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INTRODUCTION AND AIM: Adherence to colorectal cancer (CRC) screening is essential for the effectiveness of screening programs. Even though organized screening programs can improve the quality of the process and adherence, there are still challenges to overcome. The aim of the present study, in which we implemented a biennial organized screening program for CRC, was to describe adherence and participation patterns. MATERIALS AND METHODS: A longitudinal, descriptive study was conducted, in which a team of trained patient navigators carried out interventions, with reminders via cellphone communication, to follow a cohort of 301 subjects eligible for CRC screening, utilizing a fecal immunochemical test (FIT). All the follow-up subjects received a FIT kit. RESULTS: A total of 747 cellphone calls were made and divided into three interventions. From the initial cohort, 126 subjects completed their biennial screening process through the FIT, indicating a consistent adherence rate of 41.8% to our program. The participation patterns were: 126 consistent participants (41.8%), 160 inconsistent participants (53.2%), and 15 participants that were never contacted (5%). CONCLUSIONS: In conclusion, our study underlines the importance of organized screening programs in the early detection of CRC. The implementation of follow-up interventions, through reminders and the training of patient navigators, can improve adherence, but there is a need for examining new strategies, to overcome barriers to communication via cellphone.
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Neoplasias Colorretais , Detecção Precoce de Câncer , Cooperação do Paciente , Humanos , Neoplasias Colorretais/diagnóstico , Masculino , Feminino , Detecção Precoce de Câncer/métodos , Pessoa de Meia-Idade , Idoso , Estudos Longitudinais , Cooperação do Paciente/estatística & dados numéricos , Sangue Oculto , Sistemas de Alerta , Programas de Rastreamento/métodosRESUMO
AIMS: Protozoan and helminth parasitic infections pose significant public health challenges, especially in developing countries with rural populations marked by suboptimal hygiene practices and socio-economic constraints. The parasites are the etiological agents of these infections and have a notably elevated global prevalence. Therefore, this study focuses on estimating the frequency and transmission dynamics of several parasitic species, including Blastocystis, Giardia, Cryptosporidium spp., Entamoeba histolytica, Ascaris lumbricoides, Trichuris trichiura, Taenia spp. and hookworms, within a rural community in southwest Colombia with a particular emphasis on the One Health framework, considering environmental and zoonotic transmission potentials. METHODS AND RESULTS: This study involved the analysis of 125 samples, encompassing human participants (n = 99), their domestic pets (dogs) (n = 24) and water sources (n = 2). Parasite detection was carried out utilizing a combination of microscopy and molecular techniques. Furthermore, the characterization of Blastocystis subtypes (STs) was achieved through Oxford Nanopore sequencing of the rRNA-18S gene. The investigation also entailed the examination of potential associations between intestinal parasitism and various sociodemographic factors. Results revealed a high frequency of parasitic infections when employing molecular methods, with Blastocystis (n = 109/87%), Giardia (n = 20/16%), Ancylostoma duodenale (n = 28/22%), Ancylostoma ceylanicum (n = 7/5.6%), E. histolytica (n = 6/4.8%), Cryptosporidium spp. (n = 12/9.6%) and even Taenia (n = 1/0.8%) detected. Cryptosporidium spp. was also identified in water samples. Coinfections were prevalent, with 57% (n = 70) of samples exhibiting single-parasite infections and 43% (n = 53) showing various degrees of polyparasitism, emphasizing the complexity of transmission dynamics. Blastocystis subtyping, conducted via Oxford Nanopore sequencing, revealed a diversity of subtypes and coexistence patterns, with ST2 being the most prevalent. CONCLUSIONS: This research underscores the importance of using molecular techniques for frequency estimation, particularly emphasizing the relevance of zoonotic transmission in parasitic infections. It highlights the significance of the One Health approach in comprehending the circulation of parasites among animals, humans and environmental sources, thereby directly impacting public health and epidemiological surveillance.
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Enteropatias Parasitárias , Saúde Única , População Rural , Zoonoses , Colômbia/epidemiologia , Humanos , Animais , Zoonoses/transmissão , Enteropatias Parasitárias/epidemiologia , Enteropatias Parasitárias/transmissão , Enteropatias Parasitárias/parasitologia , Masculino , Adulto , Feminino , Pessoa de Meia-Idade , Adolescente , Criança , Adulto Jovem , Pré-Escolar , Fezes/parasitologiaRESUMO
RESUMEN INTRODUCCIÓN: La neurocisticercosis es una infección del sistema nervioso central causada por el estadio larvario del cestodo Taenia solium, y se estima que puede ocasionar hasta 30% de los casos de epilepsia en los países donde esta parasitosis es endémica. El objetivo de este estudio fue determinar la frecuencia de pacientes que presentaron epilepsia como secuela de neurocisticercosis en un hospital universitario en Popayán. MATERIALES Y MÉTODOS: Se realizó un estudio retrospectivo con todos los pacientes con diagnóstico de neurocisticercosis que ingresaron al Hospital Universitario San José entre enero 2014 y diciembre 2018 que cumplieron los criterios de inclusión. RESULTADOS: Se encontraron 50 pacientes, de estos, 40 (80%) reingresaron, encontrándose que 37 (74%) presentaron epilepsia como secuela. Las edades más afectadas fueron la de 41 a 60 años; 48 (96%) provenían del departamento del Cauca en especial de Mercaderes, y 33 (66%) de área rural. El síndrome convulsivo fue la manifestación clínica de ingreso más frecuente. La TAC fue la técnica de imagen de elección. CONCLUSIÓN: El departamento del Cauca se considera como una de las áreas endémicas para neurocisticercosis en Colombia, y la epilepsia secundaria es un secuela común.
