O presente estudo teve como hipótese avaliar o perfil de indivíduos da comunidade do bairro Planalto no município de Porto Velho - RO, em diversas idades, analisando seu perfil parasitológico, nutricional e odontológico. O estudo foi realizado no bairro Planalto, localizado em área periurbana do município de Porto de Velho capital do estado de Rondônia. O estudo foi descritivo, de uma população avaliando cada perfil proposto. Foram treinadas equipes multidisciplinares, com alunos dos cursos de biomedicina, nutrição e odontologia. Os avaliadores previamente treinados e calibrados fizeram a aplicação de um questionário epidemiológico, o qual teve a finalidade de obter informações para avaliar as condições sócio-econômicas, ambiental e cultural. Quanto ao perfil parasitológico, a população recebeu coletores parasitológicos (Universal) de fezes, os quais foram orientados a coletar as amostras em três dias alternados, as amostras foram analisadas no laboratório de parasitologia da Faculdade São Lucas. A condição odontológica foi avaliada por meio da aplicação dos índices CPODs, CEO e IPCs e o perfil nutricional através de avaliação antopromética e aplicação de inquérito alimentar. Os resultados mostraram que 85% dos indivíduos avaliados apresentaram enteroparasitoses, e a maior prevalência foi de protozoários intestinais como Giardia lamblia (54%) e Entamoeba histolytica (39,5%). A condição nutricional revelou que 10% das crianças apresentaram desnutrição crônica e 5% desnutrição aguda, sendo o alimento mais consumido foi carboidratos (100%). Quanto ao perfil odontológico foram encontrados 88% de prevalência de cárie entre a população de todas as idades. Optouse por não calcular o CEOD e nem dividir a amostra por faixa etária em conseqüência do número de participantes. Quanto aos defeitos de mineralização do esmalte dentário, foi encontrado 20,5% da população já com dentes permanentes (acima de 6 anos de idade) 32% tiveram todos os sextantes excluídos, provavelmente devido a perdas dentárias. Sendo que algum tipo de alteração periodontal foi encontrado nos 28% restantes. Há necessidade de promoção em saúde, bem como uma melhoria nas condições de saneamento básico podendo possibilitar uma melhoria na qualidade de vida da população estudada. / A search was developed to evaluate the peoples conditions in one of Porto Velhos neighborhood where it has 481 families living by. Porto Velho is Rondônias capital. This study had analyzed, people from diverse ages, its parasitologic, nutritional and dentistry profile. Teams had been trained to multidiscipline, with students from the following courses: Biomedicine, Nutrition and Dentistry. The team that was trained and had maden epidemiologicals questions, which had the purpose to get information to evaluate the social conditions and environmental. The population received dregss parasitologic collectors, which had been guided to collect the samples in three days alternated, the analyses had been carried through in the parasitological laboratory. The dentistry condition was evaluated through the application of the indices CPODs, CEO and IPCs. The results had shown that 85% of the evaluated individuals had presented enteroparasitosis, and the biggest prevalence was of enteric protozoan as l Giardia lamblia or Lamblia intestinalis (54%) and Entamoeba Histolytica (39.5%). The nutritional condition showed that 10% of the children had presented chronic malnutrition, a lack of nutrition and 5% sharp, acute malnutrition, the food that was more consumed was carbohydrate (100%). In relation to the dentistry evaluation, the CPO-D index was of 11,6 from people that is around fifteen to fifty three years old and the CEO was bigger in children with nine years old. There is a need of an implementation of basic sanitation and healths education to turn in a better lifes quality to the population that has been studied.

