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2.
Artículo en Inglés | MEDLINE | ID: mdl-24645805

RESUMEN

The use of antibiotics in livestock can pose a public health threat, especially if antibiotic residues remain in the food product. Understanding how often and why farmers sell products with antibiotic residues is critical to improving the quality of these products. To understand how often milk with antibiotic residues is sold on small farms in a major dairy-producing region of Peru and identify factors associated with selling milk with antibiotic residues, we tested milk samples for antibiotic residues from every provider on three routes of commercial milk companies and from bulk tanks of farmers currently treating cows with antibiotics. We also asked farmers if they sold milk from treated cows and examined factors associated with the tendency to do so. The prevalence of milk contamination with antibiotic residues on commercial routes was low (0-4.2%); however, 33/36 farmers treating their animals with antibiotics sold milk that tested positive for antibiotic residues. The self-reported sale of milk from treated cows had a sensitivity, specificity, and positive and negative predictive values of 75.8%, 100%, 100% and 27.2%, respectively (with testing of milk for residues as the gold standard). Finally, 69/156 randomly selected farmers reported selling milk from treated cows, and farmers' knowledge of antibiotics and the milk purchaser were significantly associated with a farmer's tendency to report doing so. Educating farmers on the risks associated with antibiotics and enforcement of penalties for selling contaminated milk by milk companies are needed to improve milk quality.


Asunto(s)
Antibacterianos/análisis , Industria Lechera , Residuos de Medicamentos/análisis , Contaminación de Alimentos/análisis , Leche/química , Adulto , Animales , Antibacterianos/toxicidad , Industria Lechera/métodos , Industria Lechera/normas , Recolección de Datos , Países en Desarrollo , Residuos de Medicamentos/toxicidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Leche/toxicidad , Perú , Población Rural
3.
Prev Vet Med ; 114(3-4): 213-22, 2014 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-24630404

RESUMEN

Antibiotics are commonly used in animal agriculture; they can improve animal health and productivity, but their use may also represent a public health threat. Very little is known about antibiotic use on small farms in lower/middle income countries. To understand antibiotic use on these farms and promote the judicious use of these drugs, pharmacoepidemiologic data are necessary. However, acquiring such data can be difficult, as farmers are often illiterate (and therefore cannot participate in written surveys or keep treatment records), antibiotics can be obtained over-the-counter (in which case no prescriptions are generated) and monitoring and surveillance systems for drug use are often non-existent. The goal of this study was to compare two methods of acquiring pharmacoepidemiologic data pertaining to antibiotics that are well-adapted to farms in lower-middle income countries: self-report and the collection of discarded drug packaging. A convenience sample of 20 farmers in Cajamarca, Peru, participated in the study. Farmers placed discarded antibiotic packaging in bins for six months. At the end of the six-month period, farmers were interviewed and asked to recall the antibiotic usage that occurred on their farm over the past month and past six months; these self-reported data were quantitatively and qualitatively compared to the bin contents collected in the last month and previous six months. We found that the agreement between the bins and self-report was relatively poor for both the quantity and types of antibiotics used. The bins appeared to perform better than self-report when bottles and mLs of antibiotics were measured, while self-report appeared to perform better for intra-mammary infusions. The bins also appeared to perform better when data pertaining to an extended time period (six months) were collected. The results of this study will provide guidance to investigators seeking to collect pharmacoepidemiologic data in similar environments.


Asunto(s)
Crianza de Animales Domésticos , Antibacterianos/administración & dosificación , Bovinos , Industria Lechera , Recolección de Datos/métodos , Utilización de Medicamentos , Animales , Perú/epidemiología , Población Rural , Factores Socioeconómicos
4.
Prev Vet Med ; 113(1): 88-95, 2014 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-24188819

