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A crescente urbanização associada à multiplicação do número de cidades e o aumento populacional, especialmente nos países em desenvolvimento, têm favorecido o surgimento e o crescimento desordenado das comunidades com consequente dificuldade de acesso aos serviços básicos, inadequadas condições de moradia e exposição a diversos contaminantes ambientais que contribuem para a baixa qualidade de vida e saúde. As parasitoses intestinais apresentam íntima relação com as condições sanitárias, constituindo um relevante problema de saúde pública com maior prevalência entre indivíduos de baixo nível socioeconômico. A ocorrência e manifestação da sintomatologia decorrente de uma infecção parasitária também se associa, principalmente, com a imaturidade do sistema imunológico em crianças com idade ntre 0 e 6 anos, que têm no ambiente de creches e pré-escolas outro importante fator que pode contribuir para a contaminação. Embora sejam crescentes os relatos de parasitismo intestinal em crianças que frequentam creches, ainda são escassas as pesquisas direcionadas aos pré- escolares da região Sul da Bahia, Brasil. Por essa razão, o objetivo deste estudo foi identificar a prevalência de Cryptosporidium spp. e Giardia lamblia em crianças de 0 a 6 anos que frequentam creches municipais de Itabuna, cidade localizada na região Sul do estado da Bahia. Para atender aos objetivos propostos foram aplicados dois questionários, um as diretoras das creches/pré-escolas, visando realizar o levantamento das condições de saneamento e práticas de higiene alimentar no ambiente escolar e outro aos responsáveis legais das crianças, com o intuito de conhecer as condições individuais e familiares dos participantes. Para pesquisa de Cryptosporidium spp. e Giardia lamblia foram coletadas três amostras fecais por sujeito da pesquisa, processadas e analisadas pelos métodos de Ziehl- Neelsen adaptado e Mariano & Carvalho, respectivamente. A prevalência de Cryptosporidium spp. e Giardia lamblia foi de 39,10% e 29,49%, respectivamente. A grande maioria das crianças é de famílias de baixa condição social e baixo nível de escolaridade, possuem alta quantidade de moradores por residência (transmissão interpessoal). Estes aspectos constituem fatores facilitadores para a disseminação desses parasitas na população estudada. O hábito de não lavar as mãos com água e sabão também se mostrou um fator facilitador a infecção por Giardia lamblia e Cryptosporidium spp., manter as unhas cortadas e limpas diminui a exposição dos indivíduos a infecção por Giardia lamblia. Diante dos resultados, a investigação das enteroparasitoses, em especial da criptosporidíase e giardíase em pré- escolares de Itabuna, Bahia, Brasil é fundamental, devido o alto índice de positividade dos exames coproparasitológicos. Tal aspecto, aliado à escassez de estudos sobre o tema nessa região, mostra claramente que se trata de um problema de saúde pública e que se tornam necessárias melhorias no planejamento estratégico da aplicação dos recursos financeiros em prol do controle das parasitoses no município / Increasing urbanization linked to the multiplication of the number of cities and population growth, especially in developing countries, have favored the emergence and the uncontrolled growth of communities resulting in poor access to basic services, inadequate housing conditions and exposure to several environmental contaminants that contribute to poor quality of life and health. The Intestinal parasitosis shows a close relationship with sanitary conditions representing an important public health problem with higher prevalence among individuals of low socioeconomic status. The occurrence and presenting of symptoms resulting from a parasitic infection are also mainly associated with the immune system immaturity in children aged between 0 and 6 years, who have in their daycare and kindergarten environment another important determinant that could contribute to contamination. Although the reports about intestinal parasitism in children attending day care centers are increasing, there is still scarse research addressing kindergarten children in Southern Bahia, Brazil. Therefore, the aim of this study was to identify the prevalence of Cryptosporidium spp. and Giardia lamblia in children aged fron 0 to 6 years old who are attended in some of Itabuna\'s daycare centers. Itabuna