Arbovirus Antibody Seroprevalence in the Human Population from Cauca, Colombia.

Several arboviruses have emerged or reemerged into the New World during the past several decades, causing outbreaks of significant proportion. In particular, the outbreaks of Dengue virus (DENV), Zika virus, and Chikungunya virus (CHIKV) have been explosive and unpredictable, and have led to significant adverse health effects. These viruses are considered the leading cause of acute undifferentiated febrile illnesses in Colombia. However, Venezuelan equine encephalitis virus (VEEV) is endemic in Colombia, and arboviruses such as the Mayaro virus (MAYV) and the Oropouche virus (OROV) cause febrile illnesses in neighboring countries. Yet, evidence of human exposure to MAYV and OROV in Colombia is scarce. In this study, we conducted a serosurvey study in healthy individuals from the Cauca Department in Colombia. We assessed the seroprevalence of antibodies against multiple arboviruses, including DENV serotype 2, CHIKV, VEEV, MAYV, and OROV. Based on serological analyses, we found that the overall seroprevalence for DENV serotype 2 was 30%, 1% for MAYV, 2.6% for CHIKV, 4.4% for VEEV, and 2% for OROV. This study provides evidence about the circulation of MAYV and OROV in Colombia, and suggests that they-along with VEEV and CHIKV-might be responsible for cases of acute undifferentiated febrile illnesses that remain undiagnosed in the region. The study results also highlight the need to strengthen surveillance programs to identify outbreaks caused by these and other vector-borne pathogens.

Seroprevalence and Genotypic Analysis of Ehrlichia canis Infection in Dogs and Humans in Cauca, Colombia.

Ehrlichia canis infections have been reported in humans in Venezuela and Costa Rica. In this study, 506 healthy residents and 114 dogs from four municipalities (Cauca, Colombia) were surveyed and blood samples collected. Antibodies to E. canis in human and canine sera were evaluated using the Tandem repeat protein 19 (TRP19) peptide ELISA and indirect immunofluorescence assay (IFA). Ehrlichia canis TRP19 antibodies were detected in only 1/506 human sera, but the single positive sample was negative by IFA. The majority (75/114; 66%) of dogs surveyed had antibodies to the E. canis TRP19 peptide by ELISA, and eight randomly selected sera were further confirmed by E. canis IFA. Genomic DNA samples obtained from 73 E. canis TRP19 ELISA-positive dog blood samples were examined by PCR targeting the 16S ribosomal ribonucleic acid (rRNA) gene. Ehrlichia canis 16S rRNA was amplified in 30 (41%) of the dogs, and 16 amplicons were selected for DNA sequencing, which confirmed that all were E. canis. A second PCR was performed on the 16 confirmed E. canis 16S rRNA PCR-positive samples to determine the TRP36 genotype by amplifying the trp36 gene. TRP36 PCR amplicon sequencing identified nine dogs infected with the U.S. E. canis TRP36 genotype (56%), one dog with the Brazilian genotype (6%), and six dogs with the Costa Rican genotype (38%). Moreover, these molecular genotype signatures were consistent with serologic analysis using TRP36 genotype-specific peptides. Notably, there was no serologic evidence of E. canis infection in humans, suggesting that E. canis infection in dogs in Cauca is not associated with zoonotic human infection.

Barreras para la eliminación de la malaria en Guapi-Cauca, Colombia / Obstacles to malaria elimination in Guapi-Cauca, Colombia

RESUMEN Objetivo Explicar las barreras para la eliminación de la malaria en Guapi (Cauca, Colombia), según la percepción de la comunidad. Método Se realizó un estudio cualitativo descriptivo de tipo exploratorio en Guapi, de octubre a noviembre de 2016, a través del análisis de contenido de grupos focales de ocho mujeres voluntarias y de análisis inductivo e interpretativo. Resultados Basadas en las respuestas de las voluntarias, se construyeron tres categorías, de las cuales se originaron cinco subcategorías relacionadas con barreras (tema) para la eliminación de la malaria que incluyen determinantes sociales del municipio tales como las barreras ambientales, culturales y de atención en salud. Todas ellas requieren de la intervención integral por parte de las diferentes dependencias del Estado, con la inclusión de las características propias de la comunidad guapireña. Conclusión Se identificó que la falta de planeación e infraestructura deficiente en el municipio obstaculiza no solo la eliminación de la malaria sino también la de otras enfermedades transmisibles. El desarrollo de actividades económicas como la minería, las prácticas de automedicación, la poca adherencia a las medidas de prevención por parte de la comunidad, la falta de contratación de profesionales y microscopistas y el difícil acceso a los servicios de salud constituyen las principales barreras para la eliminación de la malaria en este municipio de la región pacífica colombiana.