RESUMEN

Very little is known about the use of antibiotics on small dairy farms in lower/middle-income countries. The use of these drugs can have profound impacts on animal health, farmer income and public health. A survey of 156 farmers was conducted in Cajamarca, a major dairy-producing center in the highlands of Peru characterized by small farms (<15 cows) to assess patterns and determinants of antibiotic use and farmers' knowledge of antibiotics. The reported incidence of disease on these farms was relatively low (0.571 episodes of disease per cow-year), but more than 83% of the reported episodes were treated with antibiotics. The most commonly used antibiotics were oxytetracycline, penicillin and trimethoprim-sulfamethoxazole drugs; antiparasitic drugs were also used to treat what were likely bacterial infections. An increased incidence of treated disease was significantly associated with smaller farm size, lower farmer income, the previous use of the Californian Mastitis test on the farm and antibiotic knowledge. Farmers' knowledge of antibiotics was assessed with a series of questions on antibiotics, resulting in a "knowledge score". Increased knowledge was significantly associated with the use of antibiotics for preventative reasons, the purchase of antibiotics from feed-stores, the experience of complications in animals after having administered antibiotics, the number of workers on the farm and the educational level of the farmer. Overall, antibiotics appeared to be used infrequently, most likely because therapeutic interventions were sought only when the animal had reached an advanced stage of clinical disease. Few farmers were able to define an antibiotic, but many farmers understood that the use of antibiotics carried inherent risks to their animals and potentially to the consumers of dairy products from treated animals. The results of this study are useful for understanding the patterns of antibiotic use and associated management, demographic and knowledge factors of farmers on small dairy farms in rural Peru.


Asunto(s)
Antibacterianos/administración & dosificación , Bovinos , Agricultura , Animales , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Perú , Análisis de Regresión , Población Rural , Factores Socioeconómicos , Encuestas y Cuestionarios
5.
J Dairy Sci ; 96(11): 7349-7354, 2013.
Artículo en Inglés | MEDLINE | ID: mdl-24054290

RESUMEN

This study aimed to describe and compare the role of veterinarians and feed-store vendors in the use of antibiotics on small dairy farms in Cajamarca, Peru, a major dairy-producing center characterized by small, rural farms with poor, mostly uneducated farmers. We used a purposive sampling strategy to recruit 12 veterinarians into 2 focus group discussions and supplemented these data with 8 semi-structured interviews with feed-store vendors. Participants reported that inappropriate antibiotic usage was widespread among their clients, which may prevent the efficient use of drugs on farms where animal disease can be devastating to the livelihood of the farmer. Participants also identified many barriers to appropriate prescribing and use, including availability of drugs, competition from other prescribers, economic constraints and habits of farmers, and limited farmer knowledge of drugs and disease. Veterinarians expressed mistrust toward nonprofessional prescribers, whereas feed-store vendors felt that veterinarians were important partners in promoting the health of their clients' animals.


Asunto(s)
Antibacterianos/administración & dosificación , Comercio , Productos Lácteos/normas , Industria Lechera/normas , Prescripciones de Medicamentos/veterinaria , Utilización de Medicamentos , Veterinarios/psicología , Drogas Veterinarias/administración & dosificación , Animales , Femenino , Masculino , Perú , Rol Profesional , Encuestas y Cuestionarios
6.
Vaccine ; 29(41): 7182-7, 2011 Sep 22.
Artículo en Inglés | MEDLINE | ID: mdl-21651939

RESUMEN

Foot and mouth disease (FMD) is a highly infectious viral disease that affects cattle, sheep, goats and swine causing severe economic losses worldwide. The efficacy of inactivated vaccines is critically dependent on the integrity of foot and mouth disease virus (FMDV) particles. The recommended method to quantify the active ingredient of vaccines is the 140S quantitative sucrose density gradient analysis. This method has been an immensely valuable tool over the past three decades but it is highly operator dependent and difficult to automate. We developed a method to quantify FMDV particles during the vaccine manufacturing process that is based on separation of components by size-exclusion chromatography and measurement of virus by absorption at 254nm. The method is linear in the 5-70µg/mL range, it is applicable to different FMDV strains, and has a good correlation with the 140S test. The proposed method uses standard chromatographic media and it is amenable to automation. The method has potential as a process analytical technology and for control of final product by manufacturers, international vaccine banks and regulatory agencies.