Los estudios de crecimiento tienen amplia tradición dentro de la Antropología Biológica por su variación en función de distintos factores biológicos y socio‐ambientales y por las complejas interacciones que se establecen entre ellos. Es por esto que el crecimiento es considerado un importante indicador de la salud de los individuos y de las poblaciones. Dentro de los factores ambientales que afectan al crecimiento, la nutrición ocupa un lugar preponderante en tanto que, el desequilibrio entre ingesta y gasto de energía conduce a modificaciones en el estado nutricional de los individuos, es decir malnutrición por déficit (desnutrición) o por exceso (sobrepeso u obesidad), los cuales a su vez pueden incidir en la composición y proporción corporal. Las enteroparasitosis también pueden influir en el estado nutricional de los niños al afectar la absorción de nutrientes, alterar el equilibrio del nitrógeno y producir pérdida de apetito, entre otros. Es de considerar además, la influencia que puede ejercer el ambiente, como factor limitante o facilitador de las enfermedades parasitarias intestinales. Por otra parte, hasta hace aproximadamente 50 años, en Latinoamérica las poblaciones tenían una localización preferentemente rural, sin embargo este patrón cambió y pasaron a ser predominantemente urbanas. Esta urbanización acelerada, expresada como incremento demográfico, tuvo consecuencias en el crecimiento y estado nutricional de los niños. Sin embargo hay ciertos “desafíos conceptuales”, como la arbitrariedad en la dicotomía de las categorías “rural” y “urbana” y la tendencia a separar lo urbano y lo rural. Ejemplo de ello es el desarrollo de regiones suburbanas que rodean a las ciudades tradicionales (también llamadas áreas peri‐urbanas) o la alta heterogeneidad de las ciudades latinoamericanas. Los objetivos consisten en: a) Estimar el crecimiento, composición y proporciones corporal y estado nutricional de la población infanto‐juvenil entre 4 y 14 años; b) Diagnosticar las enteroparasitosis; c) Analizar la influencia de cada factor socio‐ambiental y d) Determinar las relaciones socio‐ambientales urbanorurales respecto al crecimiento, estado nutricional y enteroparasitosis de los niños. La hipótesis a ser contrastada es: “Las diferencias socio‐ambientales se corresponden con variaciones en el crecimiento, estado nutricional y enteroparasitosis de las poblaciones urbana y rural, del departamento de San Rafael, provincia de Mendoza, e influyen sobre la variabilidad intra‐poblacional”. Se realizó un estudio transverso en 3596 niños (1776 varones y 1820 mujeres) entre 4.0 y 13.9 años. Se registraron las variables: edad (cotejada con la que figuraba en la copia del documento nacional de identidad archivada en el establecimiento escolar); peso corporal: con balanza digital; estatura (ET) y estatura sentado (ES): con antropómetro portátil; perímetro braquial (PB): con cinta inextensible; pliegues tricipital y subsescapular (PT y PS): con calibre Lange de presión constante. El índice de masa corporal (IMC) fue calculado como: IMC=peso/estatura (Kg/m2). Para estimar el estado nutricional y la composición y proporción corporales se empleó NHANES III. El punto de corte para determinar bajo peso/edad (desnutrición global), baja talla/edad (desnutrición crónica) y bajo peso/talla (desnutrición aguda) fue el percentilo (P)5. Los individuos fueron clasificados como con sobrepeso u obesidad cuando el IMC se ubicó entre P>85 <95 ó >P95, respectivamente. La composición corporal fue estimada sobre la base del área total del brazo (AT)={(PB2)/(4*π)}, área muscular (AM)={PB‐ (PT*π)}2/(4*π) y área grasa (AG)=(AT‐AM). Para determinar el déficit y el exceso de tejido adiposo del brazo se utilizó respectivamente el punto de corte del P5 y P95. Finalmente, la distribución de la adiposidad (central o periférica) fue evaluada usando el Indice Subsescapular‐Tricipital (IST)=(PS/PT). Un IST >1 fue considerado como indicador de distribución centralizada. La proporción corporal se estimó por el Indice Estatura Sentado (IES)=(ES/ET)*100, con corte P>95. Para el estudio parasitológico se realizaron talleres en las escuelas públicas con el objeto de interactuar con los padres, tutores y autoridades escolares. La metodología del taller permitió, entre los participantes el intercambio de conocimiento acerca de la biología y los modos de transmisión de las parasitosis más frecuentes en el área. Luego, se ofreció a las familias la realización del estudio parasitológico a los niños. A las familias que asintieron realizar el análisis se les entregaron para cada niño dos frascos conteniendo formol (10%) uno para las muestras de material fecal y otro para el escobillado anal. La muestra final incluyó 752 niños (374 varones y 378 mujeres) entre 4.0 y 13.9 años. Para el procesamiento de las muestras coproparasitológicas se emplearon las técnicas de concentración y sedimentación (Ritchie) y en los casos necesarios la de flotación (Willis). Se calcularon la prevalencia total de parasitosis, de especies parásitas de mono, bi y poliparasitismo. El estudio socio‐ambiental incluyó una encuesta semiestructurada completada por los padres que aportó información sobre las condiciones interiores y exteriores de la vivienda. Se preguntó acerca de: los materiales de la vivienda; calidad del agua de consumo; eliminación de excretas; combustible para cocinar y calefaccionar; pavimento; electricidad; recolección de residuos y hacinamiento crítico. Para el nivel socio‐económico, se consideraron: régimen de tenencia de la vivienda; empleo y educación de los padres; tecnología y equipamiento (computadora, automóvil, aire acondicionado, etc), cobertura de salud; ayuda estatal y tenencia de huerta y cría de animales. El estado nutricional, composición y proporción corporales y las prevalencias de parasitosis fueron comparadas empleando X2 y regresión logística. El análisis socio‐ambiental fue analizado mediante catPCA y las diferencias testeadas por X2. Todos los procedimientos estadísticos fueron realizados mediante el programa SPSS 12.0. Los resultados obtenidos indicaron que la población infanto‐juvenil de San Rafael presenta en promedio, adecuado peso aunque menor talla que la referencia. La composición corporal a nivel braquial se encuentra modificada manifestándose disminuidos el perímetro y el área muscular y aumentada el área adiposa. La prevalencia de desnutrición es del 9%, predominando la desnutrición