Biomedical subjects

Dioclécio Campos

Publications and source records attributed to Dioclécio Campos.

5 recordsLinked to original sources

PubMed2006

Differences between Belgian and Brazilian group A Streptococcus epidemiologic landscape.

BACKGROUND: Group A Streptococcus (GAS) clinical and molecular epidemiology varies with location and time. These differences are not or are poorly understood. METHODS AND FINDINGS: We prospectively studied the epidemiology of GAS infections among children in outpatient hospital clinics in Brussels (Belgium) and Brasília (Brazil). Clinical questionnaires were filled out and microbiological sampling was performed. GAS isolates were emm-typed according to the Center for Disease Control protocol. emm pattern was predicted for each isolate. 334 GAS isolates were recovered from 706 children. Skin infections were frequent in Brasília (48% of the GAS infections), whereas pharyngitis were predominant (88%) in Brussels. The mean age of children with GAS pharyngitis in Brussels was lower than in Brasília (65/92 months, p<0.001). emm-typing revealed striking differences between Brazilian and Belgian GAS isolates. While 20 distinct emm-types were identified among 200 Belgian isolates, 48 were found among 128 Brazilian isolates. Belgian isolates belong mainly to emm pattern A-C (55%) and E (42.5%) while emm pattern E (51.5%) and D (36%) were predominant in Brasília. In Brasília, emm pattern D isolates were recovered from 18.5% of the pharyngitis, although this emm pattern is supposed to have a skin tropism. By contrast, A-C pattern isolates were infrequently recovered in a region where rheumatic fever is still highly prevalent. CONCLUSIONS: Epidemiologic features of GAS from a pediatric population were very different in an industrialised country and a low incomes region, not only in term of clinical presentation, but also in terms of genetic diversity and distribution of emm patterns. These differences should be taken into account for designing treatment guidelines and vaccine strategies.

Adolescent↗

PubMed2006

Pharyngitis in low-resources settings: a pragmatic clinical approach to reduce unnecessary antibiotic use.

OBJECTIVE: Existing scoring systems for the diagnosis of group A streptococcus pharyngitis are insensitive or inapplicable in low-resources settings. Bacterial cultures and rapid tests can allow for antibiotic prescription abstention in high-income regions. These techniques are not feasible in many low-resources settings, and antibiotics often are prescribed for any pharyngitis episode. However, judicious antibiotics prescription in the community also is of concern in low-income countries. The objective of this study was to develop a clinical decision rule that allows for the reduction of empirical antibiotic therapy for children with pharyngitis in low-resources settings by identifying non-group A streptococcus pharyngitis. PATIENTS AND METHODS: We prospectively included children with pharyngitis in 3 public hospitals of Brazil during 9 months in 2004. We filled out clinical questionnaires and performed throat swabs. Bilateral chi2 (2-tailed test) and multivariate analysis were used to determine score categories. The outcome measures were sensitivity, specificity, positive likelihood ratio, and posttest probability of non-group A streptococcus infection with the clinical approach as compared with throat culture. RESULTS: A total of 163 of the 220 children had non-group A streptococcus pharyngitis (negative culture). We established a 3-questions decision rule (age and viral and bacterial signs) with 3 possible answers. The use of this score would prevent 41% to 55% of unnecessary antimicrobial prescriptions. The specificity of the score for non-group A streptococcus pharyngitis was >84%. CONCLUSION: Such a clinical decision rule could be helpful to reduce significantly unnecessary antibiotic prescriptions for pharyngitis in children in low-resources settings.

Anti-Bacterial Agents↗

PubMed2004

Risk factors for Toxoplasma gondii infection in women of childbearing age.

OBJECTIVES: Determine the risk factors involved in toxoplasmosis transmission and determine whether pregnancy is a risk factor for toxoplasmosis infection. STUDY DESIGN: Cross-sectional study carried out on 2,242 women at childbearing age. An indirect immunofluorescence reaction was used to identify immunity to Toxoplasma gondii. Previous gestations were also analyzed as a possible risk factor. The results were analyzed by chi2 and OR tests, and by variance analysis. The sample was statistically balanced according to social-economic risk factors. RESULTS: Previously pregnant women were 1.74 times more frequently infected with toxoplasmosis, regardless of environmental conditions. Pregnant women living under unfavorable environmental conditions had an approximately two times increased risk of being infected for each risk factor (contact with host animals, presence of vehicles of oocyst transmission). Previous pregnancy was the risk factor that had the strongest influence on acquiring toxoplasmosis (variance analysis and statistical balancing). DISCUSSION: The prevalence of this zoonosis is high in Goiânia-GO, Brazil (65.8%). Inadequate environmental sanitation was not significantly correlated with toxoplasmosis infection, except when associated with previous pregnancy, showing that the fundamental cause for infection is not environmental. CONCLUSION: The finding that pregnancy makes women more vulnerable to this protozoan, makes it important to implement prophylactic control of at-risk pregnant women.

Adolescent↗

PubMed2003

Pregnancy as a risk factor for acute toxoplasmosis seroconversion.

OBJECTIVE: To test the hypothesis that pregnancy is a risk factor for toxoplasmosis seroconversion. MATERIALS AND METHODS: A prospective observational study of women at child-bearing age vulnerable to Toxoplasma gondii. Serological reactions with indirect immunofluorescent antibody and immunoenzyme tests were used. The risk estimate used limits of reliability at 95%, and the results were validated by chi(2) and RR tests. RESULTS: Acute infection among pregnant women was 8.6% (45/522), and pregnancy was confirmed to be a risk factor for seroconversion (P=0.001). Living in close contact with host animals and vehicles of oocyst transmission proved to be a statistical risk for pregnant women to seroconvert, which was aggravated in adolescents. CONCLUSION: Gestation, potentiating susceptibility to this infection, points to the need of primary and secondary prevention for all pregnant women at risk.

Adolescent↗

PubMedDate not supplied

[Zinc supplementation may recover taste for salt meals].

OBJECTIVE: To evaluate the effect of zinc on the appetite for salt foods in children aged 8 months to 5 years. METHOD: Double-blind, placebo-controlled study. Two groups of 20 children refusing to eat salt foods were followed during 6 months. The children in the first group received zinc chelate 1 mg/kg daily for 3 months. The second group received a placebo solution. The two groups were similar in terms of age, sex, weight, duration of breastfeeding, age at weaning, biochemical and hematological data. The response of children to treatment was informed by their mothers. RESULTS: 17/20 (85%) of the children receiving zinc chelate and 10/20 (50%) of the children receiving placebo improved their appetite for salt foods. The difference was statistically significant (p < 0.05, chi-square test). CONCLUSION: Zinc supplementation may improve the acceptance of salt foods by children.

Appetite↗