Substantial reduction in child stunting is differentially associated to geographical and socioeconomic disparities in Misiones Province, Argentina.

OBJECTIVE: To estimate trends in the prevalence of child stunting in the population of children under 5 years of age covered by public health programmes, between 2009 and 2014 in Misiones, Argentina. METHODS: Using Bayesian model-based geostatistics, we evaluated 724 872 anthropometric measurements corresponding to 110 633 children. In order to identify disparities at local scale, we evaluated the hypotheses of a differential reduction of stunting according to the geographical location (at two-level spatial resolution) and to the socioeconomic level in a rural or urban environment. RESULTS: The prevalence of stunting had fallen significantly in the province overall. Sex and age defined gender disparities at individual level, and there were regional disparities with higher prevalence values in the north and northeast regions. In these areas, stunting decreased to a greater degree during the studied period, although the spatial pattern remained smoother. Stunting increased in peripheral urban and dispersed rural areas that are socioeconomically vulnerable. CONCLUSIONS: The spatial multi-level geostatistical estimates of child undernutrition provide a precision public health tool to target public policies to those populations with the greatest need, in order to reduce health disparities.

OBJECTIF: Estimer les tendances dans la prévalence du retard de croissance dans la population des enfants de moins de 5 ans couverts par les programmes de santé publique, entre 2009 et 2014 à Misiones, en Argentine. MÉTHODES: En utilisant la géostatistique basée sur un modèle bayésien, nous avons évalué 724.872 mesures anthropométriques correspondant à 110.633 enfants. Afin d'identifier les disparités à l'échelle locale, nous avons évalué les hypothèses d'une réduction différentielle du retard de croissance en fonction de la situation géographique (à une résolution spatiale à deux niveaux) et du niveau socioéconomique en milieu rural ou urbain. RÉSULTATS: La prévalence du retard de croissance avait considérablement diminué dans l'ensemble de la province. Le sexe et l'âge définissaient des disparités entre les sexes au niveau individuel, et il y avait des disparités régionales avec des valeurs de prévalence plus élevées dans les régions du nord et du nord-est. Dans ces régions, le retard de croissance a diminué plus fortement au cours de la période étudiée, bien que le modèle spatial soit resté plus lisse. Le retard de croissance a augmenté dans les zones urbaines périphériques et les zones rurales dispersées qui sont socioéconomiquement vulnérables. CONCLUSIONS: Les estimations géostatistiques spatiales à plusieurs niveaux de la sous-nutrition infantile fournissent un outil de santé publique de précision pour cibler les politiques publiques sur les populations qui en ont le plus besoin, afin de réduire les disparités en matière de santé.

Retrosynthesis of CaCO3 via amorphous precursor particles using gastroliths of the Red Claw lobster (Cherax quadricarinatus).

Gastroliths are highly calcified structures formed in the cardiac stomach wall of crustaceans for the temporary storage of amorphous CaCO3 (ACC). The gastrolithic ACC is stabilized by the presence of biomolecules, and represents a novel model for research into biomineralization. For the first time, an in vitro biomimetic retrosynthesis of scaffolds of gastrolithic matrices with CaCO3 is presented. With the help of synthetic polyacrylic (PAA) and phytic (PA) acids, amorphous precursor particles were stabilized in double (DD) and gas (GD) diffusion crystallization assays. The presence of these synthetic molecules as efficient inhibitors of nucleation and growth of CaCO3, and the use of biological gastrolith scaffolds as confined reaction environments determined the kinetics of crystallization, and controlled the morphogenesis of CaCO3. The formation of ACC particles was demonstrated and their crystallization was followed by light microscopy, scanning and transmission electron microscopy, and electron diffraction.

Spatial and temporal changes in Lutzomyia longipalpis abundance, a Leishmania infantum vector in an urban area in northeastern Argentina.