ABSTRACT Objetive To explain the obstacles for malaria elimination in Guapi (Cauca, Colombia), considering the community perception. Method A qualitative, descriptive and exploratory research was carried out in Guapi, from October to November 2016, through the content analysis of eight female volunteer's focus groups. Inductive and interpretive analyses were also performed. Results Based on the volunteers' responses, three categories were built, from which five subcategories related to obstacles (issue) for malaria elimination emerged; these included municipality social determinants such as environmental, cultural and health care barriers. All of them require of comprehensive interventions by different state agencies and inclusion of the specific characteristics of the local community. Conclusion We found that lack of planning and municipal poor infrastructure limits the elimination of malaria and other communicable diseases alike. Economic activities such as mining, self-medication practices, community poor adherence to prevention measures, lack of professional and microscopists hiring and the difficulties for accessing to health services are the main obstacles for malaria elimination in this municipality of the Colombian Pacific Coast.

[Obstacles to malaria elimination in Guapi-Cauca, Colombia]. / Barreras para la eliminación de la malaria en Guapi-Cauca, Colombia.

OBJETIVE: To explain the obstacles for malaria elimination in Guapi (Cauca, Colombia), considering the community perception. METHOD: A qualitative, descriptive and exploratory research was carried out in Guapi, from October to November 2016, through the content analysis of eight female volunteer's focus groups. Inductive and interpretive analyses were also performed. RESULTS: Based on the volunteers' responses, three categories were built, from which five subcategories related to obstacles (issue) for malaria elimination emerged; these included municipality social determinants such as environmental, cultural and health care barriers. All of them require of comprehensive interventions by different state agencies and inclusion of the specific characteristics of the local community. CONCLUSION: We found that lack of planning and municipal poor infrastructure limits the elimination of malaria and other communicable diseases alike. Economic activities such as mining, self-medication practices, community poor adherence to prevention measures, lack of professional and microscopists hiring and the difficulties for accessing to health services are the main obstacles for malaria elimination in this municipality of the Colombian Pacific Coast.

OBJETIVO: Explicar las barreras para la eliminación de la malaria en Guapi (Cauca, Colombia), según la percepción de la comunidad. MÉTODO: Se realizó un estudio cualitativo descriptivo de tipo exploratorio en Guapi, de octubre a noviembre de 2016, a través del análisis de contenido de grupos focales de ocho mujeres voluntarias y de análisis inductivo e interpretativo. RESULTADOS: Basadas en las respuestas de las voluntarias, se construyeron tres categorías, de las cuales se originaron cinco subcategorías relacionadas con barreras (tema) para la eliminación de la malaria que incluyen determinantes sociales del municipio tales como las barreras ambientales, culturales y de atención en salud. Todas ellas requieren de la intervención integral por parte de las diferentes dependencias del Estado, con la inclusión de las características propias de la comunidad guapireña. CONCLUSIÓN: Se identificó que la falta de planeación e infraestructura deficiente en el municipio obstaculiza no solo la eliminación de la malaria sino también la de otras enfermedades transmisibles. El desarrollo de actividades económicas como la minería, las prácticas de automedicación, la poca adherencia a las medidas de prevención por parte de la comunidad, la falta de contratación de profesionales y microscopistas y el difícil acceso a los servicios de salud constituyen las principales barreras para la eliminación de la malaria en este municipio de la región pacífica colombiana.

Estrategias para la eliminación de malaria: una perspectiva afro-colombiana / Strategies for malaria elimination: an Afro-Colombian perspective

RESUMEN Objetivo Describir las estrategias para la eliminación de la malaria a partir de la percepción de pobladores afro-colombianos residentes en Guapi en el contexto de la Estrategia de Gestión Integrada para la promoción, prevención y control de las Enfermedades Transmitidas por Vectores en Colombia (EGI). Métodos Estudio de tipo cualitativo basado en el análisis de discurso de grupos focales. Ocho participantes residentes en zona urbana de Guapi, divididas en dos grupos: el primero correspondió a tres mujeres auxiliares de enfermería, denominadas "mujeres con mayor experiencia", trabajadoras en el actual sistema de salud y funcionarias del antiguo Servicio de Erradicación de la Malaria. El segundo correspondió a cinco mujeres auxiliares de enfermería, denominadas "mujeres con limitada experiencia", trabajadoras en el actual sistema de salud y no tuvieron formación directa con el programa de malaria. Análisis inductivo e interpretativo. Resultados Emergieron ocho subcategorias enmarcadas en la EGI, con énfasis en la promoción y prevención orientadas a disminuir la malaria, especialmente en el área rural. El abordaje del problema debe hacerse de forma integral incluyendo otras problemáticas en salud y determinantes sociales que los afectan como: saneamiento básico, acceso al servicio de salud, falta de educación, uso de tratamientos populares, fragilidad de infraestructura, entre otros. Conclusión Las participantes consideran que la malaria en Guapi se puede reducir pero no eliminar. Se requiere abordar este problema desde una perspectiva institucional y comunitaria, teniendo en cuenta las diferencias culturales, a partir de estrategias que incluyan el empoderamiento comunitario y fortalecimiento administrativo e institucional del programa.(AU)