Asunto(s)
Cromatografía en Gel/métodos , Virus de la Fiebre Aftosa/aislamiento & purificación , Tecnología Farmacéutica/métodos , Carga Viral , Vacunas Virales , Virología/métodos , Vacunas de Productos Inactivados
7.
J Virol Methods ; 162(1-2): 170-8, 2009 12.
Artículo en Inglés | MEDLINE | ID: mdl-19665482

RESUMEN

Bovine Viral Diarrhea Virus (BVDV) is the causative agent of a worldwide disease. The virus infects bovines of all ages, causing reproductive problems and contaminating biological products of high commercial value. The large-scale production of BVDV vaccines presents the challenge of processing antigenic proteins that are highly susceptible to the processing environment. Potency testing requires the immunization of cattle in order to determine the neutralizing antibodies titers induced by the vaccine. An alternative to the in vivo test is an in vitro measurement of key viral antigens. This paper describes the development and validation of a sandwich-type indirect ELISA that is able to detect and quantify BVDV E2 glycoprotein in live and inactivated BVDV. Validation parameters such as repeatability, intermediate precision, and reproducibility indicated that the developed ELISA constitutes an advanced tool for evaluating the BVDV antigen throughout manufacturing and vaccine release testing.


Asunto(s)
Antígenos Virales , Virus de la Diarrea Viral Bovina/inmunología , Ensayo de Inmunoadsorción Enzimática/métodos , Proteínas del Envoltorio Viral , Vacunas Virales , Animales , Antígenos Virales/análisis , Antígenos Virales/genética , Antígenos Virales/inmunología , Diarrea Mucosa Bovina Viral/inmunología , Diarrea Mucosa Bovina Viral/prevención & control , Células CHO , Bovinos , Cricetinae , Cricetulus , Proteínas Recombinantes/genética , Proteínas Recombinantes/inmunología , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Vacunas de Productos Inactivados/inmunología , Proteínas del Envoltorio Viral/análisis , Proteínas del Envoltorio Viral/genética , Proteínas del Envoltorio Viral/inmunología , Vacunas Virales/inmunología
8.
Hum Antibodies ; 17(3-4): 57-62, 2008.
Artículo en Inglés | MEDLINE | ID: mdl-19029662

RESUMEN

The prevalence of diabetes and other autoantibodies in patients with recently diagnosed youth onset diabetes was evaluated. Fifty-seven patients (95% black, age 19 +/- 5 years, 36% male, diabetes duration 2.6 +/- 2.2 years) were clinically diagnosed as having type 1 (n = 35), type 2 (n = 13) and lipoatrophic diabetes (n = 3) while 6 remained untyped. GAD65 was the most common diabetes-associated autoantibody in patients with type 1A diabetes (12/17; 71%). The prevalence of any diabetes-associated autoantibodies decreased with diabetes duration (OR[95%CI]/yr after diagnosis 0.50[0.31,0.82]) and was not associated with age of onset, duration or gender. Rheumatoid factor (13/57; 23%), smooth muscle (6/57; 11%), gastric-parietal cell (5/57; 9%) and thyroid microsomal antibodies (5/57; 9%) were the most frequent non-diabetes associated autoantibodies and were more common in patients with type 1A diabetes. Only one patient had clinical autoimmune disease (hypothyroidism). Type 1A diabetes may constitute up to half the cases of newly diagnosed type 1 diabetes in Jamaican youth and is associated with a higher prevalence of other organ-specific autoantibodies.


Asunto(s)
Autoanticuerpos/inmunología , Autoinmunidad/inmunología , Diabetes Mellitus/epidemiología , Diabetes Mellitus/inmunología , Adolescente , Autoanticuerpos/sangre , Región del Caribe/epidemiología , Diabetes Mellitus/sangre , Femenino , Humanos , Masculino , Prevalencia , Adulto Joven
9.
Gastroenterol Clin Biol ; 32(6-7): 581-4, 2008.
Artículo en Inglés | MEDLINE | ID: mdl-18353583

