ABSTRACT The teaching of human parasitology is essential for students of health sciences, especially medicine, because it is a major global public health problem―occurring with high frequency in low-income countries―and because of its presence in countries considered developed. In this sense, it is estimated that worldwide there are 2,800 million individuals infected with soil-transmitted helminths, 20 to 30% people infected with Toxoplasma gondii, 300 to 500 million new cases of malaria per year, and nearly 15 million Latin Americans with Chagas disease, an infection caused by Trypanosoma cruzi. This narrative review article analyzes information available in digital repositories on aspects of the traditional educational program of human or medical parasitology using descriptors or keywords closely related to the topic. The reviewed articles were mainly those published in peer-reviewed, indexed and prestigious scientific journals. Moreover, the traditional program of parasitology and the prevailing pedagogy are described with the purpose of encouraging discussion on the methods that lead to its learning. Also, given the dynamic nature of this process and the constant challenges that must be faced in this field, said information can help to explore new ways of teaching parasitology in answer to the demands of the context. In conclusion, parasitic diseases have affected humankind throughout history, causing illness, disability and death in millions of people. Therefore, among the measures to fight such a terrible scourge, the training of more and better professionals in the area is promoted due to their leading role in the design and execution of control programs. As a result, the need to describe in detail the characteristics of the traditional teaching of this branch of knowledge arises―as shown in this paper―in view of the new human teaching methods: participatory learning, problem-based learning and Internetassisted learning.

RESUMEN Es fundamental la enseñanza de la parasitología humana para los estudiantes de las carreras de ciencias de la salud, especialmente la médica, por ser un importante problema de salud pública con distribución mundial, con alta frecuencia en países de bajos recursos económicos y por su presencia en aquellos países considerados desarrollados. En este sentido, se estima que existen en el mundo 2800 millones de individuos infectados con geohelmintos, 20 % a 30 % de infectados con Toxoplasma gondii, 300 a 500 millones de casos nuevos de malaria al año y aproximadamente 15 millones de latinoamericanos con enfermedad de Chagas, una enfermedad causada por el Trypanosoma cruzi. En este artículo de revisión narrativa se analiza información disponible en repositorios digitales sobre aspectos del programa pedagógico tradicional de la parasitología humana o médica, para lo cual se emplearon descriptores o palabras clave en estrecha relación con el tema. Los artículos que se revisaron principalmente fueron aquellos publicados en revistas científicas arbitradas, indexadas y de reconocido prestigio. Asimismo, se describen el programa tradicional de parasitología y la pedagogía prevalente empleada, con el propósito de fomentar el debate sobre los métodos que conducen a su aprendizaje. Por otro lado, si se consideran el carácter dinámico que posee este proceso y los constantes desafíos que deben afrontarse en este campo, esta información puede ayudar a explorar nuevas formas de enseñar la parasitología en respuesta a las exigencias del contexto. En conclusión, las enfermedades parasitarias han afectado a la humanidad a lo largo de la historia, y han causado enfermedades, discapacidad y la muerte de millones de personas. Por tanto, entre las medidas para combatir tan terrible flagelo se señala la capacitación de más y mejores profesionales en el área, por su papel preponderante en el diseño y ejecución de los programas de control, de lo que se desprende la necesidad de describir en detalle las características de la enseñanza tradicional de esta rama del conocimiento ―como se muestra en el contenido de este escrito― en virtud de la existencia de nuevos métodos de enseñanza humana: la enseñanza participativa, aprendizaje basado en problemas y aprendizaje asistido por internet.

ABSTRACT Solid-organ transplantation procedures have witnessed a surge in frequency. Consequently, increased attention to associated infections and their impact on graft success is warranted. The liver is the principal target for infection by the flatworm Schistosoma mansoni. Hence, rigorous screening protocols for this parasite should be implemented for liver transplantation donors and recipients. This study investigated the risks posed by schistosomiasis-infected liver tissues for successful liver transplantation (LT), considering donors and recipients, by analyzing reported cases. Among the 43 patients undergoing LT (donors = 19; recipients = 24), 32 were infected with S. mansoni, five were infected with other Schistosoma species, and no identification was made in four patients. Reported follow-up periods ranged from 1 to 132 months, and all patients achieved successful recovery. As these helminths do not replicate in their vertebrate hosts, immunosuppressive treatment is not expected to promote increased morbidity or reactivation. Moreover, suspected or confirmed schistosomiasis infections often have a benign course, and generally, should not prevent LT. The available literature was reviewed and a provisional screening protocol has been proposed. Solidorgan Solid organ frequency Consequently warranted mansoni Hence schistosomiasisinfected LT, , (LT) cases 4 19 24, 24 24) 3 S species followup follow up 13 months recovery hosts reactivation Moreover course generally proposed (LT 2