city is located in the southern area of Bahia state. To meet the objectives proposed two questionnaires were applied , one to the daycare / kindergarten directors, in order to survey the conditions of sanitation and food hygiene practices in the school environment and other to the legal guardians, in order to find out the individual and family conditions of the participants. For the detection of Cryptosporidium spp. and Giardia lamblia three fecal samples were collected for each research subject, processed and analyzed by the Ziehl-Neelsen adapted, and Mariano & Carvalho methods, respectively. The prevalence of Cryptosporidium spp. Giardia lamblia were 39,10% and 29,49%, respectively. The large majority of children come from families of low social status, and educational level, live in enviroment with a high number of residents per household (person transmission). These aspects are factors that facilitate the spreading of these parasites in the studied group. The habit of not washing hands with soap and water was also a facilitating factor to infection by Giardia lamblia and Cryptosporidium spp., keep nails clean and cut decreases the exposure of individuals to infection by Giardia lamblia. Given the results, the investigation of intestinal parasites, especially giardiasis and cryptosporidiosis in the kindergarten schools Itabuna, Bahia, Brazil is critical, because of the high rate of positive results of fecal examinations. This aspect, together with the scarcity of studies on the subject in this region, clearly shows that it is a public health problem and that improvements are required in the strategic planning of the financial resources uses to the control of parasitic diseases in the city

Diss. (sammanfattning) Stockholm : Karol. inst., 2004. / Härtill 4 uppsatser.

A crescente urbanização associada à multiplicação do número de cidades e o aumento populacional, especialmente nos países em desenvolvimento, têm favorecido o surgimento e o crescimento desordenado das comunidades com consequente dificuldade de acesso aos serviços básicos, inadequadas condições de moradia e exposição a diversos contaminantes ambientais que contribuem para a baixa qualidade de vida e saúde. As parasitoses intestinais apresentam íntima relação com as condições sanitárias, constituindo um relevante problema de saúde pública com maior prevalência entre indivíduos de baixo nível socioeconômico. A ocorrência e manifestação da sintomatologia decorrente de uma infecção parasitária também se associa, principalmente, com a imaturidade do sistema imunológico em crianças com idade ntre 0 e 6 anos, que têm no ambiente de creches e pré-escolas outro importante fator que pode contribuir para a contaminação. Embora sejam crescentes os relatos de parasitismo intestinal em crianças que frequentam creches, ainda são escassas as pesquisas direcionadas aos pré- escolares da região Sul da Bahia, Brasil. Por essa razão, o objetivo deste estudo foi identificar a prevalência de Cryptosporidium spp. e Giardia lamblia em crianças de 0 a 6 anos que frequentam creches municipais de Itabuna, cidade localizada na região Sul do estado da Bahia. Para atender aos objetivos propostos foram aplicados dois questionários, um as diretoras das creches/pré-escolas, visando realizar o levantamento das condições de saneamento e práticas de higiene alimentar no ambiente escolar e outro aos responsáveis legais das crianças, com o intuito de conhecer as condições individuais e familiares dos participantes. Para pesquisa de Cryptosporidium spp. e Giardia lamblia foram coletadas três amostras fecais por sujeito da pesquisa, processadas e analisadas pelos métodos de Ziehl- Neelsen adaptado e Mariano & Carvalho, respectivamente. A prevalência de Cryptosporidium spp. e Giardia lamblia foi de 39,10% e 29,49%, respectivamente. A grande maioria das crianças é de famílias de baixa condição social e baixo nível de escolaridade, possuem alta quantidade de moradores por residência (transmissão interpessoal). Estes aspectos constituem fatores facilitadores para a disseminação desses parasitas na população estudada. O hábito de não lavar as mãos com água e sabão também se mostrou um fator facilitador a infecção por Giardia lamblia e Cryptosporidium spp., manter as unhas cortadas e limpas diminui a exposição dos indivíduos a infecção por Giardia lamblia. Diante dos resultados, a investigação das enteroparasitoses, em