ABSTRACT Background: Microscopy and enzyme-linked immunosorbent assay (ELISA) are routinely used for Cryptosporidium diagnosis, without differentiating the parasite species. Methods: Children’s feces were analyzed by modified Ziehl-Neelsen (mZN) and ELISA for Cryptosporidium diagnosis and by polymerase chain reaction-restriction fragment length polymorphism for species identification. Results: Cryptosporidium frequency was 2.6%. The sensitivity and specificity of ELISA were 85.7% and 99.7%, respectively, with excellent concordance with mZN (kappa=0.854). Parasite species were characterized as Cryptosporidium hominis (78.3%), Cryptosporidium felis (17.4%), and Cryptosporidium parvum (4.3%). Conclusions: Coproantigen ELISA is as efficient as mZN for Cryptosporidium diagnosis. Cryptosporidium genotyping suggests anthroponotic and zoonotic transmission to children.

Resumen Introducción. Giardia duodenalis es un protozoo intestinal de gran prevalencia en los niños de los países en desarrollo. En estudios moleculares se ha evidenciado la gran diversidad genética de G. duodenalis y se han identificado los conjuntos A y B, principalmente en humanos. A pesar de su importancia, el conocimiento de la epidemiología molecular de la giardiasis humana aún es limitado en Brasil. Objetivo. Caracterizar los aislamientos moleculares de G. duodenalis de muestras tomadas a niños de Salvador, Bahía, Brasil. Materiales y métodos. Las muestras fecales positivas para G. duodenalis se obtuvieron de 71 niños de dos guarderías y de 39 usuarios de un laboratorio de análisis clínicos. Las muestras se analizaron mediante PCR-RFLP de los genes gdh y beta-giardin, y secuenciación de beta-giardin. Resultados. De las 110 muestras de G. duodenalis, en 80 (72,7 %) se amplificaron uno o ambos genes. De estos, 62 (77,5 %) se identificaron como pertenecientes al conjunto A y 18 (22,5 %) al B. El subconjunto AII se identificó en el 58,8 % (n=47) de los aislamientos, seguido del AI en el 18,8% (n=15), el BIV en el 11,2% (n=9) y el BIII en el 5,0% (n=4). El subconjunto AII fue el más frecuente en los niños de ambas guarderías, en tanto que el AI solo se encontró en el grupo atendido en el laboratorio clínico. El subconjunto AII predominó en los niños menores de dos años. Conclusiones. La mayor frecuencia del subconjunto AII sugiere que la transmisión antroponótica es más común en Salvador, pero también existen vías de transmisión zoonóticas, y que pueden ocurrir cambios en la sensibilidad frente a diferentes patrones moleculares de Giardia durante el crecimiento infantil.

Abstract Introduction. Giardia duodenalis is an intestinal protozoan with a high prevalence in children of developing countries. Molecular studies revealed a great genetic diversity of G. duodenalis, with assemblages A and B found mainly in humans. Despite its importance, the information on the molecular epidemiology of human giardiasis is still limited in Brazil. Objective. To characterize G. duodenalis molecular isolates in children from Salvador, Bahia, Brazil. Materials and methods. Giardia duodenalis positive fecal samples were obtained from 71 children from two day care centers and 39 users of a clinical analysis laboratory. Samples were analyzed by PCR-RFLP of the glutamate dehydrogenase (gdh) and beta-giardin genes and by the sequencing of beta-giardin. Results. Of the 110 G. duodenalis samples, 80 (72.7%) amplified one or both target genes. Of these, 62 (77.5 %) were identified as assemblage A and 18 (22.5%) as assemblage B. The subassemblage AII was identified in 58.8% (n=47) of isolates followed by the sub-assemblage AI (18.8%, n=15), BIV (11.2%, n=9), and BIII (5.0%, n=4). The AII sub-assemblage was the most frequent in children of both day care centers whereas AI was found only in the group attended at the clinical laboratory. Sub-assemblage AII predominated in children under two years. Conclusions. The higher frequency of AII sub-assemblage suggests that anthroponotic transmission is more common in Salvador, but that zoonotic transmission pathways are also present and a change in susceptibility to different molecular patterns of Giardia may occur during child growth.

Rotavirus is a major cause of infectious diarrhea in infants and young children. The objective of this study was to characterize the genotypes of Human Rotavirus found in children hospitalized with acute diarrhea in the Pediatric Hospital Prof. Hosannah de Oliveira of the UFBA in Salvador, Bahia, Brazil, during the years of 1999, 2000 and 2002. Fecal samples were analyzed (n=358) by methods EIARA and SDS-PAGE for detection of Rotavirus. Positive samples of one or two of these methods (n=168) were submitted to RT-PCR and Multiplex-Nested PCR to determine genotypes G and P. A hundred sixty-eight (46.9%) samples were positive and 190 (53.1%) negative. Only 17 (4.7%) samples had divergent results. The distribution of genotypes G during the first year, showed that the genotype G9 was present in 96,8% of the analyzed samples, in the second year, it was responsible for 96% and in the third year, 88,1%. The characterization of genotypes P demonstrated that the genotype P1A[8] was the most outstanding in all years. In this study we discuss the benefit to control the genotypes of Rotavirus through the molecular characterization for the development of potential vaccines.