ABSTRACT INTRODUCTION: Neurocysticercosis is an infection of the central nervous system caused by the larval stage of the cestode Taenia solium, it has been estimated to produce up to 30% of the cases in countries where this parasitosis is endemic. The objective of this study was to determine the frequency of patients who presented epilepsy as a sequel of neurocysticercosis in a university hospital in Popayán. MATERIALS AND METHODS: A retrospective study was conducted with all patients with a diagnosis of neurocysticercosis who were admitted to the Hospital Universitario San José between January 2014 and December 2018 who met the inclusion criteria. RESULTS: We found 50 patients, 40 (80%) of which were readmitted and 37 (74%) presented epilepsy as sequela. The most affected age-group was 41 to 60 years; 48 (96%) were from the department of Cauca, especially Mercaderes, and 33 (66%) from rural areas. Convulsive syndrome was the most frequent clinical manifestation on admission. CT was the imaging technique of choice. CONCLUSION: The department of Cauca is considered as an endemic area for neurocysticercosis, and secondary epilepsy was a common consequence.

RESUMEN INTRODUCCIÓN: La neurocisticercosis es una infección del sistema nervioso central causada por el estadio larvario del cestodo Taenia solium, y se estima que puede ocasionar hasta 30% de los casos de epilepsia en los países donde esta parasitosis es endémica. El objetivo de este estudio fue determinar la frecuencia de pacientes que presentaron epilepsia como secuela de neurocisticercosis en un hospital universitario en Popayán. MATERIALES Y MÉTODOS: Se realizó un estudio retrospectivo con todos los pacientes con diagnóstico de neurocisticercosis que ingresaron al Hospital Universitario San José entre enero 2014 y diciembre 2018 que cumplieron los criterios de inclusión. RESULTADOS: Se encontraron 50 pacientes, de estos, 40 (80%) reingresaron, encontrándose que 37 (74%) presentaron epilepsia como secuela. Las edades más afectadas fueron la de 41 a 60 años; 48 (96%) provenían del departamento del Cauca en especial de Mercaderes, y 33 (66%) de área rural. El síndrome convulsivo fue la manifestación clínica de ingreso más frecuente. La TAC fue la técnica de imagen de elección. CONCLUSIÓN: El departamento del Cauca se considera como una de las áreas endémicas para neurocisticercosis en Colombia, y la epilepsia secundaria es un secuela común.

Abstract This purpose of this study was to compare the efficiency of the McMaster and Mini-FLOTAC quantitative techniques in the investigation of helminths in feces of pigs. An analysis was made of 74 fecal samples from pigs raised on family farms located in Rio de Janeiro, Brazil. These were analyzed by the Mini-FLOTAC and McMaster techniques in a solution of 1,200g/mL NaCl. This investigation revealed a superiority in the frequency of all helminths detected by Mini-FLOTAC, including Ascaris suum, Trichuris suis, strongyles and Strongyloides ransomi. The Kappa index revealed substantial agreement in all comparisons made in relation to the frequency of positive samples. However, significant statistical differences in the comparison of EPGs between McMaster and Mini-FLOTAC were observed for all nematodes (p ≤0.05). Higher values of Pearson’s linear correlation coefficient (r), between the techniques in relation to EPG were observed for A. suum and T. suis, differently from what was observed for strongyles and S. ransomi. Mini-FLOTAC proved to be a more satisfactory and reliable technique both for the diagnosis of parasites and for the determination of EPG in pig feces due to the larger size of its counting chambers, thus increasing the helminth egg recovery rates. MiniFLOTAC Mini FLOTAC 7 Janeiro Brazil 1200gmL gmL 1 200g mL g NaCl MiniFLOTAC, FLOTAC, suis ransomi However p ≤0.05. 005 ≤0.05 . 0 05 ≤0.05) Pearsons Pearson s r, r , (r) A T S chambers rates 00 ≤0.0 (r ≤0. ≤0 ≤

Resumo Este estudo objetivou comparar a eficiência das técnicas quantitativas de McMaster e Mini-FLOTAC para a pesquisa de helmintos em fezes de suínos. Foram analisadas 74 amostras fecais de suínos mantidos em propriedades familiares, localizadas no Rio de Janeiro, Brasil. Estas foram analisadas pelas técnicas de Mini-FLOTAC e McMaster com solução de NaCl 1.200g/mL. Pode-se verificar uma superioridade na frequência de todos os helmintos detectados por meio do Mini-FLOTAC, incluindo-se Ascaris suum, Trichuris suis, estrongilídeos e Strongyloides ransomi. O índice Kappa mostrou uma concordância substancial em todas as comparações realizadas, em relação à frequência de amostras positivas. Entretanto, diferenças estatísticas significativas na comparação do OPG entre McMaster e Mini-FLOTAC foram observadas para todos os nematoides (p ≤0.05). Elevados valores do coeficiente de correlação de Pearson foram observados entre as técnicas, em relação ao OPG para A. suum e T. suis, diferentemente do evidenciado para estrôngilos e S. ransomi. Mini-FLOTAC mostrou-se uma técnica mais satisfatória e confiável, tanto para o diagnóstico de parasitos quanto para a determinação do OPG em fezes de suínos, devido ao maior tamanho das suas câmaras de contagem, situação que acaba aumentando a eficiência da recuperação dos ovos dos helmintos. MiniFLOTAC Mini FLOTAC 7 familiares Janeiro Brasil 1200gmL gmL 1 200g mL g 1.200g/mL Podese Pode se MiniFLOTAC, FLOTAC, incluindose incluindo suis ransomi realizadas positivas Entretanto p ≤0.05. 005 ≤0.05 . 0 05 ≤0.05) A T S mostrouse confiável contagem 00 ≤0.0 ≤0. ≤0 ≤