especial da criptosporidíase e giardíase em pré- escolares de Itabuna, Bahia, Brasil é fundamental, devido o alto índice de positividade dos exames coproparasitológicos. Tal aspecto, aliado à escassez de estudos sobre o tema nessa região, mostra claramente que se trata de um problema de saúde pública e que se tornam necessárias melhorias no planejamento estratégico da aplicação dos recursos financeiros em prol do controle das parasitoses no município / Increasing urbanization linked to the multiplication of the number of cities and population growth, especially in developing countries, have favored the emergence and the uncontrolled growth of communities resulting in poor access to basic services, inadequate housing conditions and exposure to several environmental contaminants that contribute to poor quality of life and health. The Intestinal parasitosis shows a close relationship with sanitary conditions representing an important public health problem with higher prevalence among individuals of low socioeconomic status. The occurrence and presenting of symptoms resulting from a parasitic infection are also mainly associated with the immune system immaturity in children aged between 0 and 6 years, who have in their daycare and kindergarten environment another important determinant that could contribute to contamination. Although the reports about intestinal parasitism in children attending day care centers are increasing, there is still scarse research addressing kindergarten children in Southern Bahia, Brazil. Therefore, the aim of this study was to identify the prevalence of Cryptosporidium spp. and Giardia lamblia in children aged fron 0 to 6 years old who are attended in some of Itabuna\'s daycare centers. Itabuna city is located in the southern area of Bahia state. To meet the objectives proposed two questionnaires were applied , one to the daycare / kindergarten directors, in order to survey the conditions of sanitation and food hygiene practices in the school environment and other to the legal guardians, in order to find out the individual and family conditions of the participants. For the detection of Cryptosporidium spp. and Giardia lamblia three fecal samples were collected for each research subject, processed and analyzed by the Ziehl-Neelsen adapted, and Mariano & Carvalho methods, respectively. The prevalence of Cryptosporidium spp. Giardia lamblia were 39,10% and 29,49%, respectively. The large majority of children come from families of low social status, and educational level, live in enviroment with a high number of residents per household (person transmission). These aspects are factors that facilitate the spreading of these parasites in the studied group. The habit of not washing hands with soap and water was also a facilitating factor to infection by Giardia lamblia and Cryptosporidium spp., keep nails clean and cut decreases the exposure of individuals to infection by Giardia lamblia. Given the results, the investigation of intestinal parasites, especially giardiasis and cryptosporidiosis in the kindergarten schools Itabuna, Bahia, Brazil is critical, because of the high rate of positive results of fecal examinations. This aspect, together with the scarcity of studies on the subject in this region, clearly shows that it is a public health problem and that improvements are required in the strategic planning of the financial resources uses to the control of parasitic diseases in the city

Diarrhea caused by rotavirus and Giardia is a major health problem among children attending day-care centers because of inadequate personnel hygiene. Epidemiological evidence suggesting person-to-person transmission of enteric pathogens has long been recognized. This study was initiated to investigate the effectiveness of handwashing for the removal of rotavirus and Giardia from contaminated hands. The palms of participant hands were innoculated with approximately 103 Giardia cysts or 105 plaque forming units of rotavirus and the effect of washing using tap water alone, a liquid soap or a bar soap on their removal was assessed. Handwashing with liquid soap was found to be very effective in the removal of rotavirus and Giardia cysts as compared to washing with bar soap or tap water alone. The overall recovery of viruses in both bar soap and liquid soap was low (0.03-22.5%), probably due to virus inactivation by the detergent.

