Browsing by Author "Mirante, Clara"
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- Comparing concentration methods: Parasitrap® versus Kato-Katz for studying the prevalence of helminths in Bengo province, AngolaPublication . Mirante, Clara; Clemente, Isabel; Zambu, Graciette; Alexandre, Catarina; Ganga, Teresa; Mayer, Carlos; Brito, MiguelBackground: Helminth intestinal parasitoses are responsible for high levels of child mortality and morbidity. Hence, the capacity to diagnose these parasitoses and consequently ensure due treatment represents a factor of great importance. Objectives: The main objective of this study involves comparing two methods of concentration, parasitrap and Kato-Katz, for the diagnosis of intestinal parasitoses in faecal samples. Methods: Sample processing made recourse to two different concentration Methods: the commercial parasitrap® method and the Kato-Katz method. Results: We correspondingly collected a total of 610 stool samples from pre-school and school age children. The results demonstrate the incidence of helminth parasites in 32.8% or 32.3% of the sample collected depending on whether the concentration method applied was either the parasitrap method or the Kato-Katz method. We detected a relatively high percentage of samples testing positive for two or more species of helminth parasites. We would highlight that in searching for larvae the Kato-Katz method does not prove as appropriate as the parasitrap method. Conclusion: Both techniques prove easily applicable even in field working conditions and returning mutually agreeing results. This study concludes in favour of the need for deworming programs and greater public awareness among the rural populations of Angola.
- Diagnóstico da malária em Angola: um país em estreita ligação com PortugalPublication . Moura, S.; Fançony, Cláudia; Mirante, Clara; Neves, M.; Bernardino, L.; Sambo, R.; Barros, H.; Brito, MiguelAs migrações e a globalização dos viajantes têm apresentado grandes desafios no controlo da transmissão de doenças. Em 2012, o número estimado de pessoas em risco de contraíram malária foi de 3,4 biliões. Na Europa, esta é uma doença rara que, em 2012, apenas teve reportados 255 casos autóctones. Para turistas e emigrantes de áreas não endémicas, a malária representa um sério risco de morte e deve ser uma forte suspeita em casos de febre. Um diagnóstico correcto é de extrema importância para o controlo da malária. Este deve ser feito imediatamente após o aparecimento dos primeiros sintomas, daí que os serviços de saúde dos países visitados devem estar aptos a prontamente identificar e tratar esta doença. O objectivo deste trabalho doi determinar o impacto de uma formação na melhoria do diagnóstico da malária.
- Diarreia em crianças menores de cinco anos no Hospital Geral do BengoPublication . Gasparinho, Carolina; Mirante, Clara; Mayer, António Carlos; Brito, MiguelA doença diarreica constitui uma das principais causas de morte em crianças menores de cinco anos em Angola. O presente estudo assume como principal objectivo identificar os agentes patogénicos causadores de diarreia, entre eles vírus, parasitas e bactérias, das crianças admitidas no Hospital Geral do Bengo. Material de estudo - O estudo iniciou-se em Setembro de 2012, tendo sido incluídas crianças menores de 5 anos admitidas no Hospital Geral do Bengo por diarreia (serviço de urgência e consulta externa) até Outubro de 2013, sem história de antibioterapia.
- Efectividade do controlo da schistosomíase no BengoPublication . Lemos, Manuel; Sousa, Carlos Alberto Pinto de; Moura, Sofia; Mirante, Clara; Brito, MiguelIntrodução - A schistosomíase é um agente causador de anemia e outras manifestações clínicas em crianças, comprometendo o seu crescimento e a sua performance escolar. Actualmente a principal iniciativa de controlo integrado da schistosomíase é a implementação de programas de administração massiva de praziquantel e albendazol na escola ou na comunidade para o controlo da endemia. Objectivo - O objectivo deste estudo foi avaliar a efectividade do tratamento massivo de crianças em idade escolar (6-15 anos) com praziquantel na redução da prevalência e intensidade da schistosomíase no Bairro Cabungo, Dande-Bengo.
- Effect of deworming on hemoglobin concentration in children from 2 to 15 years from the Bengo Province, AngolaPublication . Brito, Miguel; Lemos, Manuel; Mirante, Clara; Moura, Sofia; Mayer, CarlosThe most common causes of anemia are micronutrient deficiencies, but other factors may influence namely inflammation, parasitic infections and inherited disorders. One strategy to combat micronutrient deficiencies is supplementation, yet, in zones with high prevalence of Schistosomiasis or Soil Transmitted Helminthes (STH), supplementation could be not sufficient. The aim of this study was to evaluate the effects of deworming, on hemoglobin concentration, in children from 2 to 15 years, from Bengo.