Resumen Introducción. Los individuos infectados por el virus linfotrópico T humano tipo 1 (HTLV-1) pueden presentar formas graves y diseminadas de infestación por Strongyloides stercoralis con poca mejoría terapéutica. Objetivo. Investigar la infestación por S. stercoralis y la seroprevalencia de IgG anti-S. stercoralis en individuos infectados por HTLV-1 atendidos en el Centro de Referencia para HTLV-1 (CHTLV), en Salvador, Bahía, Brasil. Materiales y métodos. Se hizo un estudio transversal con 178 individuos infectados por HTLV-1 atendidos en el centro especializado de HTLV entre enero de 2014 y diciembre de 2018. El diagnóstico parasitológico de S. stercoralis se hizo mediante los métodos de Hoffman, Pons y Janer, cultivo en placa de agar y Baermann-Morais. Para la detección de IgG anti-S. stercoralis, se utilizó una prueba casera de inmunoabsorción ligada a enzimas (ELISA). La infección por HTLV-1 se diagnosticó usando un ELISA comercial y se confirmó mediante Western blot. Resultados. La frecuencia de infestación por S. stercoralis fue del 3,4 % (6/178). Además, los individuos infestados por S. stercoralis provenientes de la zona rural (50,0 %; 3/6) también mostraron hiperinfestación por S. stercoralis (>3.000 larvas/gramo de heces). La frecuencia de anticuerpos IgG anti-S. stercoralis fue del 20,8 % (37/178). Conclusiones. Las personas infectadas por HTLV-1 que viven en condiciones sanitarias precarias son más propensas a desarrollar formas graves de infestación por S. stercoralis. Teniendo en cuenta la gran vulnerabilidad y el resultado desfavorable de la infección en estos individuos, se debe considerar el diagnóstico serológico de S. stercoralis para administrar el tratamiento.

Abstract Introduction: Individuals infected with the human T-lymphotropic virus type 1 (HTLV-1) may present severe and disseminated forms of Strongyloides stercoralis infection with low therapeutic response. Objective: To investigate the S. stercoralis infection and the seroprevalence of IgG anti-S. stercoralis antibodies in individuals infected with HTLV-1 attending the Reference Center for HTLV-1 (CHTLV) in Salvador, Bahia, Brazil. Materials and methods: We conducted a cross-sectional study in 178 HTLV-1-infected individuals treated at the HTLV specialized center between January, 2014, and December, 2018. The parasitological diagnosis of S. stercoralis was performed using the Hoffman, Pons and Janer, agar plate culture, and Baermann-Morais methods. The IgG anti-S. stercoralis detection was performed using an in house enzyme-linked immunosorbent assay (ELISA). The HTLV-1 infection was diagnosed using a commercial ELISA and confirmed by Western blot. Results: The frequency of S. stercoralis infection was 3.4% (6/178). Individuals infected with S. stercoralis from rural areas (50.0%; 3/6) also showed S. stercoralis hyperinfection (>3,000 larvae/ gram of feces). The frequency of circulating anti-S. stercoralis IgG antibodies was 20.8% (37/178). Conclusions: HTLV-1-infected people living in precarious sanitary conditions are more prone to develop severe forms of S. stercoralis infection. Considering the high susceptibility and unfavorable outcome of the infection in these individuals, the serological diagnosis for S. stercoralis should be considered when providing treatment.

ABSTRACT Intestinal parasitic infections (IPIs) are neglected diseases caused by helminths and protozoa, with the relationships between parasite, host and environment having the potential to produce high morbidity and incapacity to work and mortality in vulnerable areas. This study assessed the prevalence of IPIs concerning socio-environmental conditions and analyzed the knowledge, attitudes and practices related to these diseases among men living in the slums of Rio de Janeiro city, Rio de Janeiro State, Brazil. A cross-sectional study was conducted in an agglomeration of urban slums between 2018 and 2019, with men aged between 20 and 59 years. A socioeconomic status questionnaire and an IPIs knowledge, attitudes and practices questionnaire (KAPQ) were applied. Coproparasitological diagnoses (n=454) were performed using four methods and samples of water for household consumption (n=392) were subjected to microbiological and physicochemical analysis. A total of 624 participants were enrolled. About 40% of the households had “water unsuitable for consumption”. Only one Major Area, MA 3 was not statistically significant for IPIs (AOR=0.75; 95% CI: 0.30-1.88; p=0.55). The overall prevalence of IPIs was 23.8%. Endolimax nana (n=65, 14.3%) and hookworm (n=8, 1.7%) were the most frequently identified parasites. The analysis of the frequency of responses to the KAPQ has shown that men reported to seeking medical care if they were suspicious of IPIs, and around 35% would self-medicate. The results have shown the need to adopt integrated health education practices targeting male residents in urban slums to qualify the care with water for human consumption and promote self-care about IPIs. The household can be considered strategic for Primary Health Care activities for men.

