RESUMO
In 2016, Venezuela faced a large diphtheria outbreak that extended until 2019. Nasopharyngeal or oropharyngeal samples were prospectively collected from 51 suspected cases and retrospective data from 348 clinical records was retrieved from 14 hospitals between November 2017 and November 2018. Confirmed pathogenic Corynebactrium isolates were biotyped. Multilocus Sequence Typing (MLST) was performed followed by next-generation-based core genome-MLST and minimum spanning trees were generated. Subjects between 10 and 19 years of age were mostly affected (n = 95; 27.3%). Case fatality rates (CFR) were higher in males (19.4%), as compared to females (15.8%). The highest CFR (31.1%) was observed among those under 5, followed by the 40 to 49 age-group (25.0%). Nine samples corresponded to C. diphtheriae and 1 to C. ulcerans. Two Sequencing Types (ST), ST174 and ST697 (the latter not previously described) were identified among the eight C. diphtheriae isolates from Carabobo state. Cg-MLST revealed only one cluster also from Carabobo. The Whole Genome Sequencing analysis revealed that the outbreak seemed to be caused by different strains with C. diphtheriae and C. ulcerans coexisting. The reemergence and length of this outbreak suggest vaccination coverage problems and an inadequate control strategy.
Assuntos
Corynebacterium diphtheriae/genética , Difteria/epidemiologia , Filogenia , Adolescente , Adulto , Criança , Pré-Escolar , Corynebacterium diphtheriae/isolamento & purificação , Corynebacterium diphtheriae/patogenicidade , Difteria/genética , Difteria/microbiologia , Surtos de Doenças , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Tipagem de Sequências Multilocus , Estudos Retrospectivos , Venezuela/epidemiologia , Adulto JovemRESUMO
La OMS estima que para el año 2013 había 35 millones de personas infectados con VIH. Estudios informan sobre las consecuencias de la transmisión vertical y su influencia en la calidad de vida. Surgiendo así la interrogante: ¿Qué sentido le dan a sus vivencias las madres de niños VIH/ SIDA vertical que asisten a la consulta de Infectología Pediátrica de un Hospital del Estado Carabobo? Se realizó un estudio fenomenológico hermenéutico, los sujetos fueron seleccionados de manera intencional, lo conformaron 7 madres de hijos VIH/SIDA por trasmisión vertical entrevistadas a profundidad. Se evidenció que las vivencias de las madres se perciben como negativa, sentimientos como miedo, soledad, tristeza y culpa. A pesar del rechazo de la sociedad, ven como grupos de apoyo a su familia y personal de la consulta. Los hijos son motivo de lucha y su tratamiento de vital importancia. Necesitan apoyo psicológico como parte de la terapéutica.
The WHO estimates that by 2013 there were 35 million people infected with HIV. Studies report on the consequences of vertical transmission and its influence on quality of life. This raises the question: What sense do the mothers of vertical HIV / AIDS children attending the Pediatric Infectology consultation at a Carabobo State Hospital give their experiences? A phenomenological hermeneutic study was carried out, the subjects were intentionally selected, they were formed by 7 mothers of HIV / AIDS children by vertical transmission interviewed in depth. It was evidenced that the experiences of the mothers are perceived as negative, feelings as fear, loneliness, sadness and guilt. Despite the rejection of society, they see as support groups for their family and staff consultation. Children are a reason for struggle and their treatment is of vital importance. They need psychological support as part of therapeutics.
RESUMO
A nivel mundial, se estima 630 millones de individuos infectados en el área ano-genital y 190 millones con enfermedad clínica por el virus papiloma humano (VPH), siendo la primera infección de transmisión sexual. En Venezuela se estima que entre el 11 % y 12 % de las mujeres embarazadas pueden están infectadas, con riesgo de transmisión al recién nacido por mecanismo vertical/ perinatal pudiendo llevar a infección crónica en el niño. Objetivo: determinar el porcentaje de transmisibilidad materno fetal del VPH, la persistencia y tipo del mismo en faringe, y los hallazgos nasofibroscópicos en los veinticuatro primeros meses de vida, en pacientes que acuden al servicio de infectología y neumonología del Hospital Pediátrico Dr. Jorge Lizárraga, Valencia, Edo. Carabobo. Metodología: Trabajo descriptivo, longitudinal, retro y prospectivo en hijos de madre con VPH, período junio 2010 a marzo 2016, a quienes se les realizó evaluación clínica y nasofibroscópica, antes del primer año y entre el primer y segundo año de vida, con toma de muestra laríngea para PCR VPH. Resultados: Se evaluaron 12 niños. El 58 % de las madres eran menores de 25 años, el 40,6 % habían tenido más de 4 parejas sexuales; en su mayoría presentaron arrugas vulvares. Los niños fueron en su mayoría a términos, y 75 % parto vaginal; 2/3 presentaron el virus en laringe antes del primer año, predominando el tipo 6, pero persistiendo solo en uno durante el segundo año (tipo 11), con lesión vegetante. CONCLUSIONES: El inicio de actividad sexual es precoz, con una tasa importante de madres embarazadas conVPH. Transmisión vertical/ perinatal aproximada del 75 % pero con una lisis viral mayor al 90 % en el segundo año de vida.