crónica sobre la global y la emaciación. La baja talla es mayor a los 11 y 12 años de edad, posiblemente como consecuencia de la crisis económica acontecida en nuestro país en el año 2001. La desnutrición crónica se ve acompañada por elevada presencia de acortamiento de las piernas siendo más prevalente en varones y aportando nuevas evidencias de la resistencia que tienen las mujeres ante ambientes estresantes. En el otro extremo, el exceso de peso fue del 22%, siendo el sobrepeso levemente mayor que la obesidad y más prevalente en niños menores a seis años respondiendo probablemente a conductas obesogénicas sumadas a la implementación de políticas asistenciales dirigidas a madres y niños menores que suelen incluir alimentos hipercalóricos pero hipoproteicos. Prueba de ello es la presencia de exceso de tejido adiposo, acompañado por déficit de tejido muscular. La obesidad fue más prevalente en varones, presentando además centralización de la adiposidad. En las mujeres la centralización se encuentra tanto en aquellas con sobrepeso como con obesidad. Más de la mitad de la población resulta parasitada siendo los niños desnutridos los que presentan las mayores prevalencias. La riqueza especifica es de 11 especies, resultando las más prevalentes Blastocystis hominis y Enterobius vermicularis. Las condiciones climáticas y edafológicas de San Rafael limitan la viabilidad y desarrollo de los huevos de helmintos. No obstante, cabe destacar la presencia de geohelmintos en familias migrantes. El análisis de las características socio‐ambientales, independizadas de la dicotomía urbano‐rural, permite reconocer la heterogeneidad del área estudiada, distinguiéndose cuatro grupos, tres con características similares a las urbanas y el cuarto a las rurales. Los grupos urbanos (alto, medio y empobrecido) se diferencian entre sí por el nivel educativo y la situación socio‐económica de la familia. El ambiente rural se caracteriza por tenencia de huerta, cría de animales para autoconsumo y escasa provisión de servicios públicos. Son los ambientes “rural y el urbano empobrecido” los que presentan mayores prevalencias de desnutrición, especies patógenas, riqueza específica y geohelmintos. Sin embargo, los niños rurales muestran mayor prevalencia de desnutrición global y déficit de tejido muscular, evidenciándose que el estilo de vida y la economía familiar rurales no son suficientemente eficaces para mitigar las carencias nutricionales. Contrariamente el grupo “urbano alto”, con mejores condiciones sanitarias, altos niveles de instrucción y de ocupación de los padres, presenta menor prevalencia de parasitismo y de riqueza específica. Sin embargo, este grupo tiene mayor exceso de peso, probablemente por el mayor acceso a alimentos de alto valor energético, a la tecnología del hogar y a hábitos sedentarios. Asimismo, es el ambiente “urbano medio” el que comparte con el “urbano alto” el mayor nivel educativo, empleo formal de los padres y la mejor construcción de las viviendas. Sin embargo, se diferencia por el menor confort y el mayor acceso a servicios públicos. Mientras que las prevalencias de desnutrición son similares, las de exceso de peso resultan menores, siendo el déficit de tejido muscular mayor. Por último, es indudable que las poblaciones humanas tienen alta variabilidad fenotípica, variabilidad que, en muchas de ellas y en particular la de San Rafael, resultan del tiempo de adaptación a ese gran ambiente “bio‐físicocultural”. / Growth studies have a long tradition in Biological Anthropology because its variation is a result of various biological and socio-environmental factors and by the complex interactions that exist between them. Then, growth is considered an important health indicator of individuals and populations. Among environmental factors that affect growth, nutrition occupies an important place since the imbalance between energy intake and expenditure leads to changes in the nutritional status of individuals, i.e. malnutrition by deficit (undernutrition) or by excess (overweight or obesity), which may also affect body composition and proportion. Another factor that influences on the nutritional status of a child is the enteroparasitoses because it affects nutrient absorption, modifies the balance of nitrogen and causes loss of appetite, among others. It should also be considered the environmental influence as a limiting factor or facilitator of intestinal parasitic diseases. In other hand, until about 50 years ago, Latin America populations preferably had a rural location; however, this pattern changed and became predominantly urban. Such accelerated urbanization, expressed as a demographic increase, had consequences in growth and nutritional status of the children. Nevertheless, there are a certain conceptual “challenges”, such as the arbitrariness in the dichotomy of the categories “rural” and “urban” and the tendency to separate what is urban and what is rural. Example of this, it is the development of suburban regions that surround traditional cities (also called periurban areas) or the high heterogeneity of Latin American cities. The aims of the study are: a) To estimate growth, body composition and proportion and nutritional status of children from 4 to 14 years old, b) To diagnose the enteroparasites, c) To analyze the influence of each social-environmental factor, and d) to determine the relationships of rural-urban socio-environmental conditions related to growth, nutritional status and enteroparasitoses of the children. The hypothesis to be tested is: “Socio-environmental differences are in correspondence with growth, nutritional status and enteroparasitoses variations of urban and rural populations of the Department of San Rafael and it influences over intra-population variability”. 