Evalúa los parámetros de tiempo, temperatura y concentración de antimicrobianos para el crecimiento de Giardia lamblia en medio de cultivo TYI-S-33 comercial y artesanal. Se llevó a cabo en el Laboratorio de Enteroparásitos de la DEET, del Centro Nacional de Salud Pública del Instituto Nacional de Salud. Se trabajó con la cepa de Giardia intestinalis ATCC 30957 criopreservada a -70°C procedente de un aspirado duodenal de un paciente varón y se reactivó en medio TYI-S-33 comercial, las resiembras se realizaron en medio TYI-S-33 comercial y artesanal, que contenían los antibióticos; penicilina (394 U/ml), estreptomicina (394 μg/ml), gentamicina (50 μg/ml) y amikacina (156 μg/ml), para comparar la carga parasitaria en cada uno de ellos y determinar el mejor medio de cultivo para su desarrollo. Así mismo, se determinó la curva de crecimiento durante 216 horas a tres temperaturas distintas (36°C, 36.5°C y 37°C) determinándose que Giardia lamblia tiene un mejor crecimiento en medio de cultivo TYI-S-33 artesanal a 37°C y una fase log entre las 72 a 120 horas. / Tesis

Giardia lamblia, an enteric protozoan parasite, infects a large number of individuals worldwide. In South Africa prevalences ranging between 4 and 63% are documented, however, the impact of giardiasis is underreseached in this country. Giardia infections vary from asymptomatic carriage or a self-limiting acute symptomatic illness to chronic, debilitating malabsorption syndrome. The factors responsible for development of symptomatic versus asymptomatic infection are poorly understood. It is believed by some that host factors determine the clinical outcome of infection. On the other hand, the possibility of the existence of pathogenic and non-pathogenic strains (a situation akin to Entamoeba spp.) remains to be explored. One requirement for investigation of the potential contribution of strain differences to pathogenecity of infection is establishment of laboratory cultures of different strains isolated from symptomatic and asymptomatic patients. The present study was undertaken to develop and modify existing methods for: (i) establishment of laboratory cultures of Giardia trophozoites from excystation of faecal cysts, (ii) long-term maintenance and cryopreservation of the cultures and (iii) preliminary characterisation methodology. One thousand and twenty-three stool specimens were collected from day care centres, hospital wards and Hlabisa hospital laboratory. A further 6246 were retrieved from the Microbiology Laboratory at King Edward VIII Hospital and screened by direct wet preparation. Giardia was detected by light microscopy following formol-ether concentration (127 of 1023 samples) or direct examination of wet preparations (78 of 6246 samples). Cysts were purified from the positive specimens by sucrose gradient separation. Viability was assessed by a dye-exclusion method (eosin). Three in vitro excystation techniques were employed in an attempt to obtain trophozoites for initiation and establishment of viable cultures thereof. Culture conditions were optimised using two reference strains of Giardia, WB & H7 (obtained from the National Institutes of Health, USA). The percentage excystation ranged between 0-42% with all the in vitro methods of excystment. Excysted trophozoites remained viable in TYI-S-33 culture medium for periods ranging between 12-72 hours or up to 9 days, and gradually died, hence viable trophozoite cultures could not be established. Some culture initiates (overall 65%) were lost through overwhelming bacterial and!or fungal contaminants. An animal model was subsequently set up in which C57BL/6 and Praomys (Mastomys) coucha mice were used for in vivo excystation experiments. 1-3 day old suckling mice were intragastrically injected with 10,5 -cysts/ ml in 0,1 ml distilled water. Trophozoites were retrieved from the stomachs of infected mice 7-10 days after inoculation and cultivated in TYI-S-33 medium. Six local isolates were axenised using the in vivo excystation method. They have been maintained for more than 15 months in culture after stabilates and Iysates of confluent growths had been cryopreserved in Liquid Nitrogen. Successful (100%) retrieval of the cryopreserved cultures has been achieved. Seven isoenzyme electrophoresis systems have been set up and optimised. Reproducible results were obtained in six of the enzymes. Some differences in banding patterns of the enzymes were demonstrated. / Thesis (M.Med.Sc.)-University of Natal, Durban, 1999.

In mice infected with 10$ sp4$ Giardia muris cysts, a peak lymphocyte proliferation in the spleen and Peyer's patches in response to Giardia extract occurred during the elimination and latent phases, respectively. This shows that the Peyer's patch cells are more responsive than the spleen to Giardia infection. Th2-type cytokines produced by Peyer's patch cells may play a protective role during the latent and acute phases. Th1-type cytokines may contribute to this production during the elimination phase. Cytokine production in response to Giardia extract in vitro was observed in mice immunized with this extract, but not in control mice. Therefore, Giardia antigen can induce cytokine production in vitro in a specific manner.