Os objetivos deste estudo realizado com a população infantil do Alto Xingu foram: (1) analisar a evolução do peso e da estatura entre o primeiro e o quarto anos de vida, (2) comparar o estado nutricional em 1980 e 1992. Avaliaram-se o peso e a estatura de: (1) 81 crianças no primeiro e no quarto ano de vida; (2) 264 crianças avaliadas em 1980 e de 172 em 1992 (idade < 10 anos). As medianas dos escores Z das 81 crianças examinadas no primeiro e no quarto ano de vida revelaram: (1) diminuição do peso para a idade (-0,12 no primeiro ano e -0,51 no quarto ano de vida; p = 0,002); (2) diminuição do peso para a estatura (+1,31 e +0,08; p < 0,001); (3) aumento da estatura para a idade (-1,50 e -0,94, p < 0,001). Entre 1980 e 1992, observou-se: (1) manutenção do peso para a idade (-0,61 em 1980 e -0,62 em 1992; p = 0,90); (2) manutenção do peso para a estatura, (+0,27 e +0,34; p = 0,10); e (3) redução da estatura para a idade (-1,04 e -1,22; p = 0,02). Entre o primeiro e quarto ano de vida observou-se redução do déficit de estatura para a idade e do excesso de peso para a estatura. Entre 1980 e 1992, observou-se diminuição da estatura para idade, indicando a necessidade de monitorização do estado nutricional desta comunidade.

This study focused on the under-five population of the Alto Xingu region in Brazil, with the following objectives: (1) to evaluate height and weight increment from the first through the fourth years of life and (2) to compare nutritional status in 1980 and 1992. Height and weight increases were evaluated in 81 children. Weight and height were measured in 264 children evaluated in 1980 and in 172 in 1992 (< 10 years of age). Median Z-scores in the first and fourth years of life, respectively, showed: (1) a decrease in weight-for-age, (-0.12 in the first year and -0.51 in the fourth year of life; p = 0.002); (2) a decrease in weight-for-height (+1.31 and +0.08; p < 0.001); (3) an increase in height-for-age (-1.50 and -0.94; p < 0.001). Median Z-scores in 1980 and 1992 showed: (1) no change in weight-for-age (-0.61 in 1980 and -0.62 in 1992; p = 0.90); (2) no change in weight-for-height (+0.27 and +0.34; p = 0.10); and (3) a decrease in height-for-age (-1.04 and -1.22; p = 0.02). Height-for-age increased and weight-for-height decreased between the first and fourth years of life. A decrease in height-for-age was observed from 1980 to 1992, demonstrating the importance of nutritional surveillance among the population of the Alto Xingu.

Os objetivos deste estudo realizado com a população infantil do Alto Xingu foram: (1) analisar a evolução do peso e da estatura entre o primeiro e o quarto anos de vida, (2) comparar o estado nutricional em 1980 e 1992. Avaliaram-se o peso e a estatura de: (1) 81 crianças no primeiro e no quarto ano de vida; (2) 264 crianças avaliadas em 1980 e de 172 em 1992 (idade < 10 anos). As medianas dos escores Z das 81 crianças examinadas no primeiro e no quarto ano de vida revelaram: (1) diminuição do peso para a idade (-0,12 no primeiro ano e -0,51 no quarto ano de vida; p = 0,002); (2) diminuição do peso para a estatura (+1,31 e +0,08; p < 0,001); (3) aumento da estatura para a idade (-1,50 e -0,94, p < 0,001). Entre 1980 e 1992, observou-se: (1) manutenção do peso para a idade (-0,61 em 1980 e -0,62 em 1992; p = 0,90); (2) manutenção do peso para a estatura, (+0,27 e +0,34; p = 0,10); e (3) redução da estatura para a idade (-1,04 e -1,22; p = 0,02). Entre o primeiro e quarto ano de vida observou-se redução do déficit de estatura para a idade e do excesso de peso para a estatura. Entre 1980 e 1992, observou-se diminuição da estatura para idade, indicando a necessidade de monitorização do estado nutricional desta comunidade.

This study focused on the under-five population of the Alto Xingu region in Brazil, with the following objectives: (1) to evaluate height and weight increment from the first through the fourth years of life and (2) to compare nutritional status in 1980 and 1992. Height and weight increases were evaluated in 81 children. Weight and height were measured in 264 children evaluated in 1980 and in 172 in 1992 (< 10 years of age). Median Z-scores in the first and fourth years of life, respectively, showed: (1) a decrease in weight-for-age, (-0.12 in the first year and -0.51 in the fourth year of life; p = 0.002); (2) a decrease in weight-for-height (+1.31 and +0.08; p < 0.001); (3) an increase in height-for-age (-1.50 and -0.94; p < 0.001). Median Z-scores in 1980 and 1992 showed: (1) no change in weight-for-age (-0.61 in 1980 and -0.62 in 1992; p = 0.90); (2) no change in weight-for-height (+0.27 and +0.34; p = 0.10); and (3) a decrease in height-for-age (-1.04 and -1.22; p = 0.02). Height-for-age increased and weight-for-height decreased between the first and fourth years of life. A decrease in height-for-age was observed from 1980 to 1992, demonstrating the importance of nutritional surveillance among the population of the Alto Xingu.