Abstract The inadequate choice of a diagnostic method or the option for techniques that have low sensitivity and specificity may limit the diagnosis of parasitic agents that affect aquatic mammals. The aim of this study was to evaluate the performance of the FLOTAC technique and compare it with three traditional methods (Willis, sedimentation and centrifugation- flotation) used in the diagnosis of gastrointestinal parasites in aquatic mammals. For this, 129 fecal samples from 12 species were collected. Each sample was submitted to laboratory processing using the Willis, Hoffman techniques, Faust method and FLOTAC. Sensitivity, specificity, real prevalence, estimated prevalence, positive predictive value, negative predictive value, correct classification (accuracy) and incorrect classification were evaluated to compare the different diagnostic methods. The highest frequency of positive samples occurred using FLOTAC (46.51%), compared to Hoffman (23.25%), Faust (10.07%) and Willis techniques (6.97%). In the samples analyzed, the occurrence of Strongylidae eggs and Eimeriidae oocysts was frequently observed. The FLOTAC technique proved to be the most appropriate technique and due to its efficacy, is strongly recommended for coproparasitological evaluations in aquatic mammals.

The high frequency of intestinal parasites is favored by environmental and socio-cultural conditions of indigenous populations, and is still a neglected public health problem. Mass administration of broad-spectrum drugs aims to reduce the prevalence and intensity of the infections. The prevalence of intestinal parasites in school-children in an indigenous Guarani village was evaluated before and after the mass treatment of the population with albendazole. In the first phase of collection of stool samples, 81.4% of them were positive for enteroparasites and in the second phase, after two doses of antiparasitic medication, 87.5% were positive. Although the prevalence of infections by some helminths has reduced after treatment, many parasites remained frequent in the studied population, showing a change in the epidemiological profile in the distribution of these diseases in the population. The prevalence of intestinal parasites in indigenous schoolchildren proved to be high even after mass treatment with albendazole.

A alta frequência de parasitoses intestinais é favorecida por condições ambientais e socioculturais das populações indígenas, sendo ainda um problema de saúde pública negligenciado. A administração em massa de medicamentos de amplo espectro busca reduzir o número e a intensidade das infecções. Avaliou-se a prevalência de parasitoses intestinais em escolares de uma aldeia indígena Guarani, antes e após o tratamento em massa da população com o albendazol. Na primeira fase de coleta das amostras de fezes, 81,4% delas apresentaram-se positivas para enteroparasitos e na segunda fase, após duas doses de antiparasitário, 87,5% apresentaram-se positivas. Embora a prevalência de infecções por alguns helmintos tenha reduzido após o tratamento, muitos parasitos continuaram frequentes na população estudada, mostrando uma mudança no perfil epidemiológico na distribuição dessas doenças na população. A prevalência de enteroparasitoses nos escolares indígenas mostrou-se elevada mesmo após o tratamento em massa com albendazol.

ABSTRACT Introduction: Cestodes are helminths of complex life cycles which may infect animals and humans. No mass deworming programs are in place to reduce the worldwide parasite load of cestodes, given the low prevalence reported by epidemiological research. Few studies are available in the international literature about the epidemiology and detection of these infections. Objective: Describe the frequency of cestode infection and its epidemiological characteristics. Methods: A retrospective descriptive study was conducted from 3 January 2010 to 28 December 2018. Evaluation was performed of all the samples of fecal matter, adult parasites and metacestodes submitted by the health care network to the Intestinal Parasitic Disease National Reference Laboratory at Pedro Kourí Institute. The study universe was 9 833 samples, mostly received from the province of Havana. Results: Inermicapsifer madagascariensis infection prevailed among children aged under 5 years (69.6%; CI 95%: 47.1-86.8). Taenia sp. intestinal infection was mainly diagnosed in patients aged 15-65 years (88.2%; CI 95%: 63.6-98.5). Of the 47 cestode infection positive cases, 24 were female (51.1%; CI 95%: 35.7-66.4) and 23 were male (48.9%; CI 95%: 33.6-64.3). No significant differences were found between Inermicapsifer madagascariensis and Taenia sp. infection and the sex of patients (p˃ 0.05). Conclusions: Although the frequency of cestode infection detected is low, these results could be useful for an integrated control of the main cestode infections affecting the different age groups.