6 A cross-sectional anthropometric study was carried out. Participants for the study were 3596 children (1776 males and 1820 females) aged from 4.0 to 13.9 years old. The following variables were recorded: age: obtained from the identification cards or from the school’s records; body weight: measured on a digital scale; height (H) and sitting height (SH): using a portable vertical anthropometer; arm circumference (AC): using an inextensible tape measure; tricipital and subscapular skinfolds (TS and SS): with a Lange caliper using constant pressure. Body-mass index (BMI) was calculated as BMI= weight/height (Kg/m2). To estimate nutritional status and body composition and proportion, NHANES III reference were used. The cut-off value was 5th percentile (P) to determine low weight-for-age (underweight), low height-for-age (stunting), and low weight-forheight (wasting). Individuals were classified as overweight or obese when their BMI was >85 <95 percentile or >95P, respectively. Body composition was estimated on the basis of total area of the arm (TA)={(AC2) / (4 * π)}, muscle area (MA)={AC-(TS * π)}2/ (4 * π) and fat area (FA)=(TA-MA). A cut-off point of 5th percentile and 95th was used to determine deficit and excess of adipose and muscular tissues of the arm. Finally, fat distribution (central or peripheral) was evaluated using the Subscapular-Tricipital Index (STI) calculated as (STI=SS/ST). A STI score >1 was considered as an indicator of central fat distribution. Body proportion was estimated by the Sitting Height Index (SHI) as (SHI)=(SH/H)*100, with a cut-off of P>95. In the parasitological study informational workshops were carried out at the public schools with the aim of interacting with parents, tutors, and school authorities. The workshop methodology enabled an interchange among participants about knowledge and understanding of the biology and transmission modes of the most frequent parasitizes within the area. Then, parasitological tests were offered to be performed on the children of the participating families. Each consenting family was provided with two vials for each child containing 10% (v/v) aqueous formaldehyde for simple deposits of serial fecal material and anal swabs for subsequent collection and delivery to laboratory for analysis. The final sampling involved a total of 752 children (374 males and 378 females) from 4.0 to 13.9 years old. For the processing of the coproparasitological samples, techniques of concentration by sedimentation (Ritchie) and in the cases that it was necessary of flotation (Willis) were applied. Total prevalence of infection and individual parasite 7 species were calculated. Percentages of mono, bi, and polyparasitism were determined. The socio-environmental study included a structured questionnaire, completed by the parents, which provided information about interior and exterior housing conditions. We asked about: building materials; source of drinking water; wastewater disposal; fuel for cooking and heating; pavement; electricity, waste collection, and critical crowding (more than three persons per room). Regarding socio-economic status, the following variables were considered: lodging or hometenure status; parental job and educational level; technology and equipment (computer, car, air conditioning, etc); health insurance; public assistance; and farming. Nutritional categories, body proportion and composition as well as parasitological prevalence were compared using X2 tests and logistic regression. Socio-environmental analysis was analyzed by catPCA and the differences tested by X2. All statistical procedures were made with SPSS 12.0 statistical program. The results indicated that the children population of San Rafael has an adequate average weight but a smaller height than the reference. The brachial body composition is modified since the perimeter and the muscle area is decreased and the adipose tissue increased. The prevalence of malnutrition is 9%, prevailing stunting over underweight and wasting. The low height is greater at 11 and 12 years of age, possibly as a result of the economic crisis occurred in our country in 2001. Stunting is accompanied by elevated shortening of the legs being more prevalent in men and providing new evidence of the women resistance in stressful environments. At the other extreme, excess of weight was 22%, being overweight slightly higher than obesity and more prevalent in children under six years, probably, in response to obesogenic behaviors coupled with the implementation of welfare policies for mothers and children of those ages that usually include hypercaloric but hypoproteic foods. Proof of this is the presence of excess of adipose tissue, accompanied by muscle tissue deficit. Obesity was more prevalent in males, also presenting centralized adiposity. In females the centralization is present in both overweight and obese. More than half of the population is parasitized, being undernourished children those with the highest prevalence. The specific richness is 11 species, 8 being the most prevalent Blastocystis hominis and Enterobius vermicularis. Climatic and soil conditions of San Rafael limits the viability and development of helminthes eggs. However, it should be noted the presence of soil transmitted helminthes in migrant families. The analysis of the socio-environmental characteristics, beyond the urbanrural dichotomy, allows us to recognize the heterogeneity of the study area and to distinguish four groups, three equivalents to urban characteristics and the fourth to the rural ones. Urban groups (high, medium and impoverished) differ from each other by the level of education and socio-economic situation of the family. The rural environment is characterized by tenure of orchard, raising animals for consumption and poor provision of public services. The rural and urban impoverished environments show a higher prevalence of undernutrition, pathogenic species, species richness and soil transmitted helminthes. Still, rural children have higher prevalence of underweight and deficit of muscle tissue, demonstrating that lifestyle and rural household economy are not effective enough to mitigate nutritional deficiencies. Conversely, the “high urban” group, with better sanitary conditions and high level of education and job of the parents, has lower prevalence of parasites and species richness. However, this group has greater excess of weight, probably for the better access to highenergy foods, household technology and sedentary habits. At last, the “medium urban” environment shares with the “highest urban” the education level and formal employment of the parents as well as the best building homes. However it differs by less comfort and greater access to public services. While the prevalence of malnutrition is similar, the excess weight is lower being the deficit muscle tissue greater. Finally, it is clear that human populations have high phenotypic variability, variability that in many of them and especially in San Rafael, results from the adaptation time at that great bio-physical-cultural environment.

