Estudo epidemiológico das parasitoses oculares na população de escolares da cidade de Natal-RN, Brasil
The objective of this study is to estimate the prevalence of Ocular Toxocariasis, Diffuse Unilateral Subacute Neuroretinitis (DUSN), Toxoplasma gondii infection and Ocular Toxoplasmosis in a student population in Natal-RN/Brazil and relate it to demographic, epidemiologic and socio-economic risk fac...
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Toxoplasmose Toxoplasmose ocular Toxocaríase Neuroretinite subaguda difusa unilareral(DUSN) Toxoplasmose-prevalência Toxoplasmose-fatores de risco Toxocariasis Ocular Toxocariasis Toxocariasis Diffuse Unilateral Subacute Neuroretinitis (DUSN) Prevalence of toxoplasmosis Risk factors of toxoplasmosis CNPQ::CIENCIAS DA SAUDE |
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Toxoplasmose Toxoplasmose ocular Toxocaríase Neuroretinite subaguda difusa unilareral(DUSN) Toxoplasmose-prevalência Toxoplasmose-fatores de risco Toxocariasis Ocular Toxocariasis Toxocariasis Diffuse Unilateral Subacute Neuroretinitis (DUSN) Prevalence of toxoplasmosis Risk factors of toxoplasmosis CNPQ::CIENCIAS DA SAUDE Garcia, Carlos Alexandre de Amorim Estudo epidemiológico das parasitoses oculares na população de escolares da cidade de Natal-RN, Brasil |
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The objective of this study is to estimate the prevalence of Ocular Toxocariasis, Diffuse Unilateral Subacute Neuroretinitis (DUSN), Toxoplasma gondii infection and Ocular Toxoplasmosis in a student population in Natal-RN/Brazil and relate it to demographic, epidemiologic and socio-economic risk factors. The incidence of DUSN was observed in patients at the Federal University of Rio Grande do Norte Ophthalmology Service and the Prontoclinica de Olhos Ophthalmology clinic in Natal. In cases where a worm was found in the subretinal space, the result of treatment with photocoagulation using Green Laser (Eye Light ALCON) was evaluated in relation to final visual result. The sample was randomly selected among the schools of the four districts of Natal, according to the type of institution (public or private), its level (elementary or secondary), and study period (morning, afternoon or evening). The school population was studied from March to May, 2001. Initially, the students answered a questionnaire to evaluate demographic, epidemiologic and socio-economic risk factors. Afterwards, the following procedures were carried out: blood samples were taken for Toxoplasmosis (IgG, IgM) serology, hemogram, ophthalmological examination, consisting of clinical history, measurement of visual acuity, refraction under cycloplegia, biomicroscopy of the anterior segment and annexa, funduscopy and examination of extrinsic motility.
The prevalence of Toxocariasis was 0.2% or 2 per one thousand students. The sample was insufficient to estimate the prevalence of DUSN. Seventy patients with DUSN diagnosis were examined from January, 2001 to January, 2003. A live worm was found in the subretinal space of all four patients in the acute phase, and these were treated with laser photocoagulation. After follow-up (average = 11.5 months), visual acuity improved in three eyes and remained unaltered in one eye. Worms were found in 22 of the 66 patients in the chronic phase, and these also were treated with laser photocoagulation. After a follow-up period of 13.1 months, on average, visual acuity improved in two of the patients, remained unchanged in 19 and worsened in one. The comparison of visual result before and after treatment was not statistically significant (p = 0.302). The diagnosis of DUSN in the acute phase, followed by prompt localization and destruction of the worm by photocoagulation, can improve the patient s vision. However, destruction of the worm by laser photocoagulation in eyes with DUSN in the chronic phase does not improve visual acuity. Seroprevalence for IgG was 46% (Confidence Interval CI 95%-42.9-49.2%) and for IgM it was 1.4% (CI 95% = 0.8-2.4%). The prevalence of ocular lesion was 1.15% (CI 95% = 0.6 - 2.0%). Socio-economic conditions were determinants in the prevalence of Systemic and Ocular Toxoplasmosis in the bivaried analysis and confirmed in the multivaried analysis (mother s scholarity illiterate/ OR = 2.9 and p < 0.001). The T. gondii infection prevalence, although high, was less than that found in studies performed in the South and Southeast of Brazil and that of Ocular Toxoplasmosis was completely discrepant, varying from 5 to 17 times less. Although important epidemiological variables such as owning a cat, drinking unfiltered water, and coming into contact with rivers or lakes showed an association in the preliminary analysis, they lost their influence when included in the logistic model. Future studies are scheduled to begin in March, 2004, in collaboration with other Brazilian and American universities in an attempt to discover the reason for these findings, as well as identifying the different strains of Toxoplasma gondii, and studying the sources of water utilized by the population of Natal Brazil |