RESUMEN Introdución: Los cestodos son helmintos parásitos del humano y de animales, con complejos ciclos de vida. En las infecciones por los cestodos no existen programas de desparasitación masiva implementados para disminuir la carga parasitaria de estos a nivel mundial, dada la baja prevalencia que se informa en estudios epidemiológicos. Existen pocos trabajos sobre la epidemiología y la detección de estas infecciones en la literatura internacional. Objetivo: Describir la frecuencia de infección de cestodos y sus características epidemiológicas. Métodos: Estudio descriptivo y retrospectivo, realizado entre el 3 de enero de 2010 y 28 de diciembre de 2018. Se analizaron todas las muestras de heces, parásitos adultos y metacestodos enviadas de la red de Salud al Laboratorio Nacional de Referencia de Parasitismo Intestinal-IPK. El universo de estudio estuvo constituido por 9833 muestras, que fueron enviadas mayoritariamente de la provincia La Habana. Resultados: La infección por Inermicapsifer madagascariensis predominó en niños menores de 5 años (69,6 %; IC 95 %: 47,1-86,8). La infección intestinal por Taenia spp. se diagnosticó prinipalmente en pacientes entre 15 y 65 años de edad (88,2 %; IC95 %: 63,6-98,5). De los 47 casos positivos a la infección por cestodos, 24 pertenecieron al sexo femenino (51,1 %; IC95 %: 35,7-66,4) y 23 al sexo masculino (48,9 %; IC95 %: 33,6-64,3). No hubo diferencias significativas entre la infección por Inermicapsifer madagascariensis y Taenia spp. y el sexo de los pacientes (p˃ 0,05). Conclusiones: Aunque la frecuencia de infección de las cestodiosis detectadas es baja, estos resultados pudieran ser útiles para un control integrado de las principales cestodioisis en los diferentes grupos etarios.

Resumo Os resultados obtidos de estudos parasitológicos em amostras fecais e esfregaços anais enviados ao Laboratório de Parasitologia e Gastroenterologia do Hospital de Pediatría “Prof. Dr. Juan P. Garrahan” da Cidade de Buenos Aires, Argentina, foram avaliados retrospectivamente. O objetivo do estudo foi avaliar a prevalência dos parasitas intestinais observados nas amostras enviadas a este hospital e sua distribuição por faixas etárias. Durante o período compreendido entre maio de 2018 a abril de 2019 foram analisadas 4713 amostras, correspondentes a 3311 pacientes, o que deu um resultado total de 29% de positivos (1371/4713). 30% dos exames coproparasitológicos foram positivos (1193/4025) e foram encontrados ovos de Enterobius vermicularis em 26% (178/688) dos esfregaços anais. Nas amostras seriadas fecais foram obtidos 37% de resultados positivos, enquanto que em amostras únicas, 21%. Os enteroparasitas mais prevalentes na totalidade das amostras fecais foram Blastocystis spp. em 14% (579/4025), Giardia duodenalis 11% (456/4025) e Dientamoeba fragilis 7% (291/4025). Os resultados demonstraram diferenças significativas com maior prevalência de parasitas intestinais em pacientes em idade escolar da faixa etária entre 6 e 10 anos, em relação aos da pré-escola. Nas amostras fecais analisadas, evidenciou-se um predomínio de parasitismo por protozoários por sobre helmintos, pelo qual deve ser considerado o reforço do diagnóstico laboratorial dessas espécies por meio de técnicas, como colorações que permitam a sua localização e confirmação.

Abstract The results obtained of the coproparasitological studies and anal swab submitted to the laboratory of the Parasitology Section of the Hospital de Pediatría “Prof. Dr. Juan P. Garrahan” of the Buenos Aires City, Argentina, were retrospectively evaluated The aim of this study was to determine the prevalence of intestinal parasites found on the submitted samples and to evaluate their frequency according to the age of the patients. Within the period between May 2018 and April 2019, a total of 4713 samples corresponding to 3311 patients were analyzed and intestinal parasites were present in 29% (1371/4713). In 30% of coproparasitological studies parasite estructures were found (1193/4025) and 26% of anal swab samples were positive for the presence of Enterobius vermicularis eggs (178/688). In serial fecal samples, 37% positive results were obtained, while in single samples, 21%. The most prevalent enteroparasites calculated from the total fecal samples were: Blastocystis spp. with 14% (579/4025), followed by Giardia duodenalis 11% (456/4025) and Dientamoeba fragilis 7% (291/4025). The incidence of intestinal parasites was higher in the group of patients between 6 and 10 years, and the existence of significant differences between proportions of parasitized patients in preschool and school infants, was observed. In the faecal samples analyzed, a greater prevalence of parasitism caused by protozoa than by helminths was evidenced, for which reason it should be considered, reinforcing the laboratory diagnosis using techniques such as stains that allow its finding and confirmation.