Made available in DSpace on 2015-03-26T13:46:38Z (GMT). No. of bitstreams: 1 texto completo.pdf: 581786 bytes, checksum: 8b2fc3fbb4c202f3a85a87fe53745cd7 (MD5) Previous issue date: 2008-12-11 / Enteroparasitosis and anemia are two major public health problems, particularly when involving young children and pregnant women. Analysis of data from consultations and medical records of pregnant women assisted in the communities of Nova Viçosa and Posses, municipality of Viçosa-MG, the present study showed the need for control and prevention, mainly because the serious consequences of these diseases, standing out the impairment of the cognitive function and learning ability, as well as several physiological complications that can lead patients to death. Social determinants and epidemiological data were collected through the situational diagnosis for health care systems. Socio-economic, socio-demographic, socio-environmental and socio-cultural characteristics were examined. Samples of 270 pregnancies occurring over a period of 3 years - October/2005 to September/2008 - were used in the work in a descriptive transversal study. The prevalence found for enteroparasites was (59/152) 38.8% and for iron deficiency anemia was 52/152 (34.2%). The overall prevalence of helminths in this study was (24/152) 15.8%, and protozoa (42/152) 27.6%. It is emphasized the women s very low income and limited education, besides the high number of residents per household. It was confirmed the relationship between enteroparasitosis and variables of the health diagnosis, as well as it occurred with iron deficiency anemia, when it was also related to the diagnosis. The per capita income was statistically associated with the presence of anemia. Although the association between anemia and enteroparasitosis was not statistically confirmed, and, considering the very poor social conditions that the women from those communities are subjected, the need for control and prevention measures to protect those people is demonstrated, since the poor conditions certainly increase the risk of morbidity in those women. / As enteroparasitoses e a anemia ferropriva são dois grandes problemas de Saúde Pública, principalmente quando acometem crianças jovens e gestantes. Através da análise de dados obtidos junto às consultas e prontuários das gestantes assistidas nas comunidades de Nova Viçosa e Posses, município de Viçosa-MG, esse presente estudo demonstrou a necessidade de medidas de controle e prevenção, principalmente pelas graves conseqüências dessas patologias, destacando-se o comprometimento da função cognitiva e da habilidade para o aprendizado, além de várias intercorrências fisiológicas que podem levar pacientes acometidos por essas doenças ao óbito. Buscou-se os determinantes sociais e os dados epidemiológicos através da realização do Diagnóstico Situacional de Saúde . Foram analisadas características sócio-econômicas, sócio-demográficas, sócioambientais e sócio-culturais. O trabalho teve como amostra 270 gestações ocorridas em um período de 3 anos: outubro/2005 a setembro/2008, por meio de um estudo descritivo transversal. A prevalência encontrada em relação aos enteroparasitas foi de (59/152) 38,8%; e em relação à anemia ferropriva foi 52/152 (34,2%). A prevalência geral de helmintos nesse estudo foi de (24/152) 15,8%; e de protozoários (42/152) 27,6%. Destacam-se baixíssima renda e a limitada escolaridade das gestantes, além do alto número de moradores por família. Constatou-se a existência de relação das enteroparasitoses com as variáveis do Diagnóstico de Saúde realizado, assim como ocorreu com a anemia ferropriva, quando também relacionada a esse Diagnóstico. A renda per capita esteve estatisticamente associada com a presença de anemia ferropriva. Apesar de não ter sido confirmada estatisticamente associação entre anemia ferropriva e enteroparasitoses, e ainda, considerando as péssimas condições sociais a que estão submetidas as gestantes daquelas comunidades assistidas, ficou evidenciada a necessidade de medidas de controle e prevenção para a proteção daquelas pessoas, pois essas precárias condições certamente potencializaram os riscos de morbidade daquelas gestantes.