ABSTRACT Objective To describe strategies for malaria elimination based on the perception of Afro-Colombian residents in Guapi, in the context of the Integrated Management Strategy for the Promotion, Prevention and Control of Vector-Borne Diseases in Colombia (EGI-ETV). Materials and Methods Qualitative study based on focus group discourse analysis. Eight participants from the urban area of Guapi were divided into two groups. The first group included three female nursing assistants, and was called "women with more experience"; they were workers in the current health system and former Malaria Eradication Service officers. The second group was made up of female nursing assistants, and was called "women with limited experience"; they were workers in the current health system and were not directly trained in the malaria program. An inductive and interpretative analysis was performed. Results Eight subcategories emerged, framed in the EGI-EVT, making emphasis on promotion and prevention aimed at reducing malaria, especially in rural areas. This problem must be addressed comprehensively, including other health issues and social determinants that affect them, such as: basic sanitation, access to health services, lack of education, use of popular treatments, and lack of infrastructure, among others. Conclusion Participants consider that malaria in Guapi can be reduced but not eliminated. This problem needs to be addressed from an institutional and community perspective, taking into account cultural differences, based on strategies that include community empowerment and administrative and institutional strengthening of the program.(AU)

[Strategies for malaria elimination: an Afro-Colombian perspective]. / Estrategias para la eliminación de malaria: una perspectiva afro-colombiana.

OBJECTIVE: To describe strategies for malaria elimination based on the perception of Afro-Colombian residents in Guapi, in the context of the Integrated Management Strategy for the Promotion, Prevention and Control of Vector-Borne Diseases in Colombia (EGI-ETV). MATERIALS AND METHODS: Qualitative study based on focus group discourse analysis. Eight participants from the urban area of Guapi were divided into two groups. The first group included three female nursing assistants, and was called "women with more experience"; they were workers in the current health system and former Malaria Eradication Service officers. The second group was made up of female nursing assistants, and was called "women with limited experience"; they were workers in the current health system and were not directly trained in the malaria program. An inductive and interpretative analysis was performed. RESULTS: Eight subcategories emerged, framed in the EGI-EVT, making emphasis on promotion and prevention aimed at reducing malaria, especially in rural areas. This problem must be addressed comprehensively, including other health issues and social determinants that affect them, such as: basic sanitation, access to health services, lack of education, use of popular treatments, and lack of infrastructure, among others. CONCLUSION: Participants consider that malaria in Guapi can be reduced but not eliminated. This problem needs to be addressed from an institutional and community perspective, taking into account cultural differences, based on strategies that include community empowerment and administrative and institutional strengthening of the program.

OBJETIVO: Describir las estrategias para la eliminación de la malaria a partir de la percepción de pobladores afro-colombianos residentes en Guapi en el contexto de la Estrategia de Gestión Integrada para la promoción, prevención y control de las Enfermedades Transmitidas por Vectores en Colombia (EGI). MÉTODOS: Estudio de tipo cualitativo basado en el análisis de discurso de grupos focales. Ocho participantes residentes en zona urbana de Guapi, divididas en dos grupos: el primero correspondió a tres mujeres auxiliares de enfermería, denominadas "mujeres con mayor experiencia", trabajadoras en el actual sistema de salud y funcionarias del antiguo Servicio de Erradicación de la Malaria. El segundo correspondió a cinco mujeres auxiliares de enfermería, denominadas "mujeres con limitada experiencia", trabajadoras en el actual sistema de salud y no tuvieron formación directa con el programa de malaria. Análisis inductivo e interpretativo. RESULTADOS: Emergieron ocho subcategorias enmarcadas en la EGI, con énfasis en la promoción y prevención orientadas a disminuir la malaria, especialmente en el área rural. El abordaje del problema debe hacerse de forma integral incluyendo otras problemáticas en salud y determinantes sociales que los afectan como: saneamiento básico, acceso al servicio de salud, falta de educación, uso de tratamientos populares, fragilidad de infraestructura, entre otros. CONCLUSIÓN: Las participantes consideran que la malaria en Guapi se puede reducir pero no eliminar. Se requiere abordar este problema desde una perspectiva institucional y comunitaria, teniendo en cuenta las diferencias culturales, a partir de estrategias que incluyan el empoderamiento comunitario y fortalecimiento administrativo e institucional del programa.