Resumen Se evaluaron retrospectivamente los resultados obtenidos de estudios parasitológicos en muestras de heces y escobillados anales remitidos al Laboratorio de Parasitología y Gastroenterología del Hospital de Pediatría “Prof. Dr. Juan P. Garrahan” de la Ciudad de Buenos Aires, Argentina. El objetivo del trabajo fue conocer la prevalencia de los parásitos intestinales observados en las muestras remitidas a este hospital y su distribución en rangos etarios. En el período comprendido entre mayo de 2018 y abril de 2019 se analizó un total de 4713 muestras pertenecientes a 3311 pacientes, que arrojó un resultado total de 29% de positivos (1371/4713). De los exámenes coproparasitológicos el 30% fueron positivos (1193/4025) y se hallaron huevos de Enterobius vermicularis en el 26% (178/688) de los escobillados anales. En las muestras seriadas de heces se obtuvo un 37% de positividad mientras que en muestras únicas un 21%. En la totalidad de muestras fecales, los enteroparásitos más prevalentes fueron Blastocystis spp. en un 14% (579/4025), Giardia duodenalis 11% (456/4025) y Dientamoeba fragilis 7% (291/4025). Los resultados demostraron diferencias significativas con mayor prevalencia de parásitos intestinales en pacientes en edad escolar comprendidos entre los 6 y 10 años, en relación a los de edad preescolar. En las muestras fecales analizadas se evidenció un predominio de parasitismo de protozoos sobre helmintos, por lo que se debería considerar reforzar el diagnóstico de laboratorio de esas especies mediante técnicas, como coloraciones, que posibiliten su hallazgo y confirmación.

Abstract: Introduction: Inflammation associated with Helicobacter pylori (H. pylori) infection is linked to the development of a gastric precancerous lesion. Helminth infections could influence the pro-inflam matory response to such infection from LTCD4+ Th1 to a less harmful LTCD4+ Th2 response. Ob jective: To characterize the polarization of the LTCD4+ Th2 immune response in co-infected pa tients with H. pylori and helminths from low-risk areas for developing gastric cancer. Patients and Method: We analyzed 63 patients infected by H. pylori (40 adults and 23 children). Through the Multiplex Analysis technology (xMAP), we determined the serum profiles of the interleukins asso ciated with the polarization of the immune response of LTCD4+ Th1 (IL-1Β, INF-γ, TNF-α) as well as the LTCD4+ Th2 (IL-4, IL-10, and IL-13). The ratio between helminths co-infection status in H. pylori-infected patients and the polarization of the immune response mediated by LTCD4+ Th1 and LTCD4+ Th2 was assessed using a Mixed Effects Logistic Regression Model. Results: The frequency of helminths was similar between adults (15%) and children (17%). The polarization of the immu ne response was more prevalent in LTCD4+ Th1. Serum values of interleukins associated with the immune response polarization of LTCD4+ Th1 (IL-1Β, INF-γ, and TNF-α) and LTCD4+ Th2 (IL-4, IL-10, and IL-13) were independent of helminths infection status. Conclusion: The prevalence of in testinal parasitic infection was high and the immune response polarization was mainly LTCD4 + Th1.

Resumen: Introducción: La inflamación asociada con la infección por Helicobacter pylori (H. pylori) se relaciona con la pro gresión de las lesiones precancerosas gástricas. Las infecciones por helmintos podrían modular la respuesta proinflamatoria a la infección por H. pylori desde un perfil tipo LTCD4+ Th1 hacia una respuesta menos perjudicial tipo LTCD4+ Th2. Objetivo: Caracterizar la polarización de la respuesta inmune tipo LTCD4+ Th1/Th2 de pacientes coinfectados por H. pylori y helmintiasis procedentes de áreas de bajo riego para el desarrollo de cáncer gástrico. Pacientes y Método: Se analizaron 63 pacientes, 40 adultos y 23 niños infectados con H. pylori. La determinación de los perfiles séricos de las interleucinas asociadas con la polarización de la respuesta inmune tipo LTCD4+ Th1 (IL-1Β, INF-γ y TNF-α) y tipo LTCD4+ Th2 (IL-4, IL-10 e IL-13) se realizó con Análisis Multiplex (xMAP). La relación entre el estado de coinfección por helmintos en pacientes infectados con H. pylori y la polarización de la respuesta inmune mediada por LTCD4+ Th1 y LTCD4+ Th2, se estudió con un modelo de regresión logístico de efectos mixtos. Resultados: La frecuencia de helmintos fue similar en adultos (15%) y niños (17%). La polarización de la respuesta inmune fue más prevalente hacia el tipo LTCD4+ Th1. Los valores séricos de las interleucinas asociadas con la polarización de la respuesta inmune tipo LTCD4+ Th1 (IL-1 Β, INF-γ y TNF-α) y tipo LTCD4+ Th2 (IL-4, IL-10 e IL-13) fueron independientes del estado de infestación por helmintos. Conclusión: La prevalencia de infección por parasitismo intestinal fue alta y la polarización de la respuesta inmune fue predominantemente hacia un perfil tipo LTCD4 + Th1.

