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      Prevalencia de las enfermedades alérgicas en niños parasitados. Reporte negativo de causalidad Translated title: Prevalence of allergic diseases in parasitized children. Negative report of causality

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          Abstract

          Introducción: el estudio de la relación entre las parasitosis intestinales y las enfermedades atópicas, como el asma o la rinoconjuntivitis, ha arrojado resultados contradictorios. El objetivo de este estudio fue evaluar la relación existente entre la parasitosis intestinal y la prevalencia de las enfermedades atópicas. Material y métodos: se realizó un estudio observacional, transversal de campo, en niños mayores de 2 años, cuyos padres contestaron los cuestionarios para investigación de prevalencia de enfermedades atópicas. A todos los niños seleccionados les fueron realizados exámenes seriados de heces y pruebas alérgicas cutáneas. El análisis estadístico se realizó por medio de la prueba de χ, asimismo se calcularon las razones de riesgo (odds ratio [OR]) y los intervalos de confianza del 95% (IC 95). Se consideró de significancia estadística cuando p <0,05. Resultados: fueron evaluados 185 niños, la edad fue 6,82 ± 2,69 años, el 52% fueron masculinos, el 94% se ubicaron entre los estratos sociales III/IV. La prevalencia de cualquier enfermedad atópica fue del 41% y la reactividad en piel del 43%, la detección de cualquier parásito se hizo en el 47% de todos los niños. Se encontró relación con significación entre el cuestionario ISAAC y la prueba cutánea (p = 0,000). No se encontró asociación entre prueba cutánea y parasitosis intestinal (p = 1,29), así como tampoco entre los resultados de ISAAC y parasitosis (p = 0,447). Conclusión: el estudio permitió considerar que la condición alérgica no guarda relación con el diagnóstico de la parasitosis.

          Translated abstract

          Introduction: study of the relationship between intestinal parasites and atopic diseases, such as asthma or rhinoconjunctivitis, has produced contradictory results. The objective of this study was to evaluate the relationship between intestinal parasitosis and the prevalence of atopic diseases. Material and method: we conducted an observational, cross-sectional field study in children aged more than 2 years whose parents completed the questionnaires for evaluation of the presence of atopic diseases. We performed serial stool sample examinations and skin allergy tests in every child in the sample. The statistical analysis was carried out using the χ test with calculation of odd ratios and 95% confidence intervals. We defined statistical significance as p <0.05. Results: we evaluated 185 children aged 6.82±2.69 years, 52% male, 94% in the socioeconomic status category III/IV. The prevalence of atopic disease of any kind was 41%, 43% had positive results of skin allergy testing and parasites of any type were detected in 47%. We found a significant association between the results of the ISAAC questionnaire and the results of the skin prick test (p = 0.000). We did not find a significant association between the results of the skin prick test and the detection of intestinal parasitic infection (p = 1.29), or between the results of the ISAAC questionnaire and parasitic infection (p = 0.447). Conclusion: the findings of our study suggest that the presence of allergic conditions is not associated with the diagnosis of parasitic infection.

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          Most cited references29

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          Soil-transmitted helminth infections: ascariasis, trichuriasis, and hookworm.

          The three main soil-transmitted helminth infections, ascariasis, trichuriasis, and hookworm, are common clinical disorders in man. The gastrointestinal tract of a child living in poverty in a less developed country is likely to be parasitised with at least one, and in many cases all three soil-transmitted helminths, with resultant impairments in physical, intellectual, and cognitive development. The benzimidazole anthelmintics, mebendazole and albendazole, are commonly used to remove these infections. The use of these drugs is not limited to treatment of symptomatic soil-transmitted helminth infections, but also for large-scale prevention of morbidity in children living in endemic areas. As a result of data showing improvements in child health and education after deworming, and the burden of disease attributed to soil-transmitted helminths, the worldwide community is awakening to the importance of these infections. Concerns about the sustainability of periodic deworming with benzimidazole anthelmintics and the emergence of resistance have prompted efforts to develop and test new control tools.
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            The skin prick test – European standards

            Skin prick testing is an essential test procedure to confirm sensitization in IgE-mediated allergic disease in subjects with rhinoconjunctivitis, asthma, urticaria, anapylaxis, atopic eczema and food and drug allergy. This manuscript reviews the available evidence including Medline and Embase searches, abstracts of international allergy meetings and position papers from the world allergy literature. The recommended method of prick testing includes the appropriate use of specific allergen extracts, positive and negative controls, interpretation of the tests after 15 – 20 minutes of application, with a positive result defined as a wheal ≥3 mm diameter. A standard prick test panel for Europe for inhalants is proposed and includes hazel (Corylus avellana), alder (Alnus incana), birch (Betula alba), plane (Platanus vulgaris), cypress (Cupressus sempervirens), grass mix (Poa pratensis, Dactilis glomerata, Lolium perenne, Phleum pratense, Festuca pratensis, Helictotrichon pretense), Olive (Olea europaea), mugwort (Artemisia vulgaris), ragweed (Ambrosia artemisiifolia), Alternaria alternata (tenuis), Cladosporium herbarum, Aspergillus fumigatus, Parietaria, cat, dog, Dermatophagoides pteronyssinus, Dermatophagoides farinae, and cockroach (Blatella germanica). Standardization of the skin test procedures and standard panels for different geographic locations are encouraged worldwide to permit better comparisons for diagnostic, clinical and research purposes.
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              Regulation of the host immune system by helminth parasites

              Helminth parasite infections are associated with a battery of immunomodulatory mechanisms that affect all facets of the host immune response to ensure their persistence within the host. This broad-spectrum modulation of host immunity has intended and unintended consequences, both advantageous and disadvantageous. Thus the host can benefit from suppression of collateral damage during parasite infection and from reduced allergic, autoimmune, and inflammatory reactions. However, helminth infection can also be detrimental in reducing vaccine responses, increasing susceptibility to coinfection and potentially reducing tumor immunosurveillance. In this review we will summarize the panoply of immunomodulatory mechanisms used by helminths, their potential utility in human disease, and prospective areas of future research.
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                Author and article information

                Journal
                pap
                Pediatría Atención Primaria
                Rev Pediatr Aten Primaria
                Asociación Española de Pediatría de Atención Primaria (Madrid, Madrid, Spain )
                1139-7632
                September 2020
                : 22
                : 87
                : e111-e119
                Affiliations
                [5] El Pilar orgnameHospital tipo I Dr. Alberto Musa Yibirin Venezuela
                [2] Chillán orgnameHospital Clínico Herminda Martín Chile
                [4] Caracas orgnameSociedad Venezolana de Alergia, Asma e Inmunología Venezuela
                [6] Curicó orgnameCESFAM Villa Prat. Sagrada Familia. Chile
                [1] Carúpano orgnameHospital Dr. Santos Aníbal Dominicci orgdiv1Servicio de Neumología Infantil Venezuela
                [3] Cumaná orgnamePosgrado de Puericultura y Pediatría. Sahuapa. Venezuela
                Article
                S1139-76322020000400003 S1139-7632(20)02208700003
                bacea818-ed74-4cc4-8fa7-4de76c6ae885

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

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                Figures: 0, Tables: 0, Equations: 0, References: 29, Pages: 0
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                SciELO Spain

                Categories
                Originales

                Parasitic infection,Helminthiasis,Skin allergy tests,Asma,Atopia,Helmintiasis,Parasitosis,Pruebas cutáneas,Asthma,Atopic disease

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