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Memórias do Instituto Oswaldo Cruz

Print version ISSN 0074-0276

Mem. Inst. Oswaldo Cruz vol.77 no.1 Rio de Janeiro Jan./Mar. 1982

http://dx.doi.org/10.1590/S0074-02761982000100008 

Morbidade da esquistossomose mansoni no Brasil. I - Estudo de 4.652 casos observados no Rio de Janeiro de 1960 a 1979CouraJ. RodriguesQueirozGenaro Correia deFlorêncioCleber GitiranaArgentoCarlos AlbertoCoutinhoSergio GomesFigueiredoNortonWankeBodoCamillo-CouraLéa0319827716988No período de vinte anos (1960-1979), os autores observaram na Clínica de Doenças Infecciosas e Parasitárias da Faculdade de Medicina da Universidade Federal do Rio de Janeiro, sediada no Pavilhão Carlos Chagas do Hospital São Francisco de Assis, 4.652 casos de esquistossomose mansoni procedentes de 18 Estados do Brasil. Entre os casos observados 87,18% eram da forma hepatointestinal e 12,82% da forma hepatoesplênica entre os quais 30 tinham a forma pulmonar associada. Adicionalmente 30 casos da forma aguda ou toxémica foram estudados no mesmo Serviço, em famílias residentes no Rio de Janeiro. Além da observação clínica e do estudo epidemiológico incluindo o perfil migratório de cada caso e da casuística como um todo, foram realizados exames complementares como hemograma, mielograma, dosagem de transaminases, provas de função hepática, eletroforese de proteínas séricas, biópsia hepática, radiografias de tórax e de esôfago, esplenoportografia, eletrocardiograma e estudos hemodinâmicos do sistema porta, do coração e da artéria pulmonar em grupos de pacientes selecionados.A study of 4.652 schistosomiasis mansoni patients from 18 different States in Brazil, indicates a general picture of the morbidity of this disease in the country. Patients migrants (4.652) from different States were studied in the Department of Tropical Medicine of Federal University of Rio de Janeiro, between 1960 and 1979, with the following parameters: selected by a positive stool examination (sedimentation technique), clinical and epidemiological evaluation to determine the clinical form, migration pattern, age, sex and race. A routine chest X ray, E. C. G., haematologic and biochemistry tests, were performed. In a selected group of hepatosplenic cases a liver, biopsy, splenoportography and a portal hemodynamic study were done. Although some regional, familial, racial and/or individual differences in morbidity have been observed, the intensity of the primary infection and reinfections in the first two decades of life seems to be most important factors in the severity of human infection in Brazil. A direct correlation between egg out put and disease severity was observed in patientes under 30, except in negros who almost always present a mild form of the disease regardless of parasite burden. The evolutive pattern of the disease should be crefully investigated in relation to adaptation of different strains according to the host's immunological reactions and genectic constitution.Texto completo disponível apenas em PDF.Full text available only in PDF format.