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[来自亚热带地区儿童的弓首蛔虫病]

[Toxocariasis in children from a subtropical region].

作者信息

Lopez Maria De Los Angeles, Martin Graciela, Chamorro Myrian Del Carmen, Mario Alonso Jose

机构信息

Area de Inmunología, Instituto de Medicina Regional, Universidad Nacional del Nordeste, Argentina.

出版信息

Medicina (B Aires). 2005;65(3):226-30.

Abstract

Toxocariasis is present worldwide but people living in areas with sanitary deficiencies are considered at the highest risk of infection, particularly children. The aim of this work was to know clinical and immunological aspects of infantile toxocariasis in a subtropical region in Argentina. For this purpose, 182 children of both sexes, 0-16 years old and with eosinophilia higher than 10%, living in Resistencia City (Northeast Argentina) were studied. Clinical examination, personal and epidemiological data recording, parasitological fecal examination and dosage of Toxocara canis IgG and IgM levels by EIE were performed; all positive sera were confirmed by Western Blot. Out of 182 children, 122 were positive for T. canis-IgG (67.0%); 28.8% lack of potable drinking water at home, 58.8% lack of sewerage facilities, 91.1% referred a close contact with dogs or cats, 30.0% had a history of geophagia and 86.7% lived along streets without pavement. The clinical forms of the infection were: 77.8% asymptomatic, 6.7% ocular larva migrans and 15.5% visceral larva migrans. In 22 children the serological follow up until 18 months after treatment showed 10 children without change in IgG levels, in 11 it decreased but remained high, and in one it increased. There were 19 children with high levels of T. canis-IgM; in 8 it decreased along treatment, in one it remained stable and 10 of them became negative. There was one child considered as a re-infection case. Results highlight the importance that health authorities should assign to this infection in regions with sanitary deficiencies, where toxocariasis is usually not recognized as a relevant public health problem.

摘要

弓首蛔虫病在全球范围内均有发生,但生活在卫生条件较差地区的人群,尤其是儿童,被认为感染风险最高。本研究旨在了解阿根廷亚热带地区婴幼儿弓首蛔虫病的临床和免疫学特征。为此,对居住在雷西斯滕西亚市(阿根廷东北部)的182名0至16岁、嗜酸性粒细胞增多超过10%的儿童进行了研究。研究内容包括临床检查、个人和流行病学数据记录、粪便寄生虫学检查以及采用酶免疫测定法检测犬弓首蛔虫IgG和IgM水平;所有阳性血清均通过免疫印迹法进行确认。在182名儿童中,122名犬弓首蛔虫IgG呈阳性(67.0%);28.8%的家庭缺乏饮用水,58.8%缺乏污水处理设施,91.1%的儿童表示与狗或猫有密切接触,30.0%有异食癖病史,86.7%居住在无铺面的街道沿线。感染的临床类型为:77.8%无症状,6.7%为眼幼虫移行症,15.5%为内脏幼虫移行症。22名儿童在治疗后18个月进行血清学随访,结果显示10名儿童的IgG水平无变化,11名儿童的IgG水平下降但仍处于高位,1名儿童的IgG水平升高。有19名儿童犬弓首蛔虫IgM水平较高;8名儿童在治疗过程中IgM水平下降,1名儿童保持稳定,其中10名儿童的IgM转为阴性。有1名儿童被视为再次感染病例。结果凸显出卫生当局应重视卫生条件较差地区的这种感染,在这些地区,弓首蛔虫病通常未被视为一个相关的公共卫生问题。

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