RESUMEN

Giant colonic diverticulum is a rare entity first described in 1946 by Bonvin and Bonte. It may be congenital or acquired and the average age of presentation is 65. There are less than 150 reported cases in the literature. A large abdominal mass was detected during a routine physical examination in an 82-year-old man. CT scan showed a large air-filled mass, barium enema showed multiple sigmoid diverticula, but no communication with the mass was found. A diagnosis of giant sigmoid diverticulum was made, elective sigmoidectomy and resection of the diverticulum was performed with no complications. The clinical picture may be different, varying from asymptomatic to acute abdomen, intestinal perforation or fistula. It can be diagnosed with abdominal X-ray, CT scan, barium enema or MRI, but colonoscopy is not effective. There are two accepted theories of the pathophysiology of this entity: first, a congenital origin and second, that inflammatory diverticula are caused by a perforation with a ball-valve that allows gas to enter, but not to leave the cyst, thus, enlarging the false diverticulum, and progressively destroying the bowel layers, causing secondary fibrosis. Elective treatment is a segmental resection of the affected colon with the diverticulum and in cases of acute abdomen two-stage bowel resection is preferred.


Asunto(s)
Divertículo , Enfermedades del Sigmoide , Anciano de 80 o más Años , Divertículo/diagnóstico , Divertículo/cirugía , Humanos , Masculino , Enfermedades del Sigmoide/diagnóstico , Enfermedades del Sigmoide/cirugía
10.
J Vet Intern Med ; 22(1): 60-5, 2008.
Artículo en Inglés | MEDLINE | ID: mdl-18289290

RESUMEN

BACKGROUND: Vaccination and importation of dogs and cats are prohibited in the Galapagos, resulting in a uniquely isolated population. The purpose of this study was to determine the prevalence of infectious diseases of dogs and cats that impact their health, could spill over to native wildlife, or sentinel diseases of concern to humans. HYPOTHESIS: The isolation of dogs and cats in the Galapagos protects them from diseases common in mainland populations. ANIMALS: Ninety-five dogs and 52 cats presented during a neutering campaign. METHODS: A prospective cross-sectional study was performed. Blood was collected for serological and DNA evaluation of a panel of infectious diseases. RESULTS: Antibodies against parvovirus (100%), parainfluenza virus (100%), adenovirus 1/2 (66-67%), and distemper virus (22%) were present in dogs. Dirofilaria immitis was also common in dogs (34%), with lower prevalences of Wolbachia pipiens (22%), Bartonella sp. (13%), Ehrlichia/Anaplasma spp. (1%), and Mycoplasma haemocanis (1%) observed. Antibodies against panleukopenia virus (67%), Toxoplasma gondii (63%), calicivirus (44%), and herpesvirus 1 (10%) were detected in cats. Feline leukemia virus antigen, feline immunodeficiency virus antibody, or coronavirus antibodies were not detected. Bartonella sp. (44%) infections were common in cats, but only one was infected with M. haemofelis. CONCLUSIONS AND CLINICAL IMPORTANCE: Despite their relative seclusion from the rest of the world, cats and dogs of Isabela were exposed to many pathogens found in mainland South America. Parasite prophylaxis, neutering, and strict enforcement of animal movement restrictions would control a majority of the diseases. In the absence of vaccination, a reservoir of susceptible animals remains vulnerable to new disease introductions.


Asunto(s)
Enfermedades de los Gatos/epidemiología , Enfermedades Transmisibles/veterinaria , Enfermedades de los Perros/epidemiología , Animales , Gatos , Enfermedades Transmisibles/epidemiología , Estudios Transversales , Perros , Ecuador/epidemiología , Enfermedades Endémicas/veterinaria , Femenino , Masculino , Prevalencia , Estudios Prospectivos
11.
Clin Exp Allergy ; 36(11): 1399-407, 2006 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-17083350