ABSTRACT INTRODUCTION: Neurocysticercosis is an infection of the central nervous system caused by the larval stage of the cestode Taenia solium, it has been estimated to produce up to 30% of the cases in countries where this parasitosis is endemic. The objective of this study was to determine the frequency of patients who presented epilepsy as a sequel of neurocysticercosis in a university hospital in Popayán. MATERIALS AND METHODS: A retrospective study was conducted with all patients with a diagnosis of neurocysticercosis who were admitted to the Hospital Universitario San José between January 2014 and December 2018 who met the inclusion criteria. RESULTS: We found 50 patients, 40 (80%) of which were readmitted and 37 (74%) presented epilepsy as sequela. The most affected age-group was 41 to 60 years; 48 (96%) were from the department of Cauca, especially Mercaderes, and 33 (66%) from rural areas. Convulsive syndrome was the most frequent clinical manifestation on admission. CT was the imaging technique of choice. CONCLUSION: The department of Cauca is considered as an endemic area for neurocysticercosis, and secondary epilepsy was a common consequence.
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Neurocisticercose , Epilepsia , Convulsões , Taenia solium , HelmintosRESUMO
We describe two new species of monogenean parasites of the genus Gyrodactylus von Nordmann, 1832 infecting Neotropical catfishes (Siluriformes) in southern Mexico: Gyrodactylus chulini n. sp. from 'chulín', Rhamdia laticauda collected in Oaxaca; and Gyrodactylus juili n. sp. from 'juil', Rhamdia guatemalensis from Veracruz. Morphologically, both new taxa are similar to Gyrodactylus spp. infecting catfishes (Siluriformes) in South America. Sequences of the internal transcribed spacers (ITS1-5.8S-ITS2 rDNA), the D2+D3 domains of the large ribosomal subunit (28S rDNA) and the cytochrome oxidase II (COII) gene were obtained from multiple parasite specimens and analysed using Bayesian inference. Phylogenetic hypotheses using ITS rDNA and COII genes, recovered two new Gyrodactylus species from Rhamdia spp.: G. chulini n. sp.; and Gyrodactylus juili n. sp., which are sister species to Gyrodactylus lilianae, a parasite of Rhamdia quelen in Brazil, and show strong affinity to other gyrodactytlids infecting Neotropical catfishes. This suggests that these new taxa, the first gyrodactylids described from Rhamdia spp. in Mexico, co-migrated to Tropical Middle America with their Neotropical catfish hosts, after the emergence of the Isthmus of Panama.
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Peixes-Gato , Doenças dos Peixes , Laticauda , Platelmintos , Trematódeos , Animais , Laticauda/genética , Peixes-Gato/parasitologia , México , Filogenia , Teorema de Bayes , Doenças dos Peixes/parasitologia , Especificidade da Espécie , Platelmintos/genética , DNA Ribossômico/genética , BrasilRESUMO
INTRODUCTION: The aim was to determine the time elapsed between the start of treatment with antiparkinsonian agents and the modification of the pharmacological therapy, and to establish its related factors, in a group of patients with Parkinson's disease from Colombia. PATIENTS AND METHODS: Retrospective cohort study that collected information about the treatment of patients with Parkinson's disease who started drug therapy between June, 2011 and December, 2013; a five-year follow-up was performed. Survival analyses for time to therapy modification were generated, and factors related to these changes were determined using Cox regression models. RESULTS: A total of 3,224 patients (51.8% men) with a mean age of 73.1 ± 13.5 years started treatment with antiparkinsonian agents. After five years, 2,046 patients (63.5%) had modifications in drug therapy, in a mean time of 36.4 months (95% confidence interval: 35.7-37.1). A total of 1,216 patients (37.8%) required the addition of another active principle, while 830 (25.7%) had a switch to another drug. In the multivariate analysis, male sex, age over 65 years, and the start of amantadine were identified as factors that increased the likelihood of therapy modification. The use of bromocriptine, biperiden, and monotherapy as an initial treatment were associated with a reduction in this likelihood. CONCLUSIONS: After five years of treatment, 63.5% of the patients with Parkinson's disease required modifications to their therapy, with a mean time of three years. Male sex, age over 65 years, and receiving initial therapy with amantadine affected the likelihood of switching therapy in these patients in Colombia.
TITLE: Tiempo hasta la modificación de la terapia antiparkinsoniana en un grupo de pacientes de Colombia.Introducción. Se buscó determinar el tiempo transcurrido desde el inicio del tratamiento con fármacos antiparkinsonianos hasta la modificación en la terapia y establecer sus factores relacionados en un grupo de pacientes con enfermedad de Parkinson de Colombia. Pacientes y métodos. Estudio de cohorte retrospectiva que recolectó información sobre el tratamiento de pacientes con enfermedad de Parkinson que iniciaron terapia farmacológica entre junio de 2011 y diciembre de 2013; se realizó seguimiento a cinco años. Se generaron análisis de sobrevida para el tiempo trascurrido hasta la modificación de la terapia y se determinaron los factores relacionados con estos cambios utilizando modelos de regresión de Cox. Resultados. Un total de 3.224 pacientes (51,8%, hombres), con edad media de 73,1 ± 13,5 años, iniciaron tratamiento con fármacos antiparkinsonianos. Después de cinco años, 2.046 pacientes (63,5%) tuvieron modificaciones en la terapia farmacológica, con un promedio de tiempo de 36,4 meses (intervalo de confianza al 95%: 35,7-37,1). Un total de 1.216 pacientes (37,8%) requirió adición de otro principio activo, mientras que 830 (25,7%) tuvieron un cambio por otro medicamento. En el análisis multivariado, el sexo masculino, la edad mayor de 65 años y el inicio de amantadina se identificaron como factores que aumentaron la probabilidad de modificar la terapia. El uso de bromocriptina y biperideno, y la monoterapia como tratamiento inicial redujeron dicho riesgo. Conclusión. Después de cinco años de tratamiento, el 63,5% de los pacientes con enfermedad de Parkinson requirió modificaciones de la terapia, con un tiempo promedio de tres años. El sexo masculino, la edad mayor de 65 años y recibir terapia inicial con amantadina afectaron a la probabilidad de cambio de terapia en estos pacientes en Colombia.