Introducción. El estado nutricional de los individuos es considerado un valioso indicador del estado de salud de la población, así como también del accionar de factores socio-económicos y ambientales. Objetivos: Analizar la relación entre el estado nutricional, las enteroparasitosis y las condiciones socioambientales en niños de Aristóbulo del Valle, Misiones. Métodos. Estudio antropométrico transversal y parasitológico en niños de ambos sexos y entre 6 a 11 años de escuelas públicas del Municipio de Aristóbulo del Valle. Para el análisis de desnutrición se utilizó como referencia CDC/NCHS y para exceso de peso IOTF. El análisis parasitológico se realizó mediante la toma de muestras seriadas de materia fecal y escobillado anal. El relevamiento de las condiciones socio-ambientales se realizó mediante encuestas estructuradas. Resultados. El estado nutricional indicó mayor desnutrición crónica (7,5%) que global y aguda y mayor sobrepeso (9,8%) respecto a obesidad. Los niños presentaron alto porcentaje de parasitismo (86%) y las especies más prevalentes fueron Blastocystis hominis, Enterobius vermicularis y Giardia lamblia. La mayoría de las familias de estos niños habitaban viviendas de chapa y madera, con limitado acceso a servicios públicos, altos niveles de desempleo y padres con un nivel educativo básico. / Introduction: The study of the growth and nutritional status of the individuals is considered an important sign of the population health, as well as the action of socio-economic and environmental factors. Objectives: To analyze the relationship among the nutritional status, enteroparasitoses and socio-environmental conditions in children from Aristóbulo del Valle, Misiones. Methods: A cross-sectional anthropometrical and parasitological study was made in children from both sexes between 6 to 11 years old of public school from Municipality of Aristóbulo del Valle. NCHS was employed as reference in the analysis of undernutrition, and IOTF for the excess of weight. The parasitological analysis was realized by faecal samples and anal brushes. Socio-environmental conditions were evaluated through structured interviews. Results: The nutritional status indicated higher chronic undernutrition (7.5%) than underweight and wasting, and higher overweight than obesity (9.8%). Children showed high percentage of parasitism (86%) and Blastocystis hominis, Enterobius vermicularis and Giardia lamblia were the more prevalent species. Most families of these children live in precarious constructions made out of wood and/or masonry, with limited access to public services, high unemployment levels and a basic educational level of parents. Conclusions: The results obtained indicate the impact of the socio-economic, educational and sanitary impairment, in the children health from a sector Aristóbulo del Valle population, that entails to the coexistence of undernutrition, overweight and parasitic infections.

Submitted by Viviane Lima da Cunha (viviane@biblioteca.ufpb.br) on 2017-06-20T11:29:15Z No. of bitstreams: 1 arquivototal.pdf: 2425115 bytes, checksum: 0a069034ec42247b7c39a39cd02f6f63 (MD5) / Made available in DSpace on 2017-06-20T11:29:15Z (GMT). No. of bitstreams: 1 arquivototal.pdf: 2425115 bytes, checksum: 0a069034ec42247b7c39a39cd02f6f63 (MD5) Previous issue date: 2017-02-22 / Intestinal parasites are recognized as a major public health problem in developing countries. Enteroparasites are neglected diseases or neglected tropical diseases because they correspond to a group of diseases that predominantly affect the poorest and most vulnerable populations, contributing to the cycle of poverty, inequality and social exclusion. In Brazil the enteroparasitoses are still very widespread and with high prevalence, mainly in the Northeast region. The prevalence of enteroparasitoses in school-aged children is higher due to their inadequate hygiene habits, causing an outbreak of enteroparasitosis culminating for pathological effects in their host in relation to malnutrition, anemia, diarrhea, school use and nutritional deficit. The present study aims to determine the prevalence of enteroparasitoses in school - aged children, as well as to establish a relationship between the results to be obtained and the socioeconomic, health and nutritional conditions in these children. It is an observational study with a cross-sectional design and descriptive analysis, carried out with a sample of 150 children who study at the Lions Tambaú Elementary School, in the city of João Pessoa - PB. The logistic regression model was used to explain the occurrence of enteroparasitoses and to subsidize decision making based on the socioeconomic, nutritional and health variables of the children collected in the study. The prevalence of enteroparasitosis was 38.7%, children with a positive sample of these were more prevalent in male children (47.0%). The most prevalent enteroparasites were enterocomial protozoa, which presented 63.6%, which are related to the consumption of contaminated water, as well as the lack of hygiene of the people. The variables that presented statistical significance (p-value <0.05) were: gender (OR = 0.42), receive family allowance (OR = 4.42), number of rooms in the residence (OR = 3.46), (OR = 4.25), fruit and vegetable hygiene (OR = 2.03), walks barefoot (OR = 6.98), use of vermifuge for human (OR = 0.02) and visualization of Worms (OR = 24.9). The occurrence of these data reinforces the need to implement preventive measures of a theoretical and practical nature, such as health education, in order to demonstrate the damage of parasitic diseases through hygiene, basic sanitation, prevention and recognition of signs and symptoms indicative of Enteroparasitoses. / As parasitoses intestinais são reconhecidas como um grande problema de saúde pública em países em desenvolvimento. As