This study aimed to analyse changes in the spatial distribution of Lutzomyia longipalpis in Posadas, an urban area located in northeastern Argentina. Data were obtained during the summer of 2007 and 2009 through two entomological surveys of peridomiciles distributed around the city. The abundance distribution pattern for 2009 was computed and compared with the previous pattern obtained in 2007, when the first human visceral leishmaniasis cases were reported in the city. Vector abundance was also examined in relation to micro and macrohabitat characteristics. In 2007 and 2009, Lu. longipalpis was distributed among 41.5% and 31% of the households in the study area, respectively. In both years, the abundance rates at most of the trapping sites were below 30 Lu. longipalpis per trap per night; however, for areas exhibiting 30-60 Lu. longipalpis and more than 60 Lu. longipalpis, the areas increased in both size and number from 2007-2009. Lu. longipalpis was more abundant in areas with a higher tree and bush cover (a macrohabitat characteristic) and in peridomiciles with accumulated unused material (a microhabitat characteristic). These results will help to prioritise and focus control efforts by defining which peridomiciles display a potentially high abundance of Lu. longipalpis.

Efficacy, Safety, and Pain Level of Subcutaneous Catheter Use for Administration of Granulocyte Colony-Stimulating Factor (G-CSF) in Children With Cancer: A Randomized Pilot Study.

Background: The aim of this study was to explore the efficacy, safety, and pain level of granulocyte colony-stimulating factor (G-CSF) administration via a subcutaneous catheter compared with direct injection in children with cancer. Method: This was a pilot randomized controlled trial of standard G-CSF administration versus subcutaneous catheter administration. Children 2-15 years of age who were beginning G-CSF after their first chemotherapy cycle and anticipated to receive G-CSF following the next three cycles of chemotherapy were eligible. Efficacy, safety, and pain were as outcomes of the study. Results: Twenty-nine children with cancer (median age 12 years) were enrolled in the study (16 children in the subcutaneous catheter group and 13 children in the direct injection group). During Cycle 2, the median number of days to reach absolute neutrophil count (ANC) ≥ 500/mm3 was greater among those in the subcutaneous catheter group (12 vs. 10; p = .02). In Cycle 3, however, the subcutaneous catheter group received fewer doses of G-CSF (8 vs. 12; p = .004). No complications related to subcutaneous catheter use were observed. No differences in the visual analog scale pain score were observed between groups in Cycles 1 to 3; however, in Cycle 4, children in the subcutaneous catheter group had lower median pain scores than those in the direct subcutaneous injection group (Mdn = 0, [IQR] = 0-2 vs. Mdn = 1, IQR = 0-6; p < 0.01). Conclusion: Results demonstrated administering G-CSF via a subcutaneous catheter enables ANC to recover with no pain or complications associated with its use. Thus, oncology teams may consider this administration method to be used in children with cancer.

Lutzomyia longipalpis abundance in the city of Posadas, northeastern Argentina: variations at different spatial scales.

The distribution of Lutzomyia longipalpis is heterogeneous with a pattern of high abundance areas (HAAs) embedded in a matrix of low abundance areas (LAAs). The objective of this study was to describe the variability in the abundance of Lu. longipalpis at two different spatial levels and to analyse the relationship between the abundance and multiple environmental variables. Of the environmental variables analysed in each household, the condition that best explained the differences in vector abundance between HAA-LAA was the variable "land_grass", with greater average values in the peridomestic environments within the LAA, and the variables "#sp tree", "#pots" and "dist_water" that were higher in the HAA. Of the environmental variables analysed in the patches, the variable "unpaved_streets" was higher in the LAAs and the variable "prop_inf_dogs" was higher in the HAAs. An understanding of the main environmental variables that influence the vector distribution could contribute to the development of strategies for the prevention and control of visceral leishmaniasis (VL). This is the first work in which environmental variables are analysed at the micro-scale in urban areas at the southern edge of the current range of Lu. longipalpis. Our results represent a significant contribution to the understanding of the abundance of the vector in the peridomestic habitats of the region.

Lutzomyia longipalpis in Uruguay: the first report and the potential of visceral leishmaniasis transmission.