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Doença de Parkinson , Humanos , Masculino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Feminino , Doença de Parkinson/tratamento farmacológico , Estudos Retrospectivos , Colômbia , Antiparkinsonianos/uso terapêutico , Amantadina/uso terapêutico , Levodopa/uso terapêuticoAssuntos
Transtornos Mentais , Prisioneiros , Estabelecimentos Correcionais , Humanos , Peru/epidemiologia , PrisõesRESUMO
BACKGROUND: In low transmission settings early diagnosis is the main strategy to reduce adverse outcomes of malaria in pregnancy; however, microscopy and rapid diagnostic tests (RDTs) are inadequate for detecting low-density infections. We studied the performance of the highly sensitive-RDT (hsRDT) and the loop mediated isothermal DNA amplification (LAMP) for the detection of P. falciparum in pregnant women. METHODS: A cross-sectional study was conducted in two malaria-endemic municipalities in Colombia. We screened pregnant women in the context of an antenatal care program in health facilities and evaluated five tests (microscopy, conventional RDT, hsRDT, LAMP and nested polymerase chain reaction-PCR) for the detection of P. falciparum in peripheral blood, using a quantitative reverse transcription PCR (qRT-PCR) as the reference standard. Diagnostic performance of hsRDT and LAMP were compared with routine testing. RESULTS: The prevalence of P. falciparum was 4.5% by qRT-PCR, half of those infections were subpatent. The sensitivity of the hsRDT (64.1%) was slightly better compared to microscopy and cRDT (59 and 53.8% respectively). LAMP had the highest sensitivity (89.7%) for detecting P. falciparum and the ability to detect very low-density infections (minimum parasite density detected 0.08 p/µL). CONCLUSIONS: There is an underestimation of Plasmodium spp. infections by tests routinely used in pregnant women attending antenatal care visits. LAMP methodology can be successfully implemented at local hospitals in malaria-endemic areas. The relevance of detecting and treating this sub-patent P. falciparum infections in pregnant women should be evaluated. TRIAL REGISTRATION: ClinicalTrials.gov, Identifier: NCT03172221 , Date of registration: May 29, 2017.
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Malária Falciparum/diagnóstico , Técnicas de Amplificação de Ácido Nucleico/métodos , Técnicas de Amplificação de Ácido Nucleico/normas , Plasmodium falciparum/isolamento & purificação , Complicações Parasitárias na Gravidez/diagnóstico , Adulto , Colômbia/epidemiologia , Estudos Transversais , Feminino , Humanos , Malária Falciparum/epidemiologia , Técnicas de Diagnóstico Molecular , Gravidez , Complicações Parasitárias na Gravidez/epidemiologia , Cuidado Pré-Natal , Reação em Cadeia da Polimerase em Tempo Real/métodos , Sensibilidade e Especificidade , Adulto JovemRESUMO
OBJECTIVE: In Peru, prisons are spaces with overcrowding, deteriorated infrastructure, poor sanitary conditions and difficult access to medical treatment. The objective of this study is to estimate the burden of disease and access to treatment for different morbidities in the Peruvian inmate population. METHODS: An analysis of secondary data of the First National Penitentiary Census (PCNP) 2016 in Peru was carried out. The absolute frequencies and percentages of each self-reported health condition, the presence of a diagnosis of a disease before entering the prison system and access to treatment were obtained. RESULTS: 74,130 inmates were included in the analysis. The most common diseases in prisons are depression (9.6%), anxiety (8.6%), chronic lung disease (8.4%) and arterial hypertension (6.9%). All diseases included, with the exception of hepatitis, have a diagnostic before the incarceration of less than 60%. Access to medical treatment was higher in women than in men and in general, mental health illnesses had low access to medical treatment. CONCLUSIONS: Chronic and infectious diseases are frequent in those deprived of liberty, with mental health problems being more prevalent in women. In general, access to treatment is low, especially in men and for mental health illnesses. This situation reflects the need to develop intervention programs that promote health and increase the universality of health care in those deprived of liberty.
