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Prevalência e caracterização molecular de protozooses intestinais em crianças no hospital central de Maputo, Moçambique
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Os parasitas intestinais, que incluem protozoários e helmintas, são responsáveis por infecções em humanos em todo o mundo. Estas infecções estão associadas a morbilidade e mortalidade significativas, especialmente nas regiões tropicais e subtropicais. Este trabalho consistiu na determinação da prevalência de protozooses intestinais em crianças internadas no Serviço de Doenças Infecto-Contagiosas Secção das Diarreias (ICd) e no Serviço de Mal Nutrição (MN) do Departamento de Pediatria do Hospital Central de Maputo (HCM), Moçambique. Utilizaram-se métodos parasitológicos convencionais e a identificação molecular das espécies G.lamblia, E.histolytica, E.dispar e E.moshkovskii, e a genotipagem de G.lamblia. Amostras de fezes de 104 crianças, com idades compreendidas entre os 2 meses e os 94 meses foram colhidas para detecção de parasitas. 43,3% das crianças estavam internadas no serviço ICd e as restantes 56,7% no serviço MN. O exame parasitológico das fezes revelou que 32,7% (34/104) das crianças estavam infectadas com pelo menos um parasita patogénico. Estes incluíram os protozoários, G.lamblia (6,7%) e Cryptosporidium sp (15,4%) e os helmintas, Trichuris trichiura (11,5%) e Ascaris lumbricoides (2,9%). A análise molecular de todas as amostras de fezes detectou DNA de G.lamblia em 17,3% das crianças, de E.histolytica em 9,6% e de E.moshkovskii em 1,9%. Todas as crianças, excepto uma, nas quais os métodos moleculares detectaram G. lamblia e E.histolytica apresentavam diarreia. Através da genotipagem de G.lamblia verificou-se que o genótipo B (77,8%, 14/18) foi claramente mais prevalente que o genótipo A (16,7%, 3/18), não sendo observadas diferenças em termos de apresentação clínica. Este estudo contribuiu para um conhecimento da giardíase, amebíase e criptosporidiose em Moçambique.
Intestinal parasites, which include protozoan and helmints, are responsible for frequent infections in humans all over the world. These infections are associated with significant morbidity and mortality especially in tropical and subtropical regions. The aim of this work was to determine the prevalence of intestinal parasites infections, namely caused by protozoa, in children hospitalized at the section of diarrhea (ICd) in the Infectious-Contagious Diseases service and at the Malnutrition service (MN) of the Department of Pediatrics of the Hospital Central de Maputo (HCM), Mozambique. For parasite identification we used both conventional parasitological and molecular methods, the later only for detection and identification of G.lamblia, E.histolytica, E.dispar and E.moshkovskii. Stool samples of 104 children between 2 and 94 months old were obtained for parasite detection. 43.3% of the children were hospitalized at the ICd Service and the remaining 56.7% at the MN service. Parasitological analysis revealed that 32.7% (34/104) of the children were infected with at least one pathogenic parasite. These included the protozoa G.lamblia (6.7%) and Cryptosporidium (15.4%) and the helminths Trichuris trichiura (11.5%) and Ascaris lumbricoides (2.9%). Molecular analysis of all stool samples revealed that 17.3% of the children were infected with G.lamblia, 9.6% with E.histolytica and 1.9% with E.moshkovskii DNA. While microscopy was able to detect part of the children infected with G. lamblia, all infections with Entamoeba remained undetected with microscopy. The association of PCR and microscopy detected 19.2% G.lamblia infections. All but one children in whom the molecular methods detected either Giardia or E. histolytica presented diarrhea. Genotyping of G.lamblia has shown that genotype B (77.8%, 14/18) was clearly more prevalent that genotype A (16.7%, 3/18). No difference was observed in terms of clinical presentation. This study has contributed to a better understanding of giardiasis, amebiasis and cryptosporidiosis in Mozambique.
Intestinal parasites, which include protozoan and helmints, are responsible for frequent infections in humans all over the world. These infections are associated with significant morbidity and mortality especially in tropical and subtropical regions. The aim of this work was to determine the prevalence of intestinal parasites infections, namely caused by protozoa, in children hospitalized at the section of diarrhea (ICd) in the Infectious-Contagious Diseases service and at the Malnutrition service (MN) of the Department of Pediatrics of the Hospital Central de Maputo (HCM), Mozambique. For parasite identification we used both conventional parasitological and molecular methods, the later only for detection and identification of G.lamblia, E.histolytica, E.dispar and E.moshkovskii. Stool samples of 104 children between 2 and 94 months old were obtained for parasite detection. 43.3% of the children were hospitalized at the ICd Service and the remaining 56.7% at the MN service. Parasitological analysis revealed that 32.7% (34/104) of the children were infected with at least one pathogenic parasite. These included the protozoa G.lamblia (6.7%) and Cryptosporidium (15.4%) and the helminths Trichuris trichiura (11.5%) and Ascaris lumbricoides (2.9%). Molecular analysis of all stool samples revealed that 17.3% of the children were infected with G.lamblia, 9.6% with E.histolytica and 1.9% with E.moshkovskii DNA. While microscopy was able to detect part of the children infected with G. lamblia, all infections with Entamoeba remained undetected with microscopy. The association of PCR and microscopy detected 19.2% G.lamblia infections. All but one children in whom the molecular methods detected either Giardia or E. histolytica presented diarrhea. Genotyping of G.lamblia has shown that genotype B (77.8%, 14/18) was clearly more prevalent that genotype A (16.7%, 3/18). No difference was observed in terms of clinical presentation. This study has contributed to a better understanding of giardiasis, amebiasis and cryptosporidiosis in Mozambique.
Descrição
Tese de mestrado, Biologia (Microbiologia Aplicada), 2009, Universidade de Lisboa, Faculdade de Ciências
Palavras-chave
Parasitologia médica Protozoários Teses de mestrado