Phlebotomine captures were performed in February 2010 in Salto (Salto department) and Bella Unión-Cuarein (Artigas department), Uruguay. Bella Unión is located across the Paraná River from Monte Caseros, Argentina, where a focus of canine visceral leishmaniasis (VL) was reported in 2009. No VL cases have ever been recorded in Uruguay and the last reported capture of Phlebotominae was in 1932 (Lutzomyia cortelezzii and Lutzomyia gaminarai). Light traps were placed in peridomestic environments, and Lutzomyia longipalpis, the main vector of visceral leishmaniasis, was found in Salto and Bella Unión. This is a first report of an area of potential VL transmission in Uruguay. Active and coordinated surveillance is required immediately the Uruguay-Argentina-Brazil border area.

Assessment of bioclimatic change in Kazakhstan, end 20th-middle 21st centuries, according to the PRECIS prediction.

We evaluate bioclimatic changes in Kazakhstan from the end of the 20th century until the middle of the 21st century to offer natural resource managers a tool that facilitates their decision-making on measures to adapt agriculture and environmental care to foreseeable climate change. We use climatic data from the "Providing REgional Climates for Impact Studies" (PRECIS) prediction and study them following the Worldwide Bioclimatic Classification System (WBCS) of Rivas-Martínez. For three 25-year intervals (1980-2004, 2010-2034 and 2035-2059), we identify the continentality, macrobioclimates, bioclimates, bioclimatic variants, thermotypes, ombrotypes and isobioclimates of the study area. The results of the work allow us to: locate the territories where bioclimatic conditions will change, quantify the magnitude of the predicted climate changes, and determine the trends of predictable climate change. We present the results in maps, tables and graphs. For the 80-year interval, we identify 3 macroclimates, 3 bioclimatic variants, 10 bioclimates, 11 thermotypes, 10 ombrotypes and 43 isobioclimates. Some of those found bioclimates, thermotypes, ombrotypes and isobioclimates are only located in the E, SE and S mountains, where they occupy very small areas, that decrease in a generalized way as the 20th century progresses. Comparing the three successive periods, the following trends are observed: 36.2% of the territory increases in thermicity; 7.3% of the territory increases in continentality; 9.7% of the territory increases in annual aridity; 9.5% of the territory increases in summer aridity or mediterraneity; and generalized losses occur in the areas of all mountain isobioclimates. The climate change foreseen by the PRECIS model for the middle of the 21st century leads to bioclimatic homogenization, with 20.8% losses in bioclimatic diversity. We indicate on maps the locations of all the predicted bioclimatic changes; these maps may provide decision makers with a scientific basis to take necessary adaptation measures.

Multiscale environmental determinants of Leishmania vectors in the urban-rural context.

BACKGROUND: In South America, cutaneous leishmaniasis (CL) and visceral leishmaniasis (VL) are emerging diseases, expanding in the border area of Argentina, Brazil and Paraguay. Outbreaks of CL were reported since the 1990s, with Nyssomyia whitmani as the main vector in this region. Regarding VL, urban reports started in 2010 with Lutzomyia longipalpis as the main vector. The aim of this study was to evaluate environmental determinants related to the main vectors of leishmaniasis, to contribute to the prevention and control response to the emergence of VL and CL in the Argentina-Brazil-Paraguay border region. METHODS: The cross-sectional survey includes two cities and two close rural areas in the Argentinean Northeast Region, between November 2014 and January 2015, with a total of 95 sampling sites. REDILA-BL traps were set for three consecutive nights, and a total of 68 meso- and microscale environmental and landscape characteristics were surveyed. The association between vector abundance with different variables was evaluated using a generalized linear model with zero-inflated negative binomial distribution. We analyzed females for detection of Leishmania DNA. RESULTS: The analysis for Lu. longipalpis indicates an excess of absences when the mean NDWI around the sites were higher. The abundance of Lu. longipalpis at mesoscale level was higher when more urban services were present, and when blood sources such as chickens or dogs at the microscale level were present. For Ny. whitmani, no variable was found to be associated with the absences, while its abundance increased in association with the following variables: percentage of tree cover, presence of garbage collection service, hosted people and, at microscale, the presence of poultry. Leshmania infantum DNA was detected in 2/49 (4%) Lu. longipalpis. CONCLUSIONS: The abundance of both species is influenced by variables at different scales, their influence probably has a hierarchy and they are acting on different aspects of the biology of these vectors. The urban spatial segregation of Lu. longipalpis and the peri-urban and rural segregation of N. whitmani increase the risk of VL and CL. The selection of the better variables for each scale will allow the design of appropriate control strategies depending on species.

