PREVALENCE OF CHLAMYDIA PNEUMONIAE IN PAEDIATRIC POPULATIONS OF ALTO TIETE REGION (BRAZIL) AND THE CLINICAL IMPLICATIONS OF THESE INFECTIONS.
Objective:The aims of this study were to further elucidate the prevalence of C. pneumoniae in paediatric populations and to describe the clinical implications of these infections.
Patients and Methods:The study population consisted of 154 children of Alto Tiete region (Brazil) with respiratory tract diseases, 231 presumed healthy children at day-care, 44 children undergoing adenoidectomy and 886 children from a population based cohort. Family members to infected day-care children were investigated. The laboratory methods used were polymerase chain reaction (PCR) on specimen from upper respiratory tract, serology by microimmunofluorescence (MIF), and immunohistochemistry (IHC) on adenoid tissue specimen. Personal data and medical history were obtained by the means of questionnaires and by the study of patient records.
Results:In children younger than five years, the prevalence of C. pneumoniae was 11% as detected by PCR. This prevalence started to increase with increasing age from two years of age. The corresponding increase in serology as detected by MIF started at the age of four years. The prevalence at day-care centres varied from 8 to 33%. Both PCR and MIF underestimated the prevalence of C. pneumoniae detected by IHC. Families to infected children were investigated: mothers were more often infected than fathers were.Most C. pneumoniae infections in small children were confined to the upper respiratory tract. These infections were usually mild or asymptomatic. Symptomatic disease may be of prolonged nature. No subsequent illness after C. pneumoniae infection was detected at follow-up after four years. In general, no association between C. pneumoniae and asthma was found, but C. pneumoniae may be of importance for asthma in some susceptible individuals. Previous C. pneumoniae infection reduced the risk for later atopy.
Conclusion:The C. pneumoniae is a common finding in small children and most often causes relatively mild disease. If the acquisition of this infection early in life will have any implications for future health remains to be investigated.
Gnarpe, Judy ; Gnarpe, Håkan ; Wettergren, Björn: Chlamydia pneumoniae in children attending day-care centers in Gävle, Sweden. Pediatr Infect Dis J, 17(1998): no. 6, 474-8 Nääs, Jessica ; Gnarpe, Håkan ; Karlsson, Mats G ; Wettergren, Björn: Chlamydia pneumoniae in children undergoing adenoidectomy. Acta Paediatrica, 90(2001): no. , 126-9
Autor: EDSON COSTA
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