Globally, an estimated 630 million individuals are infected in the ano-genital area and 190 million with clinical disease from the Human Papillomavirus (HPV), being the first sexually transmitted infection in the world. In Venezuela, it is estimated that between 11 and 12 % of pregnant women may be infected, with risk of transmission to the newborn by vertical or perinatal mescanism, leading to complications due to chronic infection in the child. Objective: To determine the percentage of maternal fetal transmissibility of HPV, the persistence and type of the pharynx, as well as the nasofibroscopic findings in the first 24 months of life, in patients attending the infectious and pneumonology department of the Pediatric Hospital Dr. Jorge Lizárraga, Valencia, Edo. Carabobo. Methods: Descriptive, longitudinal, retrospective and prospective work in children of HPV mothers during the period June 2010 to March 2016, who underwent clinical and nasofibroscopic evaluation, before the first year and between the first and second year of life, with laryngeal sampling for HPV PCR. Results: Twelve children were evaluated. 58 % of the mothers were under 25 years old, where 40.6 % had had more than 4 sexual partners; most of them had vulvar wrinkles. In terms of children were mostly terms, 75 % vaginal delivery. Two-thirds of the children presented the virus in the larynx before the first year, predominating type 6, but persisting only in one child during the second year of life (type 11), with a persistent vegetative lesion. Conclusions: The onset of sexual activity is precocious in our population, with an important rate of pregnant mothers important for HPV. There is approximately 75 % vertical / perinatal transmission but viral lysis greater than 90 % in the second year of life.
RESUMO
El desarrollo del sistema nervioso central (SNC) es un proceso que tiene como resultado la maduración de las estructuras, adquisición de habilidades y formación del individuo como persona. Los trastornos neurocognitivos son consecuencia de una alteración en la organización funcional del SNC, siendo el virus de inmunodeficiencia humana (VIH) descrito como una de las causas de estas patologías. Objetivo: Evaluar el neurodesarrollo de niños portadores del VIH en comparación a niños sin patología base. Hospital de Niños "Dr. Jorge Lizarraga". Ciudad Hospitalaria "Dr. Enrique Tejera". Diciembre 2015- mayo 2016. Materiales y Métodos: Descriptiva, transversal, no experimental y comparativa. Contó con dos grupos a los cuales se les realizó test de Bender, test de Raven, valoración del desarrollo psicomotor y electroencefalograma. Resultados: El sexo predominante fue el masculino, los escolares formaron la mayoría de la muestra; los pacientes tuvieron un desarrollo psicomotor acorde a edad (94 %). El 66 % presentó una capacidad intelectual esperada para su edad. No se evidenció alteración visomotriz, ni electroencefalográfica en el 94 % de los pacientes. La mayoría presentó trastornos emocionales. Conclusiones: No hubo diferencia significativa entre ambos grupos. Los pacientes seropositivos que presentaron capacidad intelectual por debajo de lo esperado para su edad fueron aquellos que no tuvieron adhesión al tratamiento. Los estudios neurofisiológicos y de neuroimagen no registraron organicidad.
The development of the central nervous system (CNS) is a process that results in the maturation of structures, skills acquisition and training of the individual as a person. Neurocognitive disorders are the result of an alteration in the functional organization of the CNS, being the HIV (HIV) described as one of the causes of these diseases. Objective: To evaluate the neurodevelopment of children living with HIV compared to children without basic pathology. Children's Hospital "Dr. Jorge Lizarraga". City Hospital "Dr. Enrique Tejera". December 2015- May 2016. Materials and Methods: Descriptive, transversal and not experimental and comparative. He had two groups who underwent Bender test, Raven test, assessment of psychomotor development and electroencephalogram. Results: The majority of patients were male, school formed the majority of the sample; patients had psychomotor development according to age (94 %). 66 % hadanexpectedbrainpower age. No alteration was evident visual-motor or electroencephalographic in 94 % of patients. Most she had emotional disorders. Conclusions: There was no significant difference between the two groups. HIV-positive patients who had intellectual capacity below expected for their age were those who had no treatment adherence. Neurophysiological and neuroimaging studies organicidad recorded.