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Doenças Transmissíveis/epidemiologia , Diabetes Mellitus/epidemiologia , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Hipertensão/epidemiologia , Pneumopatias/epidemiologia , Transtornos Mentais/epidemiologia , Prisioneiros/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , Doença Crônica/epidemiologia , Doença Crônica/terapia , Doenças Transmissíveis/terapia , Diabetes Mellitus/terapia , Feminino , Disparidades nos Níveis de Saúde , Disparidades em Assistência à Saúde/estatística & dados numéricos , Hepatite/epidemiologia , Hepatite/terapia , Humanos , Hipertensão/terapia , Pneumopatias/terapia , Masculino , Transtornos Mentais/terapia , Pessoa de Meia-Idade , Neoplasias/epidemiologia , Neoplasias/terapia , Peru/epidemiologia , Prisioneiros/psicologia , Prisões , Autorrelato , Fatores SexuaisRESUMO
BACKGROUND: Intestinal parasitic protozoa represent a serious problem of public health particularly in developing countries. Protozoa such as Blastocystis, Giardia intestinalis, Entamoeba histolytica and Cryptosporidium spp. are associated with diarrheal symptoms. In Colombia, there is little region-specific data on the frequency and circulating genotypes/species of these microorganisms. Therefore, the main objective of our study was to employ molecular detection and genotyping of G. intestinalis and Blastocystis, Cryptosporidium and Entamoeba spp. in samples from different biogeographical regions of Colombia. METHODS: We collected 649 human fecal samples from five biogeographical regions of Colombia: the Amazon, Andean, Caribbean, Orinoco and Pacific regions. Blastocystis, G. intestinalis, Cryptosporidium spp. and Entamoeba complex were detected by microscopy and conventional PCR. Molecular genotyping was conducted to identify Blastocystis subtypes (STs) (18s), G. intestinalis assemblages (triose phosphate isomerase and glutamate dehydrogenase) and Cryptosporidium species (18s). Genetic diversity indices were determined using dnasp.5. RESULTS: We detected G. intestinalis in 45.4% (n = 280) of samples, Blastocystis in 54.5% (n = 336) of samples, Cryptosporidium spp. in 7.3% (n = 45) of samples, Entamoeba dispar in 1.5% (n = 9) of samples, and Entamoeba moshkovskii in 0.32% (n = 2) of samples. Blastocystis STs 1-4, 8 and 9 and G. intestinalis assemblages AII, BIII, BIV, D and G were identified. The following Cryptosporidium species were identified: C. hominis, C. parvum, C. bovis, C. andersoni, C. muris, C. ubiquitum and C. felis. The Caribbean region had the highest frequency for each of the microorganisms evaluated (91.9% for G. duodenalis, 97.3% for Blastocystis, 10.8% for Cryptosporidium spp., 13.5% for E. dispar and 2.7% for E. moshkovskii). The Orinoco region had a high frequency of Blastocystis (97.2%) and the Andean region had a high frequency of G. intestinalis (69.4%). High and active transmission was apparent in several regions of the country, implying that mechanisms for prevention and control of intestinal parasitosis in different parts of the country must be improved.
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Heterogeneous photocatalysis with natural minerals (geocatalysis) has been considered for a wide variety of redox processes, which require the participation of metals either as catalysts or promoters in the reactive system. Black mineral sand as raw material (RM), which is a natural composite frequently found in coastal deposits, was used for the preparation of a semiconductor potential. Due to iron content of mineral, it was applied several magnetic fields (0.0311 and 0.1645 Tesla) to obtain the fractions M1 and M2, respectively. The fraction that was not magnetically attracted was named NM. The chemical, structural and optical properties of each obtained composite were characterized by Zeta potential (ζ), X-ray fluorescence (XRF), energy-dispersive X-Ray analysis (EDX), scanning electron microscopy (SEM), BET area, thermal gravimetric analysis (TGA), X-ray diffraction (XRD) patterns, Fourier transform infrared (FT-IR) and UV-Vis spectroscopy techniques.
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INTRODUCCIÓN: El gasto de bolsillo en medicamentos e insumos puede afectar financieramente los hogares. Objetivo: Determinar el gasto de bolsillo en medicamentos e insumos en Perú y las características de la población con mayor gasto de este tipo en los años 2007 y 2016. MÉTODOS: Estudio transversal analítico de la Encuesta Nacional de Hogares sobre Condiciones de Vida y Pobreza 2007 y 2016. Se determinó la media y mediana del gasto de bolsillo en medicamentos e insumos en dólares americanos para la población general, y según la presencia de factores descritos en la literatura como asociados al gasto de bolsillo en medicamentos e insumos. RESULTADOS: Se incluyeron datos de 92 148 encuestados en 2007 y de 130 296 en 2016. En 2007, se encontró una mediana de 3,19 (rango intercuartílico: 0,96 a 7,99) y una media de 8,14 (intervalo de confianza 95%: 7,80 a 8,49) para el gasto de bolsillo en medicamentos. En 2016, la mediana y media de este gasto fueron de 3,55 (rango intercuartílico: 1,48 a 8,88) y 9,68 (intervalo de confianza 95%: 9,37 a 9,99), respectivamente. Para 2016, se encontró un mayor gasto de bolsillo en medicamentos en mujeres, menores de cinco y mayores de 60 años; personas de mayor nivel educativo; tener seguro privado o de las fuerzas armadas; vivir en la región costa y en zona urbana; tener una enfermedad crónica; y ser de los quintiles de gasto per cápita más altos. Entre 2007 y 2016, se incrementó significativamente (p < 0,05) el gasto de bolsillo en medicamentos e insumos en los menores de cinco años (p < 0,001), personas no aseguradas (p < 0,001), asegurados en el Seguro Integral de Salud (p < 0,001) o a las fuerzas armadas, para el área urbana y rural (p < 0,001, ambos), y en personas sin enfermedades crónicas (p < 0,001). CONCLUSIONES: Se obtuvo el gasto de bolsillo en medicamentos e insumos en población peruana en 2007 y 2016, encontrándose un incremento del mismo entre los años de estudio, existiendo grupos poblacionales con mayor gasto y con aumentos significativos. Se requiere profundizar el estudio de factores asociados al gasto de bolsillo en medicamentos en grupos de mayor vulnerabilidad económico frente al gasto directo en salud en Perú.
