Enteroparasitos em pacientes neoplásicos submetidos à quimioterapia na região sul do Rio Grande do Sul, Brasil

Abstract

Cancer patients are considered a risk group for parasitic infections, so epidemiological surveys and prevalence of these diseases are essential in the elaboration and targeting of programs for the prevention and control of parasitic diseases in the group addressed. The objectives of this study were: to evaluate the knowledge on enteroparasitoses of oncology patients of the three main cancer treatment institutions of the municipality of Pelotas, southernmost state of Rio Grande do Sul, Brazil; to determine the prevalence of enteroparasites and associated socioeconomic factors in cancer patients submitted to chemotherapy at the School Hospital of the Federal University of Pelotas (HE/UFPel); and to know the genetic diversity of Giardia lamblia in patients with neoplasias. The evaluation of the knowledge was done through questionnaires, which had the participation of 200 patients in cancer treatment, revealing that: 69.5% of the patients stated that they know or know what are intestinal parasites, but reported some signs and symptoms. symptoms mistakenly; 64% reported not knowing when they are parasitized and 52% mentioned not knowing how to avoid parasitism. It was also verified that the area of residence, schooling and family income were important determinants of ethno-cognition in a significant way. The study of the prevalence of enteroparasites in the HE/UFPel, addressed 110 cancer patients submitted to chemotherapy, from which fecal samples were collected (three per individual), and socioeconomic and epidemiological characteristics were collected through a questionnaire. The diagnosis of enteroparasites was made by stool parasitological examination (EPF) and specific staining. 58.2% of patients were positive for enteroparasites and 31.8% of them were polyparasite. The most prevalent intestinal parasites were Ascaris lumbricoides (28.2%), G. lamblia (17.3%) and Entamoeba coli (14.6%). Family income up to two minimum wages, incomplete or complete elementary education, residency in rural areas were significantly associated with the presence of enteroparasites. Finally, G. lamblia isolates from HE / UFPel oncology patients underwent DNA extraction, nested-PCR and sequencing of the mitochondrial glutamate dehydrogenase (gdh) gene fragment. The fragments of G. lamblia obtained from the sequencing had similarity with genotypes B (36.8%), C (31.6%), A (26.3%) and D (5.3%). The research revealed a lack of knowledge, mainly related to the preventive measures, and a high prevalence of enteroparasites in the population studied, besides shedding light on the genotypes of G. lamblia that affect this group.