ABSTRACT Introduction. Helminth parasites cause nutritional, physical, and cognitive decline. The WHO has expressed the need to map the prevalence of parasites in Latin America and the Caribbean. In Peru there are no studies that have measured the prevalence of this pathology. Objectives. To determine the frequency of general parasitosis and by type of helminth in 2017 and the trend of the last 8 previous ones, years nationally and by department. Methods. Analysis of secondary database (Health Information System: HIS) from 2010 to 2017, which contains the record of care in health facilities of the Ministry of Health. For the analysis of trends, segmented regression models were used. Results. At the national level, general parasites and helminth parasites were 4,9% and 3,3%, respectively, in 2017; both presented a downward trend, decreasing each year by 8,8% and 11,3% respectively. The same occurred in 68% (17/25) of the regions, presenting a greater annual percentage reduction in Amazonas, Huánuco, La Libertad, Cajamarca and Huancavelica. Ascaris and enterobiasis occurred more frequently, each representing 0,3% in 2017. Conclusions. The prevalence of general parasitosis, by group of helminths and by specific type of helminths, is lower than that reported in other studies, which were carried out in the school population unlike this study, which was carried out in the general population where 57,2% were over 18 years of age who attended a health facility.

RESUMEN Introducción. Las parasitosis por helmintos ocasionan deterioro nutricional, físico y cognitivo. La OMS ha expresado la necesidad de mapear la prevalencia de las parasitosis en América Latina y el Caribe. En el Perú no existen estudios que haya medido la prevalencia de dicha patología. Objetivos. Determinar la frecuencia de parasitosis general y por tipo de helmintos en el año 2017 y la tendencia de los últimos 8 previos, años a nivel nacional y por departamento. Métodos. Análisis de base de datos secundaria (Sistema de Información de Salud: HIS) del 2010 a 2017, que contiene el registro de las atenciones en los establecimientos de salud del Ministerio de Salud. Para el análisis de tendencias se utilizó modelos de regresión segmentada. Resultados. A nivel nacional la parasitosis general y por helmintos fue de 4,9% y de 3,3% respectivamente en el 2017; ambas presentaron una tendencia descendente, reduciéndose cada año 8,8% y 11,3% respectivamente. Igual ocurrió en el 68% (17/25) de las regiones, presentando una mayor reducción porcentual anual Amazonas, Huánuco, La Libertad, Cajamarca y Huancavelica. Áscaris y enterobiasis se presentaron con mayor frecuencia, representando en el 2017 cada una el 0,3%. Conclusiones. La prevalencia de parasitosis general, por grupo de helmintos y por tipo específico de helmintos, es menor a lo reportado en otros estudios, los cuales se realizaron en población escolar a diferencia de este estudio, el cual se realizó en población general donde el 57,2% fueron mayores de 18 años que acudieron a un establecimiento de salud.

ABSTRACT Intestinal parasites constitute an important public health problem at a global level, mainly affecting the pediatric population of tropical countries. The objective of this study was to determine the prevalence of intestinal parasites in children 2 to 5 years of age in 17 community homes of the Colombian Institute of Family Welfare (ICBF) in the Industrial Zone and Cartagena de Indias Bay, Colombia. A descriptive cross-sectional study was carried out among 207 children of both sexes. Samples were analyzed by coprology. There were no significant differences associated with sex and age (p>0.05). The frequency of enteroparasites in children aged 2 to 5 was 70.5 %, where 59.5% presented a single species of parasite, 34.2% two and 6.1% three and four species. The main protists (86.3%) found were Blastocystis hominis (60.2%) and Giardia lamblia (24.6%). In the group of Helminths (13.7%), Ascaris lumbricoides (9.6%) and Hymenolepis nana (6.2%) were observed. Intestinal parasites continue to be an important public health problem in the Colombian tropics, especially among children in vulnerable areas of Cartagena, Colombia. There is a need to review policies aimed at reducing the frequency of intestinal parasitism.

RESUMEN Las enteroparasitosis constituyen un importante problema de salud pública a nivel global, afectando principalmente a la población infantil de los países tropicales. Nuestro objetivo fue determinar la prevalencia de parásitos intestinales en niños de 2 a 5 años en 17 hogares comunitarios del Instituto Colombiano de Bienestar Familiar (ICBF) en la Zona Industrial y Bahía de Cartagena de Indias. Para ello, se realizó un estudio descriptivo de corte transversal; se analizaron muestras mediante coprología de 207 niños de ambos sexos. No hubo diferencias significativas asociadas al sexo y edad (p>0,05). La frecuencia de enteroparasitos en la población infantil de 2 a 5 años fue de un 70,5%, donde el 59,5%, presentó una sola especie de parásito, el 34,2% dos y 6,1% tres y cuatro especies. Los principales protistas (86,3%) encontrados fueron Blastocystis hominis (60,2%) y Giardia lamblia (24,6%). En el grupo de Helmintos (13,7%) se destacaron Ascaris lumbricoides (9,6%) e Hymenolepis nana (6,2%). Las enteroparasitosis continúan como un importante problema de salud pública en condiciones del trópico Colombiano, especialmente en población infantil de zonas vulnerables de Cartagena - Colombia. Evidenciando la necesidad de revisar las políticas dirigidas a reducir la frecuencia del parasitismo intestinal.