BACKGROUND: Out-of-pocket spending on medicines and supplies can lead to a heavy financial burden in households. OBJECTIVE: To determine the out-of-pocket spending on medicines and supplies in Peru and the population groups with the highest out-of-pocket spending on medicines and supplies in 2007 and 2016. METHODS: We conducted an analytical cross-sectional study of the Peruvian National Household Survey on Living and Poverty Conditions for the years 2007 and 2016. Mean and median out-of-pocket spending on medicines and supplies are reported in USD for the general population, and according to the presence or not of factors described in the literature as associated with out-of-pocket spending on medicines and supplies. RESULTS: 92 148 and 130 296 participants from 2007 and 2016 were included. In 2007, a median of 3.19 (interquartile range: 0.96 to 7.99) and an average of 8.14 (95% confidence interval: 7.80 to 8.49) were found for the out-of-pocket spending on medicines and supplies. In 2016, the median and mean out-of-pocket spending on medicines and supplies were 3.55 (interquartile range: 1.48 to 8.88) and 9.68 (95% confidence interval: 9.37 to 9.99), respectively. For 2016, higher out-of-pocket spending on medicines and supplies was found in women, children under five and over 60 years of age, people of higher educational level, having private or armed forces insurance, living in the coastal region, and being in one of the highest per capita quintile of expenditure. Between 2007 and 2016, the out-of-pocket spending on medicines and supplies was significantly increased in children under five (p < 0.001), uninsured persons (p < 0.001), insured to the Seguro Integral de Salud (p < 0.001) or the Armed Forces (p = 0.035), for the urban and rural area (both p < 0.001), and in people without chronic diseases (p < 0.001). CONCLUSIONS: An increase in out-of-pocket spending on medicines and supplies was found in the study period. There were population groups with significant increases in out-of-pocket spending on medicines and supplies. It is necessary to explore further the factors associated with out-of-pocket spending on medicines and supplies in groups of greater economic vulnerability regarding direct health spending in Peru.
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Humanos , Masculino , Feminino , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Custos de Medicamentos , Gastos em Saúde/estatística & dados numéricos , Financiamento Pessoal/economia , Peru , Pobreza , Características da Família , Estudos TransversaisRESUMO
INTRODUCTION: Neurosyphilis is the Treponema pallidum infection of the central nervous system and can occur at any time after the initial infection. In the 21st century, the incidence of neurosyphilis has increased in the post-antibiotic era. The highest rates of neurosyphilis are from low-income countries and the published studies are limited. AIM: To determine the clinical and sociodemographic characteristics of neurosyphilis patients in a tertiary care center in Pereira, Colombia. PATIENTS AND METHODS: Retrospective study of diagnosed neurosyphilis patients in a tertiary care center in Pereira, Colombia, between 2012 to 2017. The diagnosis was established based on serologic treponemal tests, VDRL in CSF, and CSF analysis. Sociodemographic, clinical, and laboratory parameters variables were obtained. RESULTS: Sixteen patients were included, 11 with definitive neurosyphilis and 5 with probable neurosyphilis. The median age was 59.50 ± 13.78 years. Men accounted for 75% (n = 12) of the patients. Four patients were (25%) HIV-infected. All the patients had positive peripheral FTA-ABS and 11 had reactive VDRL in CSF. The most frequent form was late neurosyphilis (62.5%), being general paralysis the most common. The most frequently clinical manifestations were neuropsychiatric alterations (46.9%), predominantly disorientation, behavioral changes, and cognitive impairment, followed by motor changes (36.7%). CONCLUSIONS: Late neurosyphilis was the most prevalent form, predominantly neuropsychiatric alterations. Only a quarter of patients presented HIV coinfection.
TITLE: Perfil clinico y sociodemografico de la neurosifilis: estudio retrospectivo en un centro de referencia de Colombia.Introduccion. La neurosifilis es causada por Treponema pallidum y puede afectar al sistema nervioso central en cualquier momento de la infeccion. Desde inicios de este siglo, su incidencia ha ido en aumento, aun en la era postantibiotica. En paises en vias de desarrollo, el problema tiene mayor magnitud y los estudios son escasos. Objetivo. Describir las caracteristicas de la poblacion con neurosifilis en un hospital de tercer nivel de Pereira, Colombia. Pacientes y metodos. Estudio descriptivo de corte transversal de pacientes con neurosifilis que acudieron a un centro de tercer nivel de Pereira, Colombia, entre 2012 y 2017. Los criterios diagnosticos se basaron en las siguientes variables: prueba treponemica en sangre, VDRL y analisis citoquimico del liquido cefalorraquideo. Se consideraron variables sociodemograficas, clinicas y de laboratorio. Resultados. Se incluyo a 16 pacientes, 11 con neurosifilis definitiva y cinco con neurosifilis probable, con una edad media de 59,5 ± 13,78 años. El 75% (n = 12) de los casos eran hombres. La coinfeccion por virus de la inmunodeficiencia humana fue del 25%. Todos los pacientes tenian FTA-ABS positivo en sangre y 11 presentaron VDRL reactiva en el liquido cefalorraquideo. La forma mas frecuente de neurosifilis fue la tardia (62,5%), y predomino la paralisis general. Las manifestaciones clinicas mas frecuentes fueron las alteraciones neuropsiquiatricas (46,9%), con predominio de la desorientacion, los cambios en el comportamiento y el deterioro cognitivo, seguidos de las alteraciones motoras (36,7%). Conclusiones. La neurosifilis tardia fue la presentacion mas prevalente, caracterizada por manifestaciones neuropsiquiatricas. Una cuarta parte de los pacientes presentaba infeccion por virus de la inmunodeficiencia humana.