RESUMEN

BACKGROUND: Immunological oral tolerance is being studied with great interest due to its therapeutic potential in allergy and autoimmunity processes, although the cellular and molecular mechanisms linking these different phenomena remain elusive. In the present study, two mouse lines with extreme phenotypes for susceptibility [TS Line] or resistance [TR Line] to oral tolerance and their [TS x TR]F2 segregants were used in order to evaluate the impact of these traits on the atopic potential of the individuals. OBJECTIVE: Demonstrate whether the tr and ts genes, cumulated during 18 generations of bidirectional genetic selection, influence expression of two important immunobiological traits (IgE and mast cell) critical to allergic response. METHODS: Mice with extreme phenotypes for oral tolerance to ovalbumin (OVA), produced by assortative mating (TS and TR Line), and their (TS x TR)F2 segregating were used. Serum IgE levels assayed by ELISA, and mastocytes counted with toluidine blue staining were evaluated in naïve mice. Anaphylaxis was induced by intravenous injection of OVA, intestinal inflammation by oral administration of OVA 7 days after immunization, and pulmonary inflammation by intranasal and nebulization OVA challenges. Specific IgE was dosed by passive cutaneous anaphylaxis. RESULTS: The naïve TS mice have a 20-fold lower serum IgE level and two- to threefold diminished mast cell numbers in mucosal sites, when compared with TR-mice, which were highly susceptible to allergic inflammation and anaphylactic shock. The associations of oral tolerance, serum IgE levels and mast cell numbers in naïve animals were confirmed analysing the simultaneous presence of these traits in individuals of a [TS x TR]F2 -segregating population. CONCLUSION: The results suggest that the complex of genes controlling TS and TR phenotypes play a main role in the regulation of the atopic potential of the individual. The studies of these traits in interline F2 segregants demonstrated a co-segregation of TS and TR phenotypes with IgE responsiveness and mast cell numbers. Thus, the opposite capacity of the genetically modified mice may be involved in co-adaptative mechanisms reflecting a dynamic relation between gene frequencies in a natural population. These correlations give circumstantial evidence to support clinical applications of oral tolerance in allergic and autoimmune diseases.


Asunto(s)
Hipersensibilidad/genética , Inmunoglobulina E/sangre , Mastocitos/patología , Membrana Mucosa/inmunología , Administración Oral , Animales , Animales no Consanguíneos , Cruzamiento , Líquido del Lavado Bronquioalveolar/inmunología , Recuento de Células , Predisposición Genética a la Enfermedad , Genotipo , Hipersensibilidad/inmunología , Inmunidad Innata , Inmunoglobulina E/inmunología , Mucosa Intestinal/inmunología , Ratones , Ovalbúmina , Anafilaxis Cutánea Pasiva , Fenotipo , Mucosa Respiratoria/inmunología
12.
West Indian Med J ; 55(2): 89-94, 2006 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-16921701

RESUMEN

Critical donor selection and testing increases the safety of blood transfusion by excluding donors at risk of transmitting infections. This study investigated the seroprevalence of and risk factors for sexually transmitted infections (STIs) among accepted and deferred blood donors in Jamaica. A total of 1015 blood donors consisting of 794 (78%) accepted donors and 221 (22%) deferred donors presenting at the Central Blood Bank, Jamaica, over a six-month period, were recruited for this study. A standardized questionnaire was administered to each participant and a sample of blood obtained for detection of hepatitis B surface antigen, antibodies to Treponema pallidum, human immunodeficiency virus (HIV) and human T-cell lymphotrophic virus type-1 (HTLV-1). Deferred donors were three times more likely to be seropositive for STI than accepted donors (16.3% vs 5.2%, OR 3.57, 95% CI 2.16 - 5.90, p < 0.0001). Males had significant association between STI seropositivity and having fathered children with two or more women (p = 0.0085), unprotected sexual intercourse with several persons (p = 0.0326), and history of genital herpes (p = 0.0121). Significant risk factors identified among females were unprotected sex with several partners (p = 0.0385); having more than ten lifetime partners (p = 0.0105); and use of depoprovera (p = 0.0028). This study confirms higher rates of STI among deferred blood donors and supports the donor deferral system in Jamaica.


Asunto(s)
Donantes de Sangre , Selección de Donante , Enfermedades de Transmisión Sexual/epidemiología , Adolescente , Adulto , Análisis de Varianza , Anticuerpos Antibacterianos/sangre , Anticuerpos Antivirales/sangre , Transfusión Sanguínea , Femenino , VIH/aislamiento & purificación , Antígenos de Superficie de la Hepatitis B/sangre , Virus Linfotrópico T Tipo 1 Humano/aislamiento & purificación , Humanos , Jamaica/epidemiología , Masculino , Persona de Mediana Edad , Factores de Riesgo , Estudios Seroepidemiológicos , Enfermedades de Transmisión Sexual/sangre , Enfermedades de Transmisión Sexual/terapia , Treponema pallidum/aislamiento & purificación
13.
West Indian med. j ; West Indian med. j;55(2): 89-94, Mar. 2006. tab
Artículo en Inglés | LILACS | ID: lil-472659

RESUMEN

Critical donor selection and testing increases the safety of blood transfusion by excluding donors at risk of transmitting infections. This study investigated the seroprevalence of and risk factors for sexually transmitted infections (STIs) among accepted and deferred blood donors in Jamaica. A total of 1015 blood donors consisting of 794 (78) accepted donors and 221 (22) deferred donors presenting at the Central Blood Bank, Jamaica, over a six-month period, were recruited for this study. A standardized questionnaire was administered to each participant and a sample of blood obtained for detection of hepatitis B surface antigen, antibodies to Treponema pallidum, human immunodeficiency virus (HIV) and human T-cell lymphotrophic virus type-1 (HTLV-1). Deferred donors were three times more likely to be seropositive for STI than accepted donors (16.3vs 5.2, OR 3.57, 95CI 2.16 - 5.90, p < 0.0001). Males had significant association between STI seropositivity and having fathered children with two or more women (p = 0.0085), unprotected sexual intercourse with several persons (p = 0.0326), and history of genital herpes (p = 0.0121). Significant risk factors identified among females were unprotected sex with several partners (p = 0.0385); having more than ten lifetime partners (p = 0.0105); and use of depoprovera (p = 0.0028). This study confirms higher rates of STI among deferred blood donors and supports the donor deferral system in Jamaica.


La prueba y selección crítica del donante aumenta la seguridad de la transfusión de sangre, excluyendo a los donantes con riesgo de transmitir infecciones. Este estudio investigó la seroprevalencia de las infecciones transmitidas sexualmente (ITS) entre los donantes de sangre aceptados y diferidos en Jamaica. Un total de 1015 donantes de sangre consistente en 794 (78%) donantes aceptados, y 221 (22%) donantes diferidos que acudieron al Banco de Sangre Central en Jamaica por un periodo de seis meses, fueron reclutados para este estudio. A cada uno de los participantes se le aplicó una encuesta estandarizada, y se obtuvo una muestra de sangre para la detección del antígeno de superficie de la hepatitis B, los anticuerpos del Treponema pallidum, el virus de la inmunodeficiencia humana (VIH), y el virus linfotrópico humano de células T tipo 1 (HTLV-1). Los donantes diferidos presentaron una probabilidad tres veces mayor de ser seropositivos que los donantes aceptados (16.3% frente a 5.2%, OR 3.57, 95% CI 2.16 - 5.90, p <0.0001). En los varones se dio una asociación significativa entre la seropositividad de ITS y el haber engendrado hijos con dos o más mujeres (p = 0.0085), el intercambio sexual desprotegido con distintas personas (p = 0.0326), y una historia de herpes genitales (p = 0.0121). Los factores de riesgo significativos identificados entre las hembras fueron el sexo desprotegido con diferentes parejas (p = 0.0385), el haber tenido más de diez parejas a lo largo de su vida (p = 0.0105), y el uso de depoprovera (p = 0.0028). Este estudio confirma que las tasas de ITS entre los dotantes de sangre diferidos son más altas, y respalda el sistema de aplazamiento de donantes en Jamaica.


Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto , Persona de Mediana Edad , Donantes de Sangre , Enfermedades de Transmisión Sexual/epidemiología , Selección de Donante , VIH , Anticuerpos Antibacterianos/sangre , Anticuerpos Antivirales/sangre , Antígenos de Superficie de la Hepatitis B/sangre , Análisis de Varianza , Enfermedades de Transmisión Sexual/sangre , Enfermedades de Transmisión Sexual/terapia , Estudios Seroepidemiológicos , Factores de Riesgo , Jamaica/epidemiología , Transfusión Sanguínea , Treponema pallidum/aislamiento & purificación , Virus Linfotrópico T Tipo 1 Humano/aislamiento & purificación
14.
Int J Tuberc Lung Dis ; 9(7): 771-6, 2005 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-16013773

RESUMEN

SETTING: A major university in São Paulo, Brazil, where vaccination against tuberculosis (TB) with bacille Calmette-Guerin (BCG) was routinely offered to first-year medical and nursing students. OBJECTIVES: To estimate the probability of negative tuberculin skin test (TST) results over a 4-year period following BCG revaccination, and to evaluate the effect of factors associated with reversion. DESIGN: Students were enrolled in 1997, initially given a two-step TST, and were retested annually or biannually for the duration of the study. Data on TB exposures and potential risk factors for TST negativity and reversion were collected through annual surveys. A linear mixture survival model was used to estimate the probability of negative TST results over time. RESULTS: Of 159 students, an estimated 20% had a negative TST result despite revaccination, and a further 31% reverted to negative over 4 years of follow-up. No cofactors significantly affected the probability of reversion. CONCLUSION: Overall, in the absence of reported exposure to Mycobacterium tuberculosis, 51% of students revaccinated upon entering nursing or medical school would have a negative TST result by the time they begin their internships. In this recently vaccinated population, reversion was common, suggesting that annual TST screening may remain a useful tool.


Asunto(s)
Vacuna BCG , Estudiantes de Medicina , Estudiantes de Enfermería , Prueba de Tuberculina , Tuberculosis/diagnóstico , Adolescente , Adulto , Brasil , Femenino , Humanos , Masculino , Exposición Profesional , Estudiantes de Medicina/estadística & datos numéricos , Estudiantes de Enfermería/estadística & datos numéricos
15.
J Parasitol ; 90(5): 1015-8, 2004 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-15562600

RESUMEN

The prevalence of Toxoplasma gondii in free-ranging chickens is a good indicator of the prevalence of T. gondii oocysts in the soil because chickens feed from the ground. The prevalence of T. gondii antibodies in sera of 50 free-range chickens (Gallus domesticus) from Peru was 26% on the basis of the modified agglutination test (MAT). Hearts, pectoral muscles, and brains of seropositive (MAT > or =1:5) chickens were bioassayed individually in mice. Tissues from the remaining 37 seronegative chickens were pooled and fed to 2 T. gondii-free cats. Feces of cats were examined for oocysts; they did not shed oocysts. Toxoplasma gondii was isolated from the hearts of 10 seropositive chickens but not from their brains and pectoral muscles. Genotyping of these isolates using the SAG2 locus indicated that 7 isolates were type I and 3 were type III. Six of the 7 type-I isolates were avirulent for mice, which was unusual because type-I isolates are considered virulent for mice. The T. gondii isolates were from chickens from different properties that were at least 200 m apart. Thus, each isolate is likely to be different. This is the first report of isolation of T. gondii from chickens from Peru.


Asunto(s)
Pollos/parasitología , Enfermedades de las Aves de Corral/parasitología , Toxoplasma/genética , Toxoplasma/patogenicidad , Toxoplasmosis Animal/parasitología , Pruebas de Aglutinación/veterinaria , Animales , Anticuerpos Antiprotozoarios/sangre , Bioensayo/veterinaria , Encéfalo/parasitología , Gatos , ADN Protozoario/química , ADN Protozoario/aislamiento & purificación , Heces/parasitología , Femenino , Genotipo , Corazón/parasitología , Ratones , Músculos Pectorales/parasitología , Perú , Polimorfismo de Longitud del Fragmento de Restricción , Toxoplasma/clasificación , Toxoplasma/inmunología , Virulencia
16.
Int J Tuberc Lung Dis ; 8(7): 842-7, 2004 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-15260275

RESUMEN

SETTING: The tuberculin skin test (TST) is widely used as a diagnostic or screening test for Mycobacterium tuberculosis infection and disease. A peri-urban shantytown in the desert hills of south Lima, Peru, highly endemic for tuberculosis, and where bacille Calmette-Guérin (BCG) vaccine had been given in multiple doses until 1995. OBJECTIVE: To analyze the effect of multiple BCG vaccines on TST in a community-based setting. DESIGN: Point-prevalence survey of TST reactions of 572 people aged 6-26 years from 255 households. TST reactions were compared to the observed number of BCG scars and other potential risk factors (age, living with a TST-positive person, and contact with active tuberculosis). RESULT: People with two or more scars had significantly larger reactions, even after adjusting for potential risk factors. The adjusted population attributable fraction of being TST-positive and having two or more BCG scars was 26%. CONCLUSION: There is no demonstrated benefit of repeat BCG vaccination. We therefore recommend that physicians take into consideration the number of BCG scars when interpreting the TST and that programs give no more than one BCG vaccination.