enteroparasitoses são doenças consideradas negligenciadas ou doenças tropicais negligenciadas por corresponderem a um grupo de doenças que afeta predominantemente as populações mais pobres e vulneráveis, contribuindo para o ciclo da pobreza, desigualdade e exclusão social. No Brasil as enteroparasitoses ainda se encontram bastante disseminadas e com alta prevalência, principalmente na região Nordeste. A prevalência de enteroparasitoses em crianças em idade escolar é maior devido os seus hábitos de higiene inadequados fazendo com que surja um quadro de enteroparasitose culminando para efeitos patológicos no seu hospedeiro em relação a desnutrição, anemia, diarreia, aproveitamento escolar e déficit nutricional. O presente trabalho visa determinar a prevalência das enteroparasitoses em crianças em idade escolar, bem como estabelecer uma relação entre os resultados a serem obtidos e as condições socioeconômicas, saúde e nutricional nestas crianças. Trata-se de um estudo observacional com delineamento transversal e análise descritiva, realizado com uma amostra de 150 crianças que estudam na Escola de Ensino Fundamental Lions Tambaú, no município de João Pessoa - PB. Foi utilizado o modelo de regressão logística para explicar a ocorrência de enteroparasitoses e subsidiar a tomada de decisão a partir das variáveis da condição socioeconômica, nutricional e saúde das crianças coletadas no estudo. A prevalência de enteroparasitose foi de 38,7% crianças com amostra positiva dessas foi mais prevalente nas crianças do sexo masculino (47,0%). Os enteroparasitos de maior prevalência foram os protozoários enterocomensais que apresentaram 63,6%, que estão relacionados com o consumo de água contaminada, além da falta de higiene das pessoas. As variáveis que apresentaram significância estatística (p-valor < 0,05) foram: sexo (OR= 0,42), recebe bolsa família (OR= 4,42), quantidade de cômodos na residência (OR= 3,46), núcleo familiar (OR=4,25), processo de higienização das frutas e verduras (OR= 2,03), anda descalço (OR= 6,98), uso de vermífugo para humano (OR= 0,02) e visualização de vermes (OR= 24,9). A ocorrência desses dados reforça a necessidade de serem implantadas medidas preventivas de cunho teórico e prático, como educação sanitária, com o intuito de demonstrar os danos das doenças parasitárias através de noções de higiene, saneamento básico, prevenção e reconhecimento de sinais e sintomas indicativos de enteroparasitoses.

Intestinal parasites are a problem of great public health importance. Both in rural areas as in urban areas, they are widespread due to poor sanitation and irrigation water is one of the major intestinal diseases transmission vehicles. We evaluated the prevalence of intestinal parasites in children aged 7 to 11, from a public school in Maceio, through parasitological examination of Lutz, popularly known as HPJ in two steps (with and without drug treatment) investigating whether there influence of sanitation and socioeconomic and environmental conditions. After preventive education and adequate pharmacological treatment, repeated parasitology and the physical analysis, chemical (titration of complexation and Argentometric - Alfakit/Ecokit) and microbial by the Technical Multiple tubes of water. It was the prevalence of Giardia lamblia and Ascaris lumbricoides in 59.25% of the positive samples. After preventive education and adequate pharmacological treatment the prevalence of intestinal parasites was statistically significant (p <0.05), being effective in reducing the degree of parasitism in the period. The water distributed for consumption at the Municipal School Rui Palmeira is not within the potability standards required by Brazilian law. The concentration of residual chlorine and the presence of fecal coliform leaves unsuitable for consumption. The study showed that not enough only minimum conditions of sanitation and public policy of urban and housing planning must also be encouraged educational practices of tutoring to raise awareness of the need to acquire the knowledge to prevent parasites. / As parasitoses intestinais representam um problema de grande importância em Saúde Pública. Tanto nas áreas rurais quanto nas urbanas, elas são amplamente difundidas devido às más condições sanitárias, sendo a água um dos principais veículos de transmissão de enfermidades intestinais. Avaliou-se a prevalência de enteroparasitos em crianças em idade entre 7 e 11 anos, de uma escola pública de Maceió, por meio de exame parasitológico de Lutz, conhecido popularmente como HPJ, em duas etapas (sem e com tratamento farmacológico) investigando se existe influência do saneamento básico e das condições socioeconômica e ambiental. Após educação preventiva e tratamento farmacológico adequado, repetiu-se o exame parasitológico bem como as análises físico, química (Titulação de complexação e argentimétrica – Alfakit/Ecokit) e microbiológica, pela Técnica dos Tubos Múltiplos da água. Verificou- se a prevalência de Giárdia lamblia e Ascaris lumbricoides em 59,25% das amostras positivas. Após educação preventiva e tratamento farmacológico adequado a prevalência de enteroparasitos foi estatisticamente significativa (p<0,05), sendo eficaz para reduzir o grau de parasitismo no período. A água distribuída para consumo na Escola Municipal Rui Palmeira não se apresenta dentro dos padrões de potabilidade exigidos pela legislação brasileira. A concentração de cloro residual e a presença de coliformes termotolerantes a deixa inadequada para o consumo. O estudo evidenciou que não bastam apenas mínimas condições de saneamento básico e políticas públicas de planejamento urbano e habitacional, há também que se incentivar práticas educacionais de orientação pedagógica para a conscientização da necessidade de adquirirem os conhecimentos para prevenção de parasitoses.

