Desenvolvimento de um instrumento de avaliação da vulnerabilidade de pacientes imunodeprimidos a infecções zoonóticas a partir de animais de estimação.

Abstract

Pets are potential sources of infections for humans, especially for immunocompromised, in particular HIV patients. Considering the emotional benefits that contact with animals can provide, health professionals, particularly physicians and veterinarians, should be aware of the potential role of these animals in disease transmission in order to recommend prophylactic measures. The conditions surrounding the transmission of an infectious disease from pets to humans are not well known, in particular in the Brazilian context. There is an absence of studies with the purpose of investigating the risk of pet-associated zoonotic infections. Furthermore, the existing studies suffer from the lack of a properly elaborated and validated instrument in order to capture the necessary information to accomplish this task or even to serve as a screening tool for vulnerable situations of immunocompromised patients in order to advise on preventive measures. The aim of this study is the development of a questionnaire to assess vulnerability to pet-associated zoonotic infections in immunocompromised patients. Initially, the most commonly pets found in the domestic environment, and the most important infections that they might transmit, were mapped. A set of possible transmission mechanisms was selected to be addressed. Dogs, cats, birds, reptiles and rodents were the selected species to be included in the questionnaire. The selected infections were: Salmonellosis; Criptosporidiosis; Giardiasis; Dermatophytosis (ringworm); Sporotrichosis; Bartonellosis (cat scratch disease); Cutaneous larva migrans; Roundworm infection; Psittacosis; Toxoplasmosis; Scabies; Campylobacter enteritis; Cryptococcosis and Histoplasmosis. Considering the different forms of transmission for each disease, the possible actions and behaviors with pets were identified, as well as characteristics of the animals that could increase the probability of transmission. The instrument developed was composed of a first part covering the eligibility criteria, and another involving the main scope of the instrument. Since the characteristics of contact and infection vary according to the animal s species, the instrument addressed each of the five groups of animals separately. The instrument proposed in this study concerns the initial stage of a formal development process for its use in future research about the role of pets in transmission of zoonoses to immunocompromised patients. Studies exploring the reliability and validity of the proposed instrument, as well as its acceptability, are needed before its use is recommended.