Prevalência de infecções enteroparasitárias e soroprevalência de Toxoplasma gondii em idosos atendidos pela Estratégia Saúde da Família

• Autor(a) principal: Engroff, Paula
• Data de Publicação: 2014
• Tipo de documento: Tese
• Idioma: por
• Título da fonte: Biblioteca Digital de Teses e Dissertações da PUC_RS
• Texto Completo: http://tede2.pucrs.br/tede2/handle/tede/2718
• topic: MEDICINA; GERIATRIA; IDOSOS; TOXOPLASMOSE; INFECÇÕES ENTEROPARASITÁRIAS; CNPQ::CIENCIAS DA SAUDE::MEDICINA

Introduction : Parasitic infections are a public health problem in Brazil and in other developing countries with variations according to sanitation, socioeconomic status, educational level, age, and hygienic habits, among other variables. In the elderly population, few studies have been published about intestinal parasites and Toxoplasma gondii infections. Objective : To evaluate the prevalence of intestinal parasitic infections and T. gondii seroprevalence associated with the demographic, socioeconomic, hygienic, sanitary and health conditions of the elderly of the Family Health Strategy (FHS) in the city of Porto Alegre, Rio Grande do Sul, Brazil. Methods : This cross-sectional study collected a random sample of FHS elderly individuals living in the city of Porto Alegre, from march 2011 to december 2012. For selection of the elderly, 30 FHS teams were selected, of which 36 respondents were randomly selected by ESF. Data collection was conducted by Community Health Workers (CHW) during home visits; the CHW administered a general epidemiological questionnaire and provided instructions to each patient regarding the collection of fecal samples. Blood and stool samples were collected later by the project team at the healthcare unit where each elderly individual was registered. The blood samples intended for hemograms were sent to the Clinical Pathology Laboratory of the São Lucas Hospital. The blood samples intended for toxoplasmosis examination and the fecal samples intended for parasitological stool examination were sent to the Biochemistry, Molecular Genetics and Parasitology Laboratory of the Institute of Geriatrics and Gerontology, PUCRS. Results : The prevalence of intestinal parasites was 10.8%, with the following frequencies: 29 (44.0%), Endolimax nana; 21 (32.0%), Entamoeba coli; 6 (9.0%), Giardia lamblia; 4 (6.0%), Ascaris lumbricoides; 3 (5.0%), Strongyloides stercoralis; 2 (3.0%), Trichuris trichiura; and 1 (2.0%), Iodamoeba butschlii. We found no significant association between infection and the demographic and socioeconomic variables. Regarding the hygiene and sanitary variables, the elderly who had other pets that were not cats or dogs had a higher prevalence of intestinal parasites (27.8% (P=0.041)), and those who had animals that were bathed more often had a higher prevalence of enteroparasites (16.0% (P=0.024)); these associations remained significant in the multivariate analysis. Regarding the health variables, the elderly who did not have hypertension or mental disease had a higher prevalence of intestinal parasites than those who had these diseases (15.4% (P=0.032) and 12.8% (P=0.049), respectively). In assessing the hemogram, anemia was no significant relationship with intestinal parasites and association with eosinophilia was significant when examined only the prevalence of pathogenic parasites: 7.3% (P=0.010). In T. gondii analysis were evaluated 599 elderly individuals; the seroprevalence of T. gondii IgG and IgM was 88.0% and 0.8%, respectively. In the multivariate analysis, the following variables were independently associated with IgG antibody positivity: age, personal income and use of eyeglasses. With respect to IgM antibody positivity, the independently associated variables were age, self-rated health and wears glasses. In assessing the seroprevalence, 581 elderly individuals were evaluated. Conclusion : The prevalence of intestinal parasites in the elderly was low compared with that found in other studies, and the parasites were predominantly nonpathogenic, such as E. coli and E. nana. These findings implicate interpersonal transmission, environmental contamination or the ingestion of contaminated food or water in this population. There was a high prevalence of elderly individuals who were positive for toxoplasma IgG antibodies. This finding raises concern regarding potential latent infection because this population may have compromised immunity. The findings highlight the importance of the ongoing measures related to sanitation and hygiene education in this community.