Made available in DSpace on 2014-08-20T14:31:31Z (GMT). No. of bitstreams: 1 dissertacao_ana_berne.pdf: 2199093 bytes, checksum: 8e27f9fa1c22e061e919175c81aa8bb3 (MD5) Previous issue date: 2007-03-30 / The enteroparasitosis remains as an important public health problem in children in the Brazil, showing variable prevalence, according to the State and evaluated population. Studies with day-care center children are scarce, however, already knows that the exposure of the children in these places increased the susceptibility to parasitosis. Among the parasitosis the protozoary Giardia lamblia is responsible for severe diarrhea cases in children and the routine diagnosis methods presents many false negative results. The aim of this study was investigate the enteroparasitosis prevalence in children from a day-care public center of Rio Grande county, Rio Grande do Sul State and compare diagnosis techniques in samples of their fecal material to Giardia lamblia , the ELISA immunoassay and the centrifugal-sedimentation methods. 165 fecal samples where evaluated and processed by centrifugal-sedimentation and centrifugal-flotation methods, stained by trichromium and Kinyoun after the concentration by centrifugal-sedimentation. The general prevalence of enteroparasitosis was 64,2% (106/165). The most prevalent nematods species founded was Trichuris trichiura (24,2%) and Ascaris lumbricoides (22,4%) and the the most prevalent protozoary specie was Giardia lamblia (30,3%). The presence of opportunists coccids where also registered Cryptosporidium spp. (2,4%) and Isospora belli (0,6%). Among the positives 56,6% (60 samples) showed simple infection and 43,4% (46 samples) showed associated infection. The presence of non pathogenic protozoary like Entamoeba coli (15,2%), Endolimax nana (3,6%) and Enteromonas hominis (4,8%), indicated environmental fecal source contamination. The higher prevalence of nematods and protozoary in the studied population suggests the necessity of implementation of educational measures to prevent these enteroparasites. In the evaluation of comparative diagnosis of G. lamblia a higher positivity was verified in the ELISA technique 57% (90/158), followed by the centrifugal-sedimentation method 27,8% (44/158). The obtained results in this study suggests that is higher the prevalence of nematods and protozoary in the evaluated children and the ELISA technique to detect antigen in fecal sample showed higher efficiency to giardiasis diagnosis. / As enteroparasitoses ainda constituem um importante problema de saúde pública em crianças no Brasil, com prevalências bastante variáveis, conforme a região e população avaliada. Estudos com crianças que freqüentam creches são escassos, entretanto, sabe-se que nestes ambientes, as crianças estão mais expostas as parasitoses, dentre as quais o protozoário Giardia lamblia que é responsável por quadros graves de diarréia em crianças e os métodos de rotina utilizados no diagnóstico levam a muitos casos de falso-negativos. O objetivo deste trabalho foi investigar a prevalência de enteroparasitos em crianças de uma creche pública do Rio Grande, cidade portuária, localizada na região sul do estado do Rio Grande do Sul e comparar a técnica de ELISA (kit comercial Giardia II) com os métodos de centrífugo-flutuação e centrífugo- sedimentação para o diagnóstico de G. lamblia em fezes de crianças. Primeiramente foram avaliadas 165 amostras de fezes de processadas pelo método de centrífugo-sedimentação e centrífugo-flutuação e pelas colorações de tricrômio e de Kinyoun. A prevalência geral de enteroparasitos foi de 64,2% (106/165). Os nematódeos mais prevalentes foram Trichuris trichiura (24,2%) e Ascaris lumbricoides (22,4%) e o protozoário mais prevalente foi G. lamblia (30,3%). Também foram registradas as presenças dos coccídeos oportunistas Cryptosporidium (2,4%) e Isospora belli (0,6%). Dentre os positivos, 56,6% (60) apresentaram infecção simples e 43,4% (46) associadas. Constatou-se também a presença de protozoários não patogênicos, como Entamoeba coli (15,2%), Endolimax nana (3,6%) e Enteromonas hominis (4,8%), que indicou contaminação de origem fecal do ambiente. A alta prevalência de nematódeos e protozoários na população estudada sugere a necessidade de implementação de medidas educacionais, visando a prevenção destes enteroparasitos. Na avaliação do diagnóstico comparativo de G. lamblia foi verificado maior positividade para a técnica de ELISA, 57% (90/158), seguido do método de centrifugo-flutuação, 30,3% (48/158) e centrífugo-sedimentação, 27,8% (44/158). A partir dos resultados obtidos no presente estudo pode-se concluir que é alta a prevalência de nematódeos e protozoários nas crianças avaliadas e que a técnica de ELISA para detectar antígenos nas fezes é mais eficiente que os métodos de centrífugo-flutuação e centrifugo-sedimentação, podendo, portanto, ser utilizada, tanto no diagnóstico individual como em estudos epidemiológicos da giardíase.