Small rodent species on pig and dairy farms: habitat selection and distribution.

BACKGROUND: Rodent species are common in livestock production systems, and some of them are considered serious pests because of the sanitary problems and economic losses they cause. Information about microhabitat selection by rodent species in livestock production systems is necessary for understanding rodent requirements and to contribute to effective prevention and development of control measures for pest rodent species. In this work we study microhabitat selection by rodent species that inhabit pig and dairy farms in central Argentina. Rodent trapping was conducted over three years (2008-2011) on 18 livestock farms, each one sampled seasonally during one year. To study habitat selection, microhabitat characterizations were performed describing 22 environmental variables in captured sites and random trap sites without captures. RESULTS: With a trapping effort of 7333 Sherman and 7026 cage live trap-nights, 444 rodents of seven species were captured (including the murine pest species Rattus norvegicus, R. rattus and Mus musculus and four native species). The three murines selected characteristics related to building structure and/or to food sources availability/proximity, while Akodon azarae selected sites with tall herbatious vegetation. CONCLUSIONS: We identified microhabitat characteristics that explain habitat distribution of small rodent species in these complex farm systems. This study contributes to broaden the integrated pest management of rodent pest species and could also contribute to the reduction of the use of rodenticides in these systems. © 2018 Society of Chemical Industry.

Intrinsic and extrinsic factors related to pathogen infection in wild small mammals in intensive milk cattle and swine production systems.

BACKGROUND: Understanding the ecological processes that are involved in the transmission of zoonotic pathogens by small mammals may aid adequate and effective management measures. Few attempts have been made to analyze the ecological aspects that influence pathogen infection in small mammals in livestock production systems. We describe the infection of small mammals with Leptospira spp., Brucella spp., Trichinella spp. and Cysticercus fasciolaris and assess the related intrinsic and extrinsic factors in livestock production systems in central Argentina at the small mammal community, population and individual levels. METHODOLOGY/PRINCIPAL FINDINGS: Ten pig farms and eight dairy farms were studied by removal trapping of small mammals from 2008 to 2011. Each farm was sampled seasonally over the course of one year with cage and Sherman live traps. The 505 small mammals captured (14,359 trap-nights) included three introduced murine rodents, four native rodents and two opossums. Leptospira spp., anti-Brucella spp. antibodies and Trichinella spp. were found in the three murine rodents and both opossums. Rattus norvegicus was also infected with C. fasciolaris; Akodon azarae and Oligoryzomys flavescens with Leptospira spp.; anti-Brucella spp. antibodies were found in A. azarae. Two or more pathogens occurred simultaneously on 89% of the farms, and each pathogen was found on at least 50% of the farms. Pathogen infections increased with host abundance. Infection by Leptospira spp. also increased with precipitation and during warm seasons. The occurrence of anti-Brucella spp. antibodies was higher on dairy farms and during the winter and summer. The host abundances limit values, from which farms are expected to be free of the studied pathogens, are reported. CONCLUSIONS/SIGNIFICANCE: Murine rodents maintain pathogens within farms, whereas other native species are likely dispersing pathogens among farms. Hence, we recommend preventing and controlling murines in farm dwellings and isolating farms from their surroundings to avoid contact with other wild mammals.

Changes in liver proteins of rats fed standard and high-fat and sucrose diets induced by fish omega-3 PUFAs and their combination with grape polyphenols according to quantitative proteomics.