- Etiology of diarrhea in children younger than 5 years attending the Bengo General Hospital in AngolaPublication . Gasparinho, Carolina; Mirante, Clara; Centeno-Lima, Sónia; Istrate, Claudia; Mayer, Carlos; Tavira, Luis; Nery, Susana Vaz; Brito, MiguelBackground - Diarrheal disease is among the leading causes of death in children younger than 5 years, especially in developing countries. The aim of this study was to investigate the most frequent etiological agents of diarrhea and its associated factors in children younger than 5 years attending the Bengo General Hospital in Angola. Methods - From September 2012 through December 2013, stool samples were collected from 344 children presenting with diarrhea to investigate the presence of viral, bacterial and parasitic agents. Relevant sociodemographic and clinical data were obtained from parents and caregivers. Results - An enteric pathogen was detected in 66.6% of stool samples: Cryptosporidium spp. (30.0%), rotavirus (25.1%), Giardia lamblia (21.6%), diarrheagenic Escherichia coli (6.3%), Ascaris lumbricoides (4.1%), adenovirus (3.8%), Strongyloides stercoralis (3.5%), astrovirus (2.6%), Hymenolepis nana (1.7%), Entamoeba histolytica/dispar (0.9%), Taenia spp. (0.6%), Trichuris trichiura (0.3%) and Entamoeba histolytica (0.3%). Children younger than 12 months were more frequently infected with Cryptosporidium spp. compared with older children (age: 12-59 months), independently of sex, season, lethargy and wasting [odds ratio (OR): 3.5, 95% confidence interval (95% CI): 2.0-6.2]. Age (OR: 5.0, 95% CI: 2.6-9.3), vomiting (OR: 2.7, 95% CI: 1.5-4.8) and type of admission (inpatients, OR: 0.5, 95% CI: 0.3-0.9) were significantly associated with rotavirus infection. Conclusions - This study demonstrates high rates of infection with an enteric pathogen, particularly in children younger than 12 months, emphasizing the need to address diarrheal disease in this age group.
- Impact of a training course on the quality of malaria diagnosis by microscopy in AngolaPublication . Moura, Sofia; Fançony, Cláudia; Mirante, Clara; Neves, Marcela; Bernardino, Luís; Fortes, Filomeno; Sambo, Maria do Rosário; Brito, MiguelBackground: In Angola, malaria is an endemic disease having a major impact on the economy. The WHO recommends testing for all suspected malaria cases, to avoid the presumptive treatment of this disease. In malaria endemic regions laboratory technicians must be very comfortable with microscopy, the golden standard for malaria diagnosis, to avoid the incorrect diagnosis. The improper use of medication promotes drug resistance and undesirable side effects. The present study aims to assess the impact of a three-day refresher course on the knowledge of technicians, quality of blood smears preparation and accuracy of microscopy malaria diagnosis, using qPCR as reference method. Methods: This study was implemented in laboratories from three hospitals in different provinces of Angola: Bengo, Benguela and Luanda. In each laboratory samples were collected before and after the training course (slide with thin and thick blood smears, a dried blood spot and a form). The impact of the intervention was evaluated through a written test, the quality of slide preparation and the performance of microscopy. Results: It was found a significant increase on the written test median score, from 52.5% to 65.0%. A total of 973 slides were analysed to evaluate the quality of thick and thin blood smears. Considering all laboratories there was a significant increase in quality of thick and thin blood smears. To determine the performance of microscopy using qPCR as the reference method we used 1,028 samples. Benguela presented the highest values for specificity, 92.9% and 98.8% pre and post-course, respectively and for sensitivity the best pre-course was Benguela (75.9%) and post-course Luanda (75.0%). However, no significant increase in sensitivity and specificity after the training course was registered in any laboratory analysed. Discussion: The findings of this study support the need of continuous refresher training for microscopists and other laboratory staff. The laboratories should have a quality control programme to supervise the diagnosis and also to assess the periodicity of new training. However, other variables needed to be considered to have a correct malaria diagnosis, such as adequate equipment and reagents for staining and visualization, good working conditions, motivated and qualified personnel.
- Impacto de uma formação na qualidade do diagnóstico microscópico de malária em AngolaPublication . Fançony, Cláudia; Moura, Sofia; Mirante, Clara; Neves, Marcela; Bernardino, Luís; Sambo, Rosário; Brito, MiguelA malária é uma doença endémica em Angola responsável por elevada morbilidade e mortalidade, especialmente entre crianças menores de cinco anos. Uma boa performance das técnicas de diagnóstico de malária é essencial uma vez que reduz o uso irracional de antimaláricos e melhora a qualidade da vigilância epidemiológica. A microscopia é o método de diagnóstico de referência, no entanto, a qualidade dos resultados varia consideravelmente entre laboratórios principalmente devido ao nível da experiência dos técnicos, qualidade dos reagentes e equipamentos. Neste estudo pretendemos avaliar a performance da microscopia no diagnóstico da malária, antes e após a realização de um curso de formação de 3 dias, utilizando o qPCR como método de referência.