Asunto(s)
Vacuna BCG/administración & dosificación , Prueba de Tuberculina/métodos , Tuberculosis Pulmonar/diagnóstico , Adolescente , Adulto , Niño , Cicatriz , Femenino , Encuestas Epidemiológicas , Humanos , Masculino , Perú , Pobreza , Prevalencia , Factores de Riesgo , Prueba de Tuberculina/normas , Población Urbana
19.
Rev. panam. salud pública ; 2(4): 295-298, oct. 1997.
Artículo en Español | LILACS | ID: lil-214752

RESUMEN

As a result of national and international conflicts, the number of refugees and displaced persons in various countries of the world is increasing. The complex and protracted nature of these conflicts often forces refugees to remain away from their countries for long periods, living in refugee camps. Many refugees come from countries where tuberculosis is endemic and, once the immediate problems of establishing a camp are overcome, this disease becomes the principal problem affecting refugee camps. In order to advise the persons in charge of refugee camps on how to set up tuberculosis control programs, this document details the general requirements and specific recommendations of WHO for the implementation of such programs, as well as guidelines for their evalutation and monitoring, including criteria that would justify camp closure


As a result of national and international conflicts, the number of refugees and displaced persons in various countries of the world is increasing. The complex and protracted nature of these conflicts often forces refugees to remain away from their countries for long periods, living in refugee camps. Many refugees come from countries where tuberculosis is endemic and, once the immediate problems of establishing a camp are overcome, this disease becomes the principal problem affecting refugee camps. In order to advise the persons in charge of refugee camps on how to set up tuberculosis control programs, this document details the general requirements and specific recommendations of WHO for the implementation of such programs, as well as guidelines for their evaluation and monitoring, including criteria that would justify camp closure


Asunto(s)
Refugiados , Tuberculosis , Control de Enfermedades Transmisibles , Desarrollo de Programa , Organización Mundial de la Salud
20.
Rev Hosp Clin Fac Med Sao Paulo ; 52(2): 47-50, 1997.
Artículo en Portugués | MEDLINE | ID: mdl-9435394

RESUMEN

Seventy-seven patients with symptomatic osteoarthritis of the hip and/or knee, with clinical indication for nonsteroidal anti-inflammatory drugs were studied. However, no patient was submitted to any anti-inflammatory medication seven days, prior the beginning of the study and did not complain of any gastrointestinal disease. Shortly before starting the anti-inflammatory drug therapy all patients were submitted to gastroduodenal endoscopy. This diagnostic procedure revealed that 54.6% of the patients presented at least one gastroduodenal damage, 22.1%, hyperemia, 3.9%, petechias, 23.4%, erosions and 5.2%, peptic ulcers. There results permitted to conclude that to identify and/or exclude damage of the gastrointestinal tract, data obtained in the anamnese are not sufficient. For these patients the endoscopic examination is a need. Anti-inflammatory therapy must be careful associated with dietetic orientation and the prescription of drugs to protect the gastrointestinal mucosa.


Asunto(s)
Antiinflamatorios no Esteroideos/efectos adversos , Mucosa Gástrica/efectos de los fármacos , Enfermedades Gastrointestinales/diagnóstico , Osteoartritis/tratamiento farmacológico , Antiinflamatorios no Esteroideos/uso terapéutico , Femenino , Enfermedades Gastrointestinales/inducido químicamente , Enfermedades Gastrointestinales/prevención & control , Humanos , Hiperemia/diagnóstico , Masculino , Úlcera Péptica/tratamiento farmacológico , Púrpura/diagnóstico , Antro Pilórico/efectos de los fármacos
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