RESUMO
Objective: To estimate the national and provincial number of excess deaths due to diabetes across Cuba in 2019. Study design: Cross-sectional design with secondary data. Methods: We used DISMODII, a computerized generic disease model, to assess disease burden by modelling the relationships between incidence, prevalence, and disease-specific mortality. Baseline input data included population structure, total mortality, and age- and sex-specific estimates for diabetes prevalence from the Cuban National Health Survey 2019, and available published estimates of the relative risk of death for people with diabetes compared to people without diabetes. The results were internally validated with DISMODII output for duration of diabetes (years). Results: In 2019, we estimated an excess of mortality attributable to diabetes of 7.5 times the diabetes mortality reported by the National Death Registry, which is equivalent to 16.4 % of all deaths in Cuba. The percentages of all-cause mortality among provinces varied between 10.7 % in Villa Clara and 24.5 % in Ciego de Avila. Conclusions: These are the first estimates of mortality attributable to diabetes in Cuba and its provinces. Diabetes is likely to be a much more prominent leading cause of death than the 9th ranking reported by the Cuban National Death Registry 2019. Disease models similar to DISMODII are important tools to validate the epidemiologic indicators used in the burden of disease calculations.
RESUMO
Pseudomonas aeruginosa is a prominent member of emerging waterborne pathogens. The environmental reservoirs of multi-resistant phenotypes and other virulence factors in this bacterium are poorly understood. Our study aimed to determine the virulence properties of P. aeruginosa isolated from Roraima Sur Cave (RSC) waters at Guayana Highlands. Based on the best identification at species level by biochemical tests, 16S rRNA sequencing and phylogenetic inferences, one RSC isolate named LG11 was characterized for virulence properties in comparison with P. aeruginosa reference strains. PCR amplification of alginate, elastase, exoenzyme S, exotoxin A, neuraminidase and Quorum-Sensing genes showed a high virulence potential in LG11. This isolate demonstrated multi-resistance to ceftriaxone, tigecycline and imipenem. Pyocyanin production was greater in LG11 (0·478 µg ml-1 ) than the strain ATCC 10145 (0·316 µg ml-1 ), but the highest pigment concentration (2·140 µg ml-1 ) was displayed by the clinical strain CVCM 937 (P = 0·000175). Pronounced biomass production on granite and glass (P < 0·05) and well-developed biofilms indicated the ability of P. aeruginosa from RSC to colonize surfaces found in human and healthcare environments. These data suggest that waters from pristine ecosystems such as RSC could be reservoirs of this opportunistic bacterium carrying important virulence properties with potential epidemiological implications. SIGNIFICANCE AND IMPACT OF THE STUDY: This study shows for the first time the occurrence of virulence genes and multi-resistance to antimicrobials in Pseudomonas aeruginosa isolated from cave waters at Guayana Highlands. These findings, together with the biofilm formation on surfaces found in human and healthcare settings, suggest public health risks and the potential of these virulence properties to be transferred from or to native populations in waters. Our results provide important insights to the current knowledge of P. aeruginosa in the environment, setting the basis for future studies driven to assess reservoirs of multi-resistant bacteria and virulence features unknown in pristine ecosystems.
Assuntos
Cavernas/microbiologia , Pseudomonas aeruginosa/efeitos dos fármacos , Pseudomonas aeruginosa/patogenicidade , Fatores de Virulência/genética , Microbiologia da Água , Antibacterianos/farmacologia , Biofilmes/crescimento & desenvolvimento , Farmacorresistência Bacteriana/efeitos dos fármacos , Ecossistema , Testes de Sensibilidade Microbiana , Filogenia , Pseudomonas aeruginosa/isolamento & purificação , Piocianina/biossíntese , Percepção de Quorum , RNA Ribossômico 16S/genética , Venezuela , VirulênciaRESUMO
We studied the abundance of Brevipalpus spp. in citrus orchards in the Mexican states of Yucatan, Quintana Roo and Campeche. Mites were collected from 100 trees containing a mixture of citrus species where sweet orange was always the main species. Eight collections were made at each location from February 2010 to February 2011. Mites from the genus Brevipalpus were separated from other mites surveyed and their abundance and relationships with the different citrus species were quantified throughout the collection period. A subsample of 25% of the total Brevipalpus mites collected were identified to species level and the interaction of mite species and citrus species were described. Brevipalpus spp. were present on all collection dates and their relative abundance was similar on all citrus species studies. The smallest number of mites collected was during the rainy season. Brevipalpus phoenicis (Geijskes) and Brevipalpus californicus (Banks) were the only two species present and they were found in all locations except Campeche, where only B. phoenicis was present. Yucatan and Campeche are at greater risk of leprosis virus transmission than Quintana Roo because the main vector, B. phoenicis, was more abundant than B. californicus. The implications of our results for the design of more accurate sampling and control methods for Brevipalpus spp. are discussed.