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RISK FACTORS ASSOCIATED WITH ASYMPTOMATIC INFECTION BY LEISHMANIA CHAGASI IN NORTH-EAST BRAZIL.
Leishmania chagasi
Asymptomatic infection
Children
Prevalence
Incidence
Risk factors
Brazil
Leishmaniose Visceral/epidemiologia
Animais
Brasil/epidemiologia
Pré-Escolar
Ensaio de Imunoadsorção Enzimática
Feminino
Humanos
Hipersensibilidade Tardia/epidemiologia
Incidência
Lactente
Recém-Nascido
Masculino
Prevalência
Estudos Prospectivos
Fatores de risco
Autor
Afiliación
Federal University of Maranhão. Nucleus of Tropical Pathology and Social Medicine. São Luis, MA, Brasil
Federal University of Maranhão. Nucleus of Tropical Pathology and Social Medicine. São Luis, MA, Brasil
Federal University of Maranhão. Public Health Department. São Luis, MA, Brasil
Federal University of Bahia. School of Medicine. Immunology Service. Salvador, BA, Brasil
Federal University of Bahia. School of Medicine. Immunology Service. Salvador, BA, Brasil / Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil
Federal University of Maranhão. Nucleus of Tropical Pathology and Social Medicine. São Luis, MA, Brasil
Federal University of Maranhão. Public Health Department. São Luis, MA, Brasil
Federal University of Bahia. School of Medicine. Immunology Service. Salvador, BA, Brasil
Federal University of Bahia. School of Medicine. Immunology Service. Salvador, BA, Brasil / Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil
Resumen en ingles
Various factors have been associated with a predisposition to the development of clinical American visceral leishmaniasis (AVL). However, little information is available about the factors that predispose to asymptomatic infection. To identify the risk factors associated with asymptomatic infection, a study was carried out between July 1997 and June 1998 on children aged 0-5 years in the districts of Vila Nova and Bom Viver in the municipality of Raposa in the island of São Luís, State of Maranhão, Brazil. A questionnaire containing socioeconomic, demographic and epidemiological data was used. The delayed-type hypersensitivity (DTH) test was carried out on 639 children in the first phase, and on 572 in the second, 7 months after the first survey, using Leishmania amazonensis antigen. Infection was determined by enzyme-linked immunosorbent assay (ELISA) in 638 children during the first phase, and in 572 during the second. Six outcome measures were used: initial prevalence, final prevalence and incidence, each determined by DTH and ELISA. The incidence of infection was 10.8% when determined by DTH and 28.5% when determined by ELISA. After adjustment for confounding variables using Cox regression, infection by L. chagasi was associated with child's age (> or = 2 years), location of the dwellings (Vila Nova) and reporting of relatives with AVL. Bathing outside the house and playing outdoors between 18:00 and 20:00 were identified as risk factors in some analyses but not in others. Presence of intra- and peridomestic Lutzomyia sandflies and animals such as dogs or chickens in the house or in the neighbourhood appeared as risk factors in some analyses but in others they unexpectedly seemed to protect from infection. Malnutrition was not found to be associated with infection.
Palabras clave en ingles
Visceral leishmaniasisLeishmania chagasi
Asymptomatic infection
Children
Prevalence
Incidence
Risk factors
Brazil
DeCS
Leishmania infantumLeishmaniose Visceral/epidemiologia
Animais
Brasil/epidemiologia
Pré-Escolar
Ensaio de Imunoadsorção Enzimática
Feminino
Humanos
Hipersensibilidade Tardia/epidemiologia
Incidência
Lactente
Recém-Nascido
Masculino
Prevalência
Estudos Prospectivos
Fatores de risco
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