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Neurossífilis/epidemiologia , Idoso , Colômbia/epidemiologia , Demografia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores SociológicosRESUMO
BACKGROUND: Parasitic infections, particularly those caused by protozoa, represent a considerable public health problem in developing countries. Blastocystis, Giardia duodenalis, Cryptosporidium spp. and the Entamoeba complex (Entamoeba histolytica, Entamoeba dispar and Entamoeba moshkovskii) are the most common etiological causes of intestinal parasitic infections. METHODS: We carried out a descriptive cross-sectional study in school-age children attending a daycare institution in commune eight of Popayán, Cauca (Southwest Colombia). A total of 266 fecal samples were collected (258 from children and eight from pets). Blastocystis, G. duodenalis, Cryptosporidium spp. and the Entamoeba complex were identified by microscopy, quantitative real-time PCR (qPCR) and conventional PCR. The concordance of qPCR and microscopy was assessed using the Kappa index. Molecular characterization was conducted to identify Blastocystis subtypes (18S), G. duodenalis assemblages (tpi and gdh) and Cryptosporidium species/subtypes (18S and GP60). Potential associations between intestinal parasitism and sociodemographic factors were examined using bivariate analyses. RESULTS: A total of 258 fecal samples from children were analyzed by microscopy and 255 samples were analyzed by qPCR. The prevalence of Blastocystis was between 25.19% (microscopy) and 39.22% (qPCR), that of G. duodenalis was between 8.14% (microscopy) and 10.59% (qPCR), that of Cryptosporidium spp. was estimated at 9.8% (qPCR), and that of the Entamoeba complex was between 0.39% (conventional PCR) and 0.78% (microscopy). The concordance between microscopy and qPCR was very low. Blastocystis ST1 (alleles 4, 8, and 80), ST2 (alleles 11, 12, and 15), ST3 (alleles 31, 34, 36, 38,57, and 151), and ST4 (alleles 42 and 91), G. duodenalis assemblages AII, BIII, BIV and D, C. parvum subtype IIa and C. hominis subtype IbA9G3R2 were identified. The only identified member of the Entamoeba complex corresponded to E. histolytica. No statistically significant association was identified between parasitic infection and any sociodemographic variable. CONCLUSION: This study revealed the usefulness of molecular methods to depict the transmission dynamics of parasitic protozoa in southwest Colombia. The presence of some of these protozoa in domestic animals may be involved in their transmission.
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Giardíase/epidemiologia , Enteropatias Parasitárias/epidemiologia , Animais de Estimação/parasitologia , Animais , Infecções por Blastocystis/epidemiologia , Infecções por Blastocystis/parasitologia , Infecções por Blastocystis/veterinária , Pré-Escolar , Colômbia/epidemiologia , Estudos Transversais , Criptosporidiose/epidemiologia , Criptosporidiose/parasitologia , Cães/parasitologia , Entamebíase/epidemiologia , Entamebíase/parasitologia , Entamebíase/veterinária , Fezes/parasitologia , Feminino , Giardíase/parasitologia , Giardíase/veterinária , Humanos , Enteropatias Parasitárias/parasitologia , Masculino , Microscopia/métodos , Epidemiologia Molecular/métodos , Prevalência , Reação em Cadeia da Polimerase em Tempo Real , Fatores SocioeconômicosRESUMO
Introducción La adolescencia es una de las etapas de la vida que presenta mayor cantidad de suicidios. En Perú, 22% de los suicidios ocurren en personas entre 10 y 19 años. Sin embargo, existen pocos estudios en salud mental y sobre los factores asociados con los comportamientos suicidas. Objetivo Determinar la prevalencia de comportamientos suicidas (ideación e ideación más planificación suicida) y sus factores asociados en adolescentes escolares peruanos. Métodos Se realizó un estudio transversal que analizó los datos para Perú de la Global School-based Student Health 2010, para medir la prevalencia de comportamientos suicidas (ideación e ideación más planificación) y sus factores asociados en adolescentes peruanos. Resultados De los 2521 estudiantes evaluados, el 19,9% (intervalo de confianza 95%: 17,8 a 22,2) presentaron ideación suicida el 12,7% (intervalo de confianza 95%: 11,1 a 14,5) presentaron planificación suicida en los últimos 12 meses. En las mujeres se presentó una mayor prevalencia de ideación (27,5%, intervalo de confianza 95%: 24,9 a 30,4) e ideación más planificación suicida (18,5%, intervalo de confianza 95%: 16,4 a 20,7) en comparación con los hombres. El análisis multivariado encontró que ser mujer, tener poco apoyo o comprensión de los padres, sentirse solo, haber sufrido agresiones físicas, haber sido acosado y el consumo de alcohol se asociaron con la ideación e ideación más la planificación suicida en estudiantes adolescentes. Conclusión La ideación y la ideación más la planificación suicida son un problema en la población adolescente peruana y se vincula con varios factores. Se necesitan estrategias para identificar y registrar el suicidio entre los adolescentes en Perú y para desarrollar programas de prevención.
Introduction Adolescence is one of the stages in life most affected by suicide. In Peru, 22% of suicides occur in people 10 to 19 years old. However, mental health overall and factors associated with suicidal behaviors have not been well studied. Objective To determine the prevalence of suicidal behaviors (ideation and ideation plus suicidal planning) and associated factors in Peruvian adolescent students. Methods A cross-sectional study analyzing data from the Global School-based Student Health Survey for Peru in 2010 was conducted to measure the prevalence of suicidal behaviors (ideation and ideation plus suicidal planning) and associated factors in Peruvian adolescent students. Results Of the 2521 students evaluated, 19.9% (95% CI: 17.8 to 22.2) presented suicidal ideation and 12.7% (95% CI: 11.1 to 14.5) presented suicidal planning in the last 12 months. Females had a higher prevalence of both ideation (27.5%, 95% CI: 24.9 to 30.4) and ideation plus suicidal planning (18.5%, 95% CI: 16.4 to 20.7). Multivariate analysis found that being female, having little parental support, having felt loneliness, having suffered from physical aggression, having been bullied, and alcohol consumption, were associated with ideation and ideation plus suicidal planning in adolescent students. Conclusion Ideation and ideation plus suicidal planning is a problem in the Peruvian adolescent population and is associated with several factors. Strategies are needed to identify and register suicide in adolescents in Peru and to develop prevention programs.
