Common infectious diseases and skin test anergy in children from an urban slum in northeast Brazil.
Common infectious diseases and skin test anergy in children from an urban slum in northeast Brazil.
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DOI：
10.1590/s1413-86702003000600006
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发表时间：
2003-12-01
期刊：
影响因子：
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通讯作者：
Lima, Aldo A M
中科院分区：
文献类型：
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作者：
Castro, Melania X;Soares, Alberto M;Lima, Aldo A M
背景：急性呼吸道感染 (ARI)、腹泻病 (DD) 和感染性皮炎 (ID) 是巴西东北部五岁以下儿童发病的重要原因。 目的： (a) 评估 ARI、DD 和 ID 的发病率； (b) 确定它们与巴西福塔莱萨贫困城市儿童细胞免疫的关系。 材料和方法：一项前瞻性队列研究。入组时，根据标准程序进行多次穿刺皮肤测试（Multitest CMI）并进行解释。通过每周家访对儿童进行传染病随访。结果：在一个正在进行的新生儿队列中招募了 71 名 6 至 21 个月大的儿童。每个儿童平均进行 39 次（6 至 63 次）家访，每个儿童观察年检测到 184.5 天有症状。 62% 的患病天数（10,221 天中的 6,378 天）存在 ARI，DD 占 23%（2,296 天），ID 占 6%（597 天），其他感染占 4%（373 天）。每个儿童年的发作次数为：ARI 10 次，DD 7 次，ID 1 次。 71 名儿童中有 12 名 (17%) 缺乏反应。反应性儿童与反应性无反应儿童的 ARI、DD 和 ID 发生率相似。无反应组的 ID 平均持续时间为 8.5 天，而有反应组为 4.3 天（P=0.007）。无反应与年龄、性别和营养状况无关。结论：这些贫困城市儿童中 ARI 和 DD 的发病率较高。皮试反应与营养不良无关，也与 ARI 和 DD 的发病率无关，但过敏儿童的感染性皮炎持续时间较长。
BACKGROUND: Acute respiratory infection (ARI), diarrheal disease (DD) and infective dermatitis (ID) are important causes of morbidity in children under five, in Northeast Brazil.OBJECTIVES: (a) to evaluate the morbidity of ARI, DD and ID; and (b) to determine their association with cellular immunity in poor urban children from Fortaleza, Brazil.MATERIALS AND METHODS: A prospective cohort study. At enrollment, multipuncture skin-tests (Multitest CMI) were performed and interpreted according to standard procedures. Children were followed for infectious diseases by weekly home visits.RESULTS: Seventy-one children aged 6 to 21 months were recruited in an ongoing cohort of newborns. A mean of 39 (6 to 63) home visits per child were made, which detected 184.5 symptomatic days per child-year of observation. ARI was present in 62% of the days of illness (6,378 out of 10,221), DD in 23% (2,296 days), ID in 6% (597) and other infections in 4% (373). Episodes per child-year were: 10 for ARI, 7 for DD and 1 for ID. Twelve (17%) out of 71 children were anergic. The incidences of ARI, DD and ID were similar in responsive versus anergic children. The mean duration of ID in anergy was 8.5 days, while it was 4.3 in the responsive group (P=0.007). Anergy was independent of age, sex and nutritional status.CONCLUSIONS: A high incidence of ARI and DD was found in these poor urban children. Skin-test responsiveness was not related to malnutrition, nor to morbidity due to ARI and DD, however anergic children had a longer duration of infective dermatitis.