This study considered the physiological modulation of liver proteins due to the supplementation with fish oils under two dietary backgrounds: standard or high in fat and sucrose (HFHS), and their combination with grape polyphenols. By using a quantitative proteomics approach, we showed that the capacity of the supplements for regulating proteins depended on the diet; namely, 10 different proteins changed into standard diets, while 45 changed into the HFHS diets and only scarcely proteins were found altered in common. However, in both contexts, fish oils were the main regulatory force, although the addition of polyphenols was able to modulate some fish oils' effects. Moreover, we demonstrated the ability of fish oils and their combination with grape polyphenols in improving biochemical parameters and reducing lipogenesis and glycolysis enzymes, enhancing fatty acid beta-oxidation and insulin signaling and ameliorating endoplasmic reticulum stress and protein oxidation when they are included in an unhealthy diet.

Enhanced depth OCT imaging of the lamina cribrosa for 24 hours.

The lamina cribrosa thickness (LCT) could be affected by dynamic changes in its structure. Using Spectral-domain-optical coherence tomography (SD-OCT), we have studied the behaviour of the laminar region in 14 young subjects over 24h. Significant changes in LCT were observed, depending on the time at which the measurement was taken, with the maximum thickness being observed at 7.30 p.m., and the minimum at 7.30 a.m. This finding could suggests a circadian pattern in the LCT thickness in healthy subjects, which could have implications for the classification, diagnosis and prognosis of both normal and glaucomatous subjects.

Performance of light-emitting diode traps for collecting sand flies in entomological surveys in Argentina.

The performance of two light-emitting diode traps with white and black light for capturing phlebotomine sand flies, developed by the Argentinean Leishmaniasis Research Network (REDILA-WL and REDILA-BL traps), were compared with the traditional CDC incandescent light trap. Entomological data were obtained from six sand fly surveys conducted in Argentina in different environments. Data analyses were conducted for the presence and the abundance of Lutzomyia longipalpis, Migonemyia migonei, and Nyssomyia whitmani (106 sites). No differences were found in presence/absence among the three types of traps for all sand fly species (p>0.05). The collection mean of Lu. longipalpis from the REDILA-BL didn´t differ from the CDC trap means, nor were differences seen between the REDILA-WL and the CDC trap collection means (p>0.05), but collections were larger from the REDILA-BL trap compared to the REDILA-WL trap (p<0.05). For Mg. migonei and Ny. whitmani, no differences were found among the three types of traps in the number of individuals captured (p>0.05). These results suggest that both REDILA traps could be used as an alternative capture tool to the original CDC trap for surveillance of these species, and that the REDILA-BL will also allow a comparable estimation of the abundance of these flies to the CDC light trap captures. In addition, the REDILA-BL has better performance than the REDILA-WL, at least for Lu. longipalpis.

Trypanosoma cruzi Calreticulin Topographical Variations in Parasites Infecting Murine Macrophages.

Trypanosoma cruzi calreticulin (TcCRT), a 47-kDa chaperone, translocates from the endoplasmic reticulum to the area of flagellum emergence. There, it binds to complement components C1 and mannan-binding lectin (MBL), thus acting as a main virulence factor, and inhibits the classical and lectin pathways. The localization and functions of TcCRT, once the parasite is inside the host cell, are unknown. In parasites infecting murine macrophages, polyclonal anti-TcCRT antibodies detected TcCRT mainly in the parasite nucleus and kinetoplast. However, with a monoclonal antibody (E2G7), the resolution and specificity of the label markedly improved, and TcCRT was detected mainly in the parasite kinetoplast. Gold particles, bound to the respective antibodies, were used as probes in electron microscopy. This organelle may represent a stopover and accumulation site for TcCRT, previous its translocation to the area of flagellum emergence. Finally, early during T. cruzi infection and by unknown mechanisms, an important decrease in the number of MHC-I positive host cells was observed.