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Humanos , Masculino , Feminino , Criança , Adolescente , Adulto Jovem , Estudantes/estatística & dados numéricos , Suicídio/estatística & dados numéricos , Comportamento do Adolescente/psicologia , Peru/epidemiologia , Instituições Acadêmicas , Estudantes/psicologia , Suicídio/psicologia , Prevalência , Estudos Transversais , Inquéritos EpidemiológicosRESUMO
INTRODUCCIÓN En Perú, el cáncer de mama es la segunda neoplasia más prevalente y la tercera causa neoplásica de mayor mortalidad en mujeres. La implementación de programas de tamizaje mediante mamografías ha reducido considerablemente la mortalidad por cáncer de mama en países de altos ingresos. OBJETIVOS Analizar los factores bio-sociodemográficos asociados a la realización de mamografías en mujeres peruanas de 40 a 59 años. MÉTODOS Análisis secundario de la Encuesta Demográfica y de Salud Familiar 2018 realizada en Perú. La muestra de representatividad nacional consistió en 4822 mujeres de 40 a 59 años. Se consideró como variable principal la realización de una mamografía en los últimos 24 meses, con lo cual se calcularon proporciones ponderadas y razones de prevalencia crudas y ajustadas. RESULTADOS El 16,9% de las mujeres encuestadas reportó la realización de mamografía. La mayor proporción de realización de mamografías se encontró en mujeres con nivel educativo superior (30,1%), mayor quintil de riqueza (34,2%) y aquellas provenientes de ciudad tipo capital (26,9%). El análisis multivariado mostró que solo el mayor quintil de riqueza (razón de prevalencias: 5,75; intervalo de confianza 95%: 2,97 a 11,15) comparado con el menor quintil, y el grupo etario de 55 a 59 años (razón de prevalencias: 1,83; intervalo de confianza 95%: 1,31 a 2,55) comparado con mujeres de 40 a 44 años; estuvieron asociados significativamente con la realización de mamografías en los últimos 24 meses. CONCLUSIONES La realización de mamografía como examen preventivo de cáncer de mama en Perú aún es baja en comparación a otros países. La asociación de la realización de mamografía con el quintil de riqueza evidencia las desigualdades de acceso a salud preventiva en el país.
INTRODUCTION Breast cancer is the second most prevalent neoplasm in women after cervical cancer in Peru. It is also the third leading cause of female mortality. The implementation of screening programs using mammography has led to a considerable reduction in the mortality of this cancer in high-income countries. OBJECTIVES To analyze the factors associated with mammography use in Peruvian women between the ages of 40 and 59. METHODS Secondary analysis of the 2018 Demographic and Health Survey in Peru. The national representative sample consisted of 4822 women between the ages of 40 and 59. The main outcome was the use of mammography during the last 24 months, with which we calculated percentages and crude and adjusted prevalence ratios (PR). RESULTS 16.9% of the surveyed women reported a mammography exam. A higher proportion of mammography use was observed in women with a higher level of education (30.1%), higher wealth quintile (34.2%) and those from capital cities (26.9%). Multivariate analysis showed that only the highest wealth index quintile (prevalence ratio: 5.75; 95% confidence interval: 2.97 to 11.15) compared to the lowest quintile; and the 55 to 59 age group (prevalence ratio: 1.83; 95% confidence interval: 1.31 to 2.55) compared to the 40 to 44 age group, were significantly associated with mammography. CONCLUSIONS The use of mammography as a preventive examination for breast cancer in Peru is still low compared to other countries. The association of mammography with the better-off quintile shows the inequalities of access to preventive health in the country.
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Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Neoplasias da Mama/diagnóstico , Mamografia/estatística & dados numéricos , Programas de Rastreamento/estatística & dados numéricos , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Peru , Mamografia/economia , Programas de Rastreamento , Inquéritos Epidemiológicos , Fatores Etários , Disparidades em Assistência à Saúde , Detecção Precoce de CâncerRESUMO
BACKGROUND: Cryptococcosis is a systemic opportunistic mycosis, caused by Cryptococcus neoformans and Cryptococcus gattii, which affects mainly the central nervous system of immunocompromised patients; no reports have been made on the isolation of the fungus from the environment of Popayán, Colombia. AIMS: The main objective of this investigation was to determinate the incidence of C. neoformans in the urban perimeter in the City of Popayán, Colombia. METHODS: A total of 303 samples from droppings of Columba livia and Bubulcus ibis were collected between September 2012 and June 2013. The samples were processed by conventional techniques; identification of colonies was performed by biochemical tests, and molecular patterns were determined by PCR fingerprinting with the primer (GTG)5 and restriction fragment length polymorphism (RFLP) of the gene URA5. RESULTS: A total of 118 (38.94%) samples were positive for Cryptococcus in excreta of C. livia, and 361 strains belonging to Cryptococcus neoformans var. grubii were isolated. From the latter, 99.2% corresponded to the molecular pattern VNI and 0.8% to VNII, with an increased occurrence (24.4%) at a temperature of 22.5°C and a humidity of 60.8%. The excreta of B. ibis did not show the presence of the fungus. CONCLUSIONS: C. livia excreta is a key environmental niche for C. neoformans var. grubii, type VNI, supporting growth and reproduction, and serving as a major source of infection for susceptible populations in Popayán. This represents the first report on the isolation of the agent of cryptococcosis from the environment in this region, with a significant prevalence in bird excreta.
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Aves/microbiologia , Cryptococcus neoformans/classificação , Cryptococcus neoformans/isolamento & purificação , Fezes/microbiologia , Animais , Colômbia , Saúde da População UrbanaRESUMO
The Surface Immunogenic Protein (SIP) of Group B Streptococcus (GBS) had been described as a good target for vaccine development. To date, SIP has been reported as a highly conserved protein, and in a mouse model it induces protection against lethal GBS challenge. Also, similar effects have been described by intranasal immunization with a SIP-based vaccine. In this study, we show the immune response induced by an oral SIP-based vaccine formulated on alum in a mouse model. Our vaccine can reduce vaginal GBS colonization and induce specific SIP-antibodies with opsonophagocytosis activities against GBS. Moreover, we observed the activation of T-cells producing IFN-γ, TNF-α, IL-10, IL-2, and increased expression of the transcription factor T-bet, suggesting a Th1-type humoral response. The oral SIP-based vaccine is a novel alternative in the development of a vaccine against GBS.