- Integrated community-based intervention for urinary schistosomiasis and soil-transmitted helminthiasis in children from Caxito, AngolaPublication . Lemos, Manuel; Fançony, Cláudia; Moura, Sofia; Mirante, Clara; Sousa, Pinto de; Barros, Henrique; Nery, Susana; Brito, MiguelBackground: Schistosomiasis and soil-transmitted helminths (STH) infections are major public health problems. We aimed to study the 6-mo impact of mass drug administration with praziquantel and albendazole on urinary schistosomiasis and STH. Methods: We examined children (aged 2–15 y) from one hamlet, who provided urine and feces samples at baseline (n=197), 1 mo (n=102), and 6 mo (n=92); 67 completed the protocol. Results: At baseline, 47/67 (70.1%) children presented Schistosoma haematobium (75.8% in the baseline total sample) and 12/67 (17.9%) with STH (30.5% in the initial sample, p=0.010). Among the children, 47.3% had heavy Schistosoma haematobium infection. The most frequent STH was Trichuris trichiura in 9.0%. We also found Hymenolepis nana (13.2%) and Plasmodium falciparum (9.1%) infections and anemia (82.1%). One mo after chemotherapy there was a significant (p=0.013) reduction of Schistosoma haematobium prevalence (23.5%) and a high egg reduction rate (86.9%). Considering the sample of 67 children, the mean egg concentration was 498 at baseline, 65 at 1 mo, and 252 at 6 mo (p<0.05). We also observed a reduction in STH infections, 50% in Ascaris lumbricoides, 33.3% in T. trichiura, and 50% in hookworms. At 6 mo, the prevalence of Schistosoma haematobium (76.1%) was similar to the baseline and the STH reduction was not significant. Conclusions: Longitudinal studies have reported many losses in these settings, but we were able to show that mass drug administration for control of schistosomiasis and STH presents low effectiveness, that reinfections occur rapidly and that stand-alone anthelmintic therapy is not a sustainable choice.
- Mapping freshwater snails in north-western Angola: distribution, identity and molecular diversity of medically important taxaPublication . Allan, Fiona; Sousa-Figueiredo, Jose Carlos; Emery, Aidan M.; Paulo, Rossely; Mirante, Clara; Sebastião, Alfredo; Brito, Miguel; Rollinson, DavidBackground - This study was designed to determine the distribution and identity of potential intermediate snail hosts of Schistosoma spp. in Bengo, Luanda, Kwanza Norte and Malanje Provinces in north-western Angola. This is an area where infection with Schistosoma haematobium, causing urogenital schistosomiasis, is common but little is yet known about transmission of the disease. Angola has had a varied past with regard to disease control and is revitalising efforts to combat neglected tropical diseases. Methods - Snails were sampled from 60 water-contact points. Specimens of the genera Bulinus, Biomphalaria or Lymnaea were screened for trematode infections by inducing cercarial shedding. Snails were initially identified using shell morphology; subsequently a cytochrome c oxidase subunit 1 (cox1) gene fragment was amplified from a subset of snails from each site, for molecular identification. Cercariae were captured onto FTA cards for molecular analysis. Specimens of Bulinus angolensis collected from the original locality of the type specimen have been characterised and comparisons made with snails collected in 1957 held at the Natural History Museum, London, UK. Results - In total snails of nine genera were identified using morphological characteristics: Biomphalaria, Bulinus, Gyraulus, Lanistes, Lentorbis, Lymnaea, Melanoides, Physa and Succinea. Significant for schistosomiasis transmission, was the discovery of Bulinus globosus, B. canescens, B. angolensis, B. crystallinus and Biomphalaria salinarum in their type-localities and elsewhere. Bulinus globosus and B. angolensis occurred in two distinct geographical areas. The cox1 sequence for B. globosus differed markedly from those from specimens of this species collected from other countries. Bulinus angolensis is more closely related to B. globosus than originally documented and should be included in the B. africanus group. Schistosoma haematobium cercariae were recovered from B. globosus from two locations: Cabungo, Bengo (20 snails) and Calandula, Malanje (5 snails). Schistosoma haematobium cercariae were identified as group 1 cox1 corresponding to the type common throughout the African mainland. Conclusions - Various freshwater bodies in north-western Angola harbour potential intermediate snail hosts for urogenital schistosomiasis, highlighting the need to map the rest of the country to identify areas where transmission can occur and where control efforts should be targeted. The molecular phylogeny generated from the samples confirmed that considerable variation exists in B. globosus, which is the primary snail host for S. haematobium in many regions of Africa.