Las redes sociales en la estrategia de implementación de evidencias en la práctica clínica: experiencia del Hospital Regional Universitario de Málaga, España / Social networks in the clinical practice evidence implementation strategy: experience from Hospital Regional Universitario de Málaga, Spain / Redes sociais na estratégia de implementação de evidências na prática clínica: experiência do Hospital Regional Universitario de Málaga, Espanha

Introducción. Twitter se ha convertido en el foro favorito para la comunicación de la atención médica, en cuanto permite a los usuarios publicar y compartir mensajes fácilmente a sus seguidores. En el Hospital Regional Universitario de Málaga (HRUM) se ha recurrido al uso de las redes sociales, particularmente Twitter, para facilitar la implementación y difusión de las recomendaciones de las Guías de Buenas Prácticas (GBP) de la Registered Nurses Association of Ontario (RNAO) en la práctica clínica. El objetivo del presente artículo es describir la estrategia y reflexionar acerca del rol de las redes sociales en las estrategias y los resultados de implantación de recomendaciones de GBP de la RNAO. Temas de reflexión. Siguiendo la metodología del modelo Best Practice Spotlight Organization (BPSO), se ha otorgado un papel protagonista a las enfermeras asistenciales de cada unidad a través de la formación, creación de equipos de implantación y difusión del programa. El uso de nuevos registros y, sobre todo, el uso de las redes sociales, ha obtenido unos resultados excelentes de adherencia de los profesionales al programa tanto a nivel cuantitativo como cualitativo. Conclusiones. El uso de las redes sociales como estrategia de difusión en la implantación de las recomendaciones de las GBP de la RNAO ha conseguido muy buena acogida por parte de los profesionales, pues muestra un alto nivel de participación, y es una herramienta útil como estrategia de difusión. Se necesita más tiempo para monitorizar el uso de las redes sociales y su posible impacto en la implantación de evidencias y la mejora de los resultados de salud de los pacientes y organizaciones de salud. Cómo citar: Bujalance Hoyos J, Grinspun D, Pérez Jiménez MT, Viñas Vera C, Jiménez Fernández MS, García Sánchez JA. Las redes sociales en la estrategia de implementación de evidencias en la práctica clínica: experiencia del Hospital Regional Universitario de Málaga, España. MedUNAB. 2020;23(1):107-117. doi:10.29375/01237047.3571

Introduction. Twitter has become the favored forum for communicating health care, since it allows users to publish and share messages with their followers. At Hospital Regional Universitario de Málaga (HRUM), they have used social networks, particularly Twitter, to facilitate implementing and broadcasting the recommendations from the Registered Nurses Association of Ontario's (RNAO) Best Practice Guideline (BPG) for clinical practice. The objective of this paper is to describe the strategy and reflect on the role of social networks on the strategies and results of implementing the RNAO's BPG recommendations. Topics of reflection. In accordance to the methodology of the Best Practice Spotlight Organization (BPSO) model, a leading role has been given to the nurses at each unit through training, creation of implementation teams and broadcasting the program. Using new records and, most of all, social networks, the strategy has obtained excellent results from professionals when it comes to adherence to the program, both quantitatively and qualitatively. Conclusions. The use of social networks as a broadcasting strategy in implementing the RNAO's BPG recommendations has been well received by professionals. The strategy shows high participation levels and is a useful tool as a broadcasting strategy. More time is needed to monitor social network use and its possible impact on generating evidence, as well as the improvement of healthcare organizations and patient's health results. Cómo citar: Bujalance Hoyos J, Grinspun D, Pérez Jiménez MT, Viñas Vera C, Jiménez Fernández MS, García Sánchez JA. Las redes sociales en la estrategia de implementación de evidencias en la práctica clínica: experiencia del Hospital Regional Universitario de Málaga, España. MedUNAB. 2020;23(1):107-117. doi:10.29375/01237047.3571

Introdução. O Twitter se tornou o fórum favorito para a comunicação no atendimento médico, pois permite que os usuários publiquem e compartilhem facilmente mensagens para seus seguidores. No Hospital Regional Universitário de Málaga (HRUM), foram utilizadas as redes sociais, particularmente o Twitter, para facilitar a implementação e disseminação das recomendações das Guias de Boas Práticