Jornal de Pediatria (Apr 2005)
Estudo clínico-epidemiológico da toxocaríase em população infantil Clinical-epidemiological study of toxocariasis in a pediatric population
Abstract
OBJETIVO: A diversidade de manifestações clínicas da toxocaríase e sua relação com asma motivaram este estudo, cujo objetivo foi estudar a soropositividade de T. canis nas crianças atendidas no serviço público de saúde e sua associação com variáveis clínicas, epidemiológicas e laboratoriais. MÉTODOS: Este estudo é de corte transversal e controlado. Foram realizadas sorologias em 208 crianças de 1 a 14 anos de idade, atendidas nos ambulatórios de Pediatria, Imunologia e Pneumologia Pediátrica da Universidade de Santo Amaro, no período de janeiro de 2000 a janeiro de 2001. Os anticorpos foram detectados por ELISA usando-se antígeno de excreção e secreção do T. canis.. Foi utilizado teste qui-quadrado para associações da soropositividade para T. canis (título > 1:320) com cães filhotes domiciliares, contato com terra, geofagia, onicofagia, escolaridade materna, asma, tosse crônica, pneumonias de repetição, manifestações cutâneas, rinite, hepatomegalia, esplenomegalia, dor abdominal, anemia, eosinofilia, imunoglobulinas, parasitoses e desnutrição, e método de análise de variância por postos de Kruskal-Wallis para comparação média dos soropositivos e soronegativos, sendo significante p OBJECTIVE: The variety of toxocariasis clinic manifestations and its relationship with asthma motivated this study. The aim was to study T.canis seropositivity at a public pediatric service and its association with laboratory, epidemiological and clinical factors. METHODS: This study was cross-sectional and controlled. Two hundred and eight children, from 1 to 14 years old and treated at the University of Santo Amaro Pediatric Department's Immunology and Pneumology clinic between January 2000 and January 2001, underwent serology testing. Antibodies were detected by ELISA testing for the larval excretory-secretory antigen of T. canis. We used the chi-square test for T.canis seropositivity (titers > 1:320) associations with: puppies at home, contact with soil, geophagia, onicophagia, mother's educational level, asthma, chronic cough, repetitive pneumonia, skin manifestations, rhinitis, hepatomegaly, splenomegaly, abdominal pain, anemia, eosinophilia, immunoglobulins, parasitosis and stunted growth. The Kruskal-Wallis variance analysis method was used for mean comparisons between seropositive and seronegative groups. Significance was set at p < 0.05. RESULTS: Seroprevalence was 54.8%, with a mean age of 6.5 years while for seronegative children the mean age was 5.8 years, showing no significant difference. There was also no difference between sexes. Seropositivity was significantly associated with puppies at home, contact with soil, hepatomegaly, asthma, eosinophilia, increased serum immunoglobulin (Ig) E levels and stunted growth. CONCLUSION: Seroprevalence was elevated in this study . T.canis infection must be considered in at-risk children, such as those with puppies at home, who have had contact with soil, who have hepatomegaly and/or asthma with eosinophilia and increased serum IgE.
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