Resumo As parasitoses intestinais em pacientes imunocomprometidos podem levar a graves complicações se não diagnosticadas e tratadas precocemente. Este estudo teve como objetivo investigar a frequência de parasitos intestinais em pacientes oncológicos submetidos ao tratamento quimioterápico. Foram coletadas três amostras de fezes de cada paciente, sendo processadas pelas técnicas de Ritchie e Faust e submetidas à métodos de coloração específicos para protozoários intestinais. Foi encontrada positividade de 61,6% para parasitos e/ou comensais. Os helmintos identificados foram Ascaris lumbricoides (33,3%), Taenia spp. (6,6%), Strongyloides stercoralis (4,4%) e Trichuris trichiura (2,2%). Dentre os protozoários, foram identificados Giardia lamblia (26,6%), Cryptosporidium spp. (13,3%) e Cystoisospora belli (4,4%). Também foi registrada presença de Entamoeba coli, Endolimax nana e Entamoeba hartmanni. Os resultados encontrados alertam para a importância do diagnóstico parasitológico de fezes junto à utilização de colorações específicas para parasitos intestinais em pacientes oncológicos, sendo que os mesmos deveriam ser requeridos como conduta já na primeira consulta clínica destes pacientes, dada à elevada prevalência aqui constatada e a possível severidade que tais moléstias podem acarretar nestes indivíduos.

Abstract Intestinal parasitic infections in immunocompromised patients can lead to serious complications when not diagnosed and treated early. This study aimed to investigate the frequency of intestinal parasites in cancer patients undergoing chemotherapy in the South of Brazil. Three fecal samples collected from each patient (73 individuals) were processed by Ritchie and Faust techniques and submitted to specific staining methods for intestinal protozoa. A 61.6% parasite and/or commensal positivity was found. Helminths identified were Ascaris lumbricoides (33.3%), Taenia spp. (6.6%), Strongyloides stercoralis (4.4%) and Trichuris trichiura (2.2%). Among protozoans, Giardia lamblia (26.6%), Cryptosporidium spp. (13.3%) and Cystoisospora belli (4.4%) were identified. The presence of Entamoeba coli, Endolimax nana and Entamoeba hartmanni was also recorded. The results obtained warn of the importance of fecal parasitological diagnosis and the use of specific staining methods for the detection of intestinal parasites in cancer patients. These exams should be regularly requested at the patient’s first clinic visit, given the high prevalence found in this study and the possible severity of such conditions for these individuals.

The aim of this study was to evaluate the intestinal parasitism in dogs and cats with owners of the city of Barranquilla. A retrospective descriptive study was carried out, which included the reports of coprological analyses made in a veterinary clinical laboratory during the years 2014 and 2015 to 925 dogs and 45 cats from 26 veterinary centres located in the city. Results showed that 73.3% of dogs and 62.2% of cats had some type of intestinal parasites, without significant difference between species. The most frequent helminths were Toxocara sp (12.4 and 8.9% in dogs and cats, respectively), followed by Ancylostoma sp (3.4 and 4.4% in dogs and cats, respectively). The most frequent protozoa were Entamoeba sp, Isospora sp and Giardia sp in dogs and the last two in cats. The high frequency of intestinal parasites of zoonotic transmission found in dogs and cats showed the need to establish corrective and preventive measures for their control based on public health.

El objetivo del estudio fue evaluar el parasitismo intestinal en perros y gatos con dueño de la ciudad de Barranquilla. Se realizó un estudio descriptivo retrospectivo donde se incluyeron los reportes de análisis coprológicos realizados en un laboratorio clínico veterinario durante los años 2014 y 2015 a 925 perros y 45 gatos provenientes de 26 veterinarias ubicadas en la ciudad. El 73.3% de los perros y el 62.2% de los gatos presentaban algún tipo de parásito intestinal, sin diferencia significativa entre especies. Los parásitos más frecuentes fueron los helmintos Toxocara sp (12.4 y 8.9% en perros y gatos, respectivamente), seguido de Ancylostoma sp (3.4 y 4.4% en perros y gatos, respectivamente). Los protozoarios más frecuentes fueron Entamoeba sp, Isospora sp y Giardia sp en perros y los dos últimos en gatos. La alta frecuencia de parásitos intestinales de transmisión zoonótica encontrados en perros y gatos demuestra la necesidad de instaurar medidas correctivas y preventivas desde el ámbito de la salud pública para su control.