Navegando por Assunto "Leishmaniose visceral americana (LVA)"

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Acesso aberto (Open Access)
Forma oligossintomática da leishmaniose visceral americana: aspectos clínico e soroepidemiológico
(Universidade Federal do Pará, 2003) ATHAYDE, Aidalucy do Socorro Costa de; SILVEIRA, Fernando Tobias; http://lattes.cnpq.br/8106158306299969
The american visceral leishmaniasis (LVA) is a infectious disease, no contagious of chronic evolution and high mortality rate, being Brazil holder of 90% of the cases notified in the American continent. However, they still are not explained in an objective way the signs and symptoms of the subclinical infection, causing retard or confusion in the diagnosis of the disease. In this sense, the present work intended to previously accompany clinic and serologically the defined population, in order to characterize the subclinical form of LVA, and to study the prevalence and incidence of the infection. 307 individuals were accompanied, infected or not for the Leishmania chagasi , children and adults from 61 households, residents of the place Cabresto, Barcarena-Para, selected through clinical exam and the specific antibodies was detected by immunofluorescence reaction, between january 2000 and january 2001. For the calculation of the incidence of the infection and clinical determinant were excluded of the sample 06 patients that had already developed the classic form of the disease, in previous period. The statistical analysis was accomplished with aid of aid of the program EPINFO 0.04 and BioEstat 2.0, and the applied tests were the Quisquare, Exact Test of Fisher and G Test. In the moment of the first exam (serologically selection), 34 (11%) patients had positive serologically for the infection, however 06 of those patient ones, they had already developed the classic manifestations of LVA, elapsed the 12 months of the research appeared more 09 individuals with positive serologically of larger titles or same to ]/320, making an full of 43 (14%) infected patients by the parasite. Among the infected patients: the age groups of larger concentration were the one of young individuals, up to 24 years of age (44%); the sex of larger predominance was the male with 28 (65,1%); the signs and obvious symptoms or noticed by the subclinical individuals (5,5%), they were: paleness cutaneous-mucous membrane, lymphadenopathy, heart alteration, hepatomegaly, abdominal larging and cough. The tax of incidence of the infection was of 2,9%. None of the infected patients presented exacerbation of the symptoms or similarity manifested with the sharp form of the disease, during the twelve months of study, same when they presented higher titles of the serologically compatible with to those of patients in the classic way of LVA.
Acesso aberto (Open Access)
Infecção humana por Leishmania (Leishmania) chagasi em área endêmica de leishmaniose visceral no estado do Pará, Brasil: uma abordagem epidemiológica, clínica e imunológica
(Universidade Federal do Pará, 2010) ROSAS FILHO, Mário de Souza; SILVEIRA, Fernando Tobias; http://lattes.cnpq.br/8106158306299969
A transeccional study was carried out in a cohort of 946 individuals of both sexes, from one year old and upwards, living in endemic area of American visceral leishmaniasis (AVL), municipality of Barcarena, northeast Pará, Brazil. The major aim of this study was to identify individuals with the symptomatic and/or asymptomatic infection due to Leishmania (L.) chagasi, and to study the two types of infection, both clinically and immunologicall. For diagnosis of infection there were used the indirect fluorescent antibody test (IFAT) and the leishmanin skin test (LST) with amastigotes and promastigotes antigens of Leishmania (Leishmania) chagasi, respectively. Results were scored as + to ++++: for the IFAT, serological titres (IgG) of 80-160 and 320-640 were given + and ++, with those of 1.280-2.560 and 5.120- 10.240 as +++ and ++++ respectively. For the LST, exacerbated reactions (³16mm) were regarded as ++++, strongly positive (13-15mm) as +++, moderately positive (9- 12mm) as ++, and weakly positive (5-8mm) as +. Analysis of the difference among the clinical-immunological profiles of infection was based on the programme BioEstat 4.0 and the X2 and Binomial tests with confidence of 95%. During the study, 12 infected persons showed high serological titres (1.280 to 10.240 IgG) with negative LST reactions: 5 children and 2 adults developed of AVL with IFAT titres ³ 2.560 (IgG) and a negative LST, and 2 children and 3 adults developed subclinical infections with IFAT titre of 1.280 (IgG) and a negative LST. In addition, the two tests enabled the identification of 5 different clinical-immunological profiles within the total of 231 cases of infection diagnosed, as follows: 1. 77% with asymptomatic infection (AI), with LST ranging from +/++++ and a negative IFAT; 2. 2% with symptomatic infection (SI = AVL) and 3. 1.3% with subclinical oligosymptomatic infection (SOI), both groups with a negative LST and IFAT ranging from +++/++++; 4. 9.9% with a subclinical resistant infection (SRI), showing both LST and IFAT with +/++, and 5. 9.8% with an indeterminate initial infection (III), with a negative LST and IFAT +/++. Regarding evolution of infection, the major observation was that only a single case of SI (= AVL) evolved from the profile III (23 cases), from which most infections evolved to the profiles SRI (9 cases) or SOI (5 cases) while the lastly 8 cases remained as III.