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Antígenos de Bactérias/imunologia , Infecções Estreptocócicas/imunologia , Streptococcus agalactiae/imunologia , Vacinas/imunologia , Vagina/imunologia , Administração Oral , Compostos de Alúmen/administração & dosagem , Compostos de Alúmen/química , Animais , Anticorpos Antibacterianos/imunologia , Antígenos de Bactérias/química , Feminino , Células HL-60 , Humanos , Camundongos Endogâmicos C57BL , Infecções Estreptocócicas/microbiologia , Infecções Estreptocócicas/prevenção & controle , Streptococcus agalactiae/efeitos dos fármacos , Streptococcus agalactiae/fisiologia , Vacinação/métodos , Vacinas/administração & dosagem , Vacinas/química , Vagina/efeitos dos fármacos , Vagina/microbiologiaRESUMO
OBJECTIVE: To assess the prevalence of drug abuse before prison admission and to identify associated sociodemographic and family history risk factors, according to gender, in prisons of Peru. MATERIALS AND METHODS: A secondary analysis was carried out with data from the First National Prisoner Census 2016, using a questionnaire of 173 items that was applied to the whole prison population of Peru. The types of drugs used before admission were analyzed according to characteristics of the penitentiary population, and generalized linear models were used to calculate prevalence ratios with 95% confidence intervals to identify possible factors associated with drug use. RESULTS: Out of a population of 76,180 prisoners, 71,184 (93.4%) answered the survey (men 67,071, 94.2%). The overall prevalence of drug consumption before admission was 24.4% (25.3 % in men and 9.1% in women), the highest prevalence in the 18-29 age group (36.3% in men and 14.9% in women). The most commonly used drugs were marijuana (58.2%), coca paste/cocaine or crack (40.3%) and inhalants (1%). The factors most strongly associated with consumption were having a family member who consumed drugs (59.8%), history of previous imprisonment (59.1%), unemployment (48.4%), relationships at school with classmates who had problems with the law (46.9%), background of a family member who attended a penitentiary (38.4%), and history of running away from home before age 15 (35.9%). CONCLUSIONS: In Peru, drug use is higher in the prison population than in the general population, and there are differences according to sex in the prevalence of drug use and associated factors prior to admission to a prison. The study demonstrated that childhood events, such as child abuse, having a family member imprisoned, having a family member who used drugs, or who previously abused alcohol, are factors associated with drug use in the penitentiary population. Some of these risk factors are modifiable, so it is important to consider these in the design of social and health policies focused on specific subpopulations to prevent drug use and crime.
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Prisioneiros/estatística & dados numéricos , Transtornos Relacionados ao Uso de Substâncias/etiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Peru/epidemiologia , Prevalência , Prisioneiros/psicologia , Fatores de Risco , Fatores Sexuais , Fatores Socioeconômicos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adulto JovemRESUMO
Psoriasis is a chronic inflammatory disease that generally affects the skin, nails and joints. The burden of psoriatic disease in Latin America and the Caribbean (LAC) remains largely unknown. To estimate the burden of psoriasis in LAC. We conducted a systematic review following the MOOSE and PRISMA statements. We searched published studies in MEDLINE, EMBASE, LILACS and CENTRAL from 1st January 2000 to 5th August 2015. We included studies that reported incidence, prevalence, health resource use and health expenditures, treatment patterns, comparative effectiveness of different drugs, patients reported outcomes, adherence to treatment and patient preferences in LAC. Risk of bias was assessed evaluating selection of participants, control of cofounders, measurement of exposure and outcome and conflict of interest. Pairs of reviewers independently selected, extracted and assessed the bias risk of the studies. The systematic review was registered at PROSPERO (CRD42016038325). A total of 18 studies from 12 LAC countries were included. Most were observational studies, between which there was a large heterogeneity of outcomes. Population-based studies were not found and most data came from hospital registries. One study reported an incidence of psoriatic arthritis in 6.26 cases per 100 000 person-years. Another study found an incidence of psoriasis 1020 per 100 000 patient-year attending at a dermatology clinic. The prevalence reported in the Argentinean health service was 74 cases per 100 000. Further, psoriasis has been shown to have a substantial negative impact on quality of life. A number of studies also indicated that non-communicable disease burden increases with the presence and severity of psoriasis. With regard to treatment pattern, methotrexate was the dominant systemic therapy. In conclusion, there is an important lack of information from LAC concerning the burden of psoriasis. Further studies investigating the burden of psoriasis in representative LAC populations are needed.
Assuntos
Psoríase , Região do Caribe/epidemiologia , Humanos , Incidência , América Latina/epidemiologia , Prevalência , Psoríase/epidemiologia , Psoríase/terapiaRESUMO
La enfermedad inflamatoria intestinal es una patología crónica, con una incidencia cada vez mayor. Dentro de este grupo de afecciones, la enfermedad de Crohn y la colitis ulcerosa son las más frecuentes. La enterografía por tomografía computada (ETC) y por resonancia magnética (ERM) son las modalidades de elección para la evaluación y seguimiento de la entidad, permitiendo examinar la apariencia de la mucosa, la pared intestinal, las manifestaciones extraintestinales y las complicaciones asociadas. La elección del estudio debe hacerse de acuerdo con la condición clínica de cada paciente
Inflammatory bowel disease is a chronic condition with increasing incidence. Crohn's disease and ulcerative colitis are the most common pathologies. Computed tomography (CT) enterography and magnetic resonance (MR) enterography are the methods of choice for evaluating and monitoring this entity, assessing the appearance of intestinal wall, mucosa, extra-intestinal manifestations, and associated complications. The preferred imaging methods must be selected according to the clinical conditions of the patient