, because a Ct-HPV association would require not only HPV vaccination but also adoption of protocols for diagnosis and treatment of the bacteria. Considering that, in Brazil and Latin America in general, few studies have examined this possibility, we conducted a molecular detection study of HPV and Ct infections in Brazilian women with different grades of abnormal cervical cytology and CC in an attempt to contribute to elucidating the involvement of Ct in cervical carcinogenesis.Six hundred twenty-two women of low socioeconomic status, ages 15-83 years, were recruited between August 1, 2009 and March 31, 2012 in three cities of the state of Paraná , southern Brazil: Maringá , Paiçandú , and Uniã o da Vitó ria. The epidemiological characteristics were obtained through the analysis of data from a standard registration form for each woman. Each woman involved signed the authorization, and the execution of this project was approved by the Committee for Ethics in Research Involving Humans at the State University of Maringá /Paraná , ...

Introduction:The aim of this study was to investigate the knowledge of toxoplasmosis among professionals and pregnant women in the public health services in Paraná, Brazil. Methods: A cross-sectional observational and transversal study of 80 health professionals (44 nurses and 36 physicians) and 330 pregnant women [111 immunoglobulin M (IgM)-and IgG-non-reactive and 219 IgG-reactive] was conducted in 2010. An epidemiological data questionnaire was administered to the professionals and to the pregnant women, and a questionnaire about the clinical aspects and laboratory diagnosis of toxoplasmosis was administered to the professionals. Results: The participants frequently provided correct responses about prophylactic measures. Regarding the clinical and laboratory aspects, the physicians provided more correct responses and discussed toxoplasmosis with the pregnant women. The professionals had diffi culty interpreting the avidity test results, and the physicians stated that they referred pregnant women with high-risk pregnancies to a county reference center. Of the professionals, 53 (91.4%) reported that they instructed women during prenatal care, but only 54 (48.6%) at-risk pregnant women and 99 (45.2%) women who were not at risk reported receiving information about preventive measures. The physicians provided verbal instructions to 120 (78.4%) women, although instructional materials were available in the county. The pregnant women generally lacked knowledge about preventive measures for congenital toxoplasmosis, but the at-risk pregnant women tended to respond correctly. Conclusions: This study provides data to direct public health policies regarding the importance of updating the knowledge of primary care professionals. Mechanisms should be developed to increase public knowledge because prophylactic strategies are important for preventing congenital toxoplasmosis.

Abstract. We determined the prevalence of seven clinically important pathogens that cause sexually transmitted infections (STIs) (Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, Trichomonas vaginalis, herpes simplex virus 1 [HSV-1], HSV-2, and Treponema pallidum), by using a multiplex polymerase chain reaction (M-PCR) in samples from Brazilian woman infected with human immunodeficiency virus 1 (HIV-1) and uninfected Brazilian women (controls). The M-PCR assay identified all STIs tested for and surprisingly, occurred association between the control and STIs. This association was probably caused by excellent HIV infection control and regular monitoring in these women established by public health strategies in Brazil to combat HIV/acquired immunodeficiency syndrome. Studies using this M-PCR in different populations may help to better elucidate the roles of STIs in several conditions.

In this study, the prevalence and risk factors for enteroparasites were determined in food handlers from Maringá, Paraná State, southern Brazil. Fecal and subungual materials of 150 street food vendors were analyzed by the methods of Lutz, Faust, and Mello, respectively. A questionnaire on hygiene and sanitary conditions of the workplace and of domicile was applied. The prevalence of enteroparasites was 28%, and the protozoa infection was more expressive (21.3%) than by helminths (6.7%), but without significant difference (p > 0.05). Entamoeba coli was the most frequent species occurring in 15.3%, while the prevalence of protozoa pathogenic was low (Giardia lamblia: 2.7% and Entamoeba histolytica: 0.7%). The subungual material presented negative results. The presence of pets in domiciles has increased twice the risk of infection. The working conditions of the majority of street food vendors were inappropriate. The results highlight the need for more rigorous programs of continuing education, parasitological examination every six months, and health surveillance. In this way, the quality of the service provided to the population can be improved and the transmission of food-borne diseases can be prevented.

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