| author2 |
Oréfice, Fernando |
| author_facet |
Oréfice, Fernando Garcia, Carlos Alexandre de Amorim |
| format |
doctoralThesis |
| author |
Garcia, Carlos Alexandre de Amorim |
| author_sort |
Garcia, Carlos Alexandre de Amorim |
| title |
Estudo epidemiológico das parasitoses oculares na população de escolares da cidade de Natal-RN, Brasil |
| title_short |
Estudo epidemiológico das parasitoses oculares na população de escolares da cidade de Natal-RN, Brasil |
| title_full |
Estudo epidemiológico das parasitoses oculares na população de escolares da cidade de Natal-RN, Brasil |
| title_fullStr |
Estudo epidemiológico das parasitoses oculares na população de escolares da cidade de Natal-RN, Brasil |
| title_full_unstemmed |
Estudo epidemiológico das parasitoses oculares na população de escolares da cidade de Natal-RN, Brasil |
| title_sort |
estudo epidemiológico das parasitoses oculares na população de escolares da cidade de natal-rn, brasil |
| publisher |
Universidade Federal do Rio Grande do Norte |
| publishDate |
2014 |
| url |
https://repositorio.ufrn.br/jspui/handle/123456789/13362 |
| work_keys_str_mv |
AT garciacarlosalexandredeamorim estudoepidemiologicodasparasitosesocularesnapopulacaodeescolaresdacidadedenatalrnbrasil |
| _version_ |
1773962225702141952 |
| spelling |
ri-123456789-133622019-05-26T05:17:27Z Estudo epidemiológico das parasitoses oculares na população de escolares da cidade de Natal-RN, Brasil Garcia, Carlos Alexandre de Amorim Oréfice, Fernando http://lattes.cnpq.br/4712768649797366 http://lattes.cnpq.br/8841547160023098 Medeiros, Aldo da Cunha http://lattes.cnpq.br/9873289951810864 Jerônimo, Selma Maria Bezerra http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4785584A3&dataRevisao=null Toxoplasmose Toxoplasmose ocular Toxocaríase Neuroretinite subaguda difusa unilareral(DUSN) Toxoplasmose-prevalência Toxoplasmose-fatores de risco Toxocariasis Ocular Toxocariasis Toxocariasis Diffuse Unilateral Subacute Neuroretinitis (DUSN) Prevalence of toxoplasmosis Risk factors of toxoplasmosis CNPQ::CIENCIAS DA SAUDE The objective of this study is to estimate the prevalence of Ocular Toxocariasis, Diffuse Unilateral Subacute Neuroretinitis (DUSN), Toxoplasma gondii infection and Ocular Toxoplasmosis in a student population in Natal-RN/Brazil and relate it to demographic, epidemiologic and socio-economic risk factors. The incidence of DUSN was observed in patients at the Federal University of Rio Grande do Norte Ophthalmology Service and the Prontoclinica de Olhos Ophthalmology clinic in Natal. In cases where a worm was found in the subretinal space, the result of treatment with photocoagulation using Green Laser (Eye Light ALCON) was evaluated in relation to final visual result. The sample was randomly selected among the schools of the four districts of Natal, according to the type of institution (public or private), its level (elementary or secondary), and study period (morning, afternoon or evening). The school population was studied from March to May, 2001. Initially, the students answered a questionnaire to evaluate demographic, epidemiologic and socio-economic risk factors. Afterwards, the following procedures were carried out: blood samples were taken for Toxoplasmosis (IgG, IgM) serology, hemogram, ophthalmological examination, consisting of clinical history, measurement of visual acuity, refraction under cycloplegia, biomicroscopy of the anterior segment and annexa, funduscopy and examination of extrinsic motility. The prevalence of Toxocariasis was 0.2% or 2 per one thousand students. The sample was insufficient to estimate the prevalence of DUSN. Seventy patients with DUSN diagnosis were examined from January, 2001 to January, 2003. A live worm was found in the subretinal space of all four patients in the acute phase, and these were treated with laser photocoagulation. After follow-up (average = 11.5 months), visual acuity improved in three eyes and remained unaltered in one eye. Worms were found in 22 of the 66 patients in the chronic phase, and these also were treated with laser photocoagulation. After a follow-up period of 13.1 months, on average, visual acuity improved in two of the patients, remained unchanged in 19 and worsened in one. The comparison of visual result before and after treatment was not statistically significant (p = 0.302). The diagnosis of DUSN in the acute phase, followed by prompt localization and destruction of the worm by photocoagulation, can improve the patient s vision. However, destruction of the worm by laser photocoagulation in eyes with DUSN in the chronic phase does not improve visual acuity. Seroprevalence for IgG was 46% (Confidence Interval CI 95%-42.9-49.2%) and for IgM it was 1.4% (CI 95% = 0.8-2.4%). The prevalence of ocular lesion was 1.15% (CI 95% = 0.6 - 2.0%). Socio-economic conditions were determinants in the prevalence of Systemic and Ocular Toxoplasmosis in the bivaried analysis and confirmed in the multivaried analysis (mother s scholarity illiterate/ OR = 2.9 and p < 0.001). The T. gondii infection prevalence, although high, was less than that found in studies performed in the South and Southeast of Brazil and that of Ocular Toxoplasmosis was completely discrepant, varying from 5 to 17 times less. Although important epidemiological variables such as owning a cat, drinking unfiltered water, and coming into contact with rivers or lakes showed an association in the preliminary analysis, they lost their influence when included in the logistic model. Future studies are scheduled to begin in March, 2004, in collaboration with other Brazilian and American universities in an attempt to discover the reason for these findings, as well as identifying the different strains of Toxoplasma gondii, and studying the sources of water utilized by the population of Natal Brazil Esta pesquisa teve como objetivo, estimar a prevalência da Toxocaríase Ocular, Neuroretininte Sub-aguda Difusa Unilateral (DUSN), Infecção pelo Toxoplasma gondii e Toxoplasmose Ocular na população de escolares de Natal-RN/Brasil e relacioná-la aos fatores de risco demográficos, epidemiológicos e socioeconômicos. Estudar a incidência de DUSN em pacientes atendidos no Serviço de Oftalmologia da Universidade Federal do Rio Grande do Norte e Prontoclinica de Olhos, em Natal, bem como, avaliar, nos casos em que foi encontrada larva no espaço sub-retiniano, o resultado do tratamento com fotocoagulação utilizando o Laser Verde (Eye Light ALCON) em relação ao resultado visual. A amostra foi selecionada aleatoriamente e distribuída nas escolas dos quatro distritos da cidade de Natal de acordo com a natureza da instituição (pública ou privada), seu nível (fundamental ou médio) e turno em que o escolar estudava (matutino, vespertino ou noturno). A população de escolares foi estudada no período de março a maio de 2001. Inicialmente, responderam a um questionário para avaliação de fatores de risco demográfico, epidemiológico e socioeconômico. Depois foram feitos os seguintes procedimentos: coleta de sangue para realização de sorologia para Toxoplasmose (IgG, IgM), hemograma, exame oftalmológico constando de história clínica, medida da acuidade visual, refração sob cicloplegia, biomicroscopia do segmento anterior e anexos, fundoscopia e exame da motilidade extrínseca. A prevalência de Toxocaríase foi de 0,2% ou 2 por mil escolares. A amostra não foi suficiente para estimar a prevalência de DUSN. Foram examinados 70 pacientes com diagnóstico de DUSN, no período de janeiro de 2001 a janeiro de 2003. Foi encontrada larva viva no espaço sub-retiniano de todos os quatro que se encontravam na fase aguda, e tratados com fotocoagulação a laser. Após acompanhamento dos pacientes (média = 11,5 meses), a acuidade visual melhorou em três olhos e permaneceu inalterada em um olho. Dos 66 pacientes na fase crônica, foi encontrada larva em 22 deles e tratados com fotocoagulação a laser. Após acompanhamento por um período de 13,1 meses em média, a acuidade visual melhorou em dois, permaneceu a inicial em 19 e diminuiu em um paciente. A comparação do resultado visual antes e após o tratamento, não foi estatisticamente significante (p = 0,302). O diagnóstico de DUSN na fase aguda, seguida por pronta localização e destruição da larva por fotocoagulação, pode melhorar a visão dos pacientes. No entanto, a destruição da larva por fotocoagulação a laser em olhos com DUSN, na fase crônica, não melhora a acuidade visual. A soroprevalência para IgG foi de 46% (Intervalo de Confiança -IC 95% - 42,9-49,2%) e para IgM foi 1,4% (IC 95% = 0,8-2,4%). A prevalência de lesão ocular foi 1,15% (IC 95% = 0,6 2,0%). As condições socioeconômicas foram determinantes na prevalência da Infecção pelo T. gondii e Toxoplasmose Ocular na análise bivariada e confirmada na análise multivariada (escolaridade da mãe não alfabetizada/OR = 2,9 e p< 0,001). A prevalência de Toxoplasmose Sistêmica, embora elevada, foi menor do que a encontrada em estudos realizados no Sul e Sudeste do Brasil e, a da Toxoplasmose Ocular foi totalmente discrepante, variando de 5 a 17 vezes menos. Embora importantes variáveis epidemiológicas, tais como possuir gato, beber água não filtrada, ter contato com lagoas ou rios, tenham mostrado associação na análise preliminar, perderam sua influência quando incluídas no modelo logístico. Estudos futuros já estão planejados para ter inicio em março próximo, em colaboração com outras Universidades do Brasil e dos Estados Unidos com a finalidade de encontrar a razão destes achados, bem como, identificar diferentes tipos de cepas do Toxoplasma gondii, e estudar as fontes de água utilizadas pela população de Natal-RN 2014-12-17T14:13:56Z 2007-07-03 2014-12-17T14:13:56Z 2004-02-19 doctoralThesis GARCIA, Carlos Alexandre de Amorim. Estudo epidemiológico das parasitoses oculares na população de escolares da cidade de Natal-RN, Brasil. 2004. 112 f. Tese (Doutorado em Ciências da Saúde) - Universidade Federal do Rio Grande do Norte, Natal, 2004. https://repositorio.ufrn.br/jspui/handle/123456789/13362 por Acesso Aberto application/pdf application/pdf Universidade Federal do Rio Grande do Norte BR UFRN Programa de Pós-Graduação em Ciências da Saúde Ciências da Saúde |