Assuntos
Oncocercose/epidemiologia , Criança , Equador/epidemiologia , Infecções Oculares Parasitárias/epidemiologia , Filaricidas/provisão & distribuição , Humanos , Ivermectina/provisão & distribuição , América Latina/epidemiologia , Oncocercose/tratamento farmacológico , Saúde da População Rural/estatística & dados numéricos , Dermatopatias Parasitárias/epidemiologiaRESUMO
Onchocerciasis is a major blinding disease in equatorial Africa and Central and South America. Ivermectin is a safe and effective drug in the treatment of this disease and now forms the basis of disease control in most endemic areas. We report the findings of long-term control of this infection in the Río Santiago focus in Ecuador, between January 1990 and December 1996, using a strategy of giving ivermectin treatments biannually in hyperendemic communities and annually in meso- and hypoendemic communities. Ivermectin was administered by local health workers from each community. A high level of compliance to ivermectin was achieved, with 81.9% to 98.0% of those eligible receiving the drug at each treatment instance. The impact of ivermectin therapy was monitored using a cohort of 120 randomly selected infected individuals from 8 hyperendemic communities. The geometric mean microfilarial density of this group declined from 19.3 to 0 mf/mg over the 84-month observation period. Ivermectin had a significant impact on anterior segment ocular disease, acute onchodermatitis and sowda. The rate of infection of blackflies declined from 1.1% in 1989-0.08% in 1996, which is below the vectorial capacity of the Simulium vector and, as no new nodules were detected after 1994 and no children under 5 became infected over the observation period, it is likely that the transmission of this infection was interrupted in the study area.
Assuntos
Filaricidas/uso terapêutico , Ivermectina/uso terapêutico , Oncocercose/tratamento farmacológico , Animais , Pré-Escolar , Estudos de Coortes , Serviços de Saúde Comunitária , Equador/epidemiologia , Humanos , Lactente , Oncocercose/epidemiologia , Prevalência , Distribuição Aleatória , SimuliidaeRESUMO
The prevalence of onchocerciasis infection was determined in communities on 7 rivers located in the northern area of the canton San Lorenzo, province of Esmeraldas. Diagnosis of the infection was obtained by skin biopsies and recombinant-antigen based-serology. No evidence of infection was detected in 9 communities studied along the Rio Mataje, which forms the frontier between Ecuador and Colombia, nor in 10 adjacent communities located on 5 interior rivers. Evidence for Onchocerca volvulus infection was found in 4 communities on the Rio Tululvi with the following prevalence: La Boca (3.5% by biopsy and 3.9% by serology), Guayabal (9.1% by both biopsy and serology), La Ceiva (51.5% by biopsy and 53% by serology), and Salidero (4% by biopsy and 7.7% by serology). A few individuals in these communities were seropositive for O. volvulus in the absence of detectable dermal microfilariae: these might harbor very light or prepatent infections. No clinical disease attributable to onchocerciasis was found. The infected communities will be included in the ivermectin-based National Control Program for the disease, with no evidence of the infection having extended north of the Ecuadorian-colombian border.
Assuntos
Oncocercose/epidemiologia , Colômbia/epidemiologia , Equador/epidemiologia , Humanos , PrevalênciaRESUMO
Human bartonellosis was investigated in the Ecuadorian province of Zamora Chinchipe; 17 cases were identified retrospectively from hospital records over the period 1984-1995, mostly from 6 communities in the provincial district of Zumba. A questionnaire concerning risk factors for disease transmission was administered in these 6 communities. Blood samples were taken from individuals with current febrile illnesses or skin lesions suggestive of bartonellosis. Samples for detection of Bartonella bacilliformis were also taken from all school-age children in communities where historical cases had been identified by questionnaire. No bacteriologically positive case was identified and no evidence of asymptomatic infection was detected. Risk factors for disease transmission, identified by the questionnaire, included the presence of sick or dying chickens and guinea-pigs. It was suggested that bartonellosis is a zoonosis with wild animals, probably rodents, as the reservoir. The widespread use of residual insecticides and the easy availability of antibiotics is likely to have modified the epidemiology of this disease over the last decade.
Assuntos
Infecções por Bartonella/epidemiologia , Adolescente , Adulto , Infecções por Bartonella/patologia , Criança , Pré-Escolar , Equador/epidemiologia , Saúde da Família , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de RiscoRESUMO
Se realiza una revision actualizada de algunos metodos anticonceptivos, que se utilizan actualmente sobre todo los hormonales y aquellos que se encuentran en fase de experimentacion. En muchos de los metodos anticonceptivos se exponen sus efectos favorables y desfavorables.Como la mayoria de los metodos anticonceptivos revisados, de tipo hormonal, antes de analizar cada uno de ellos se hace una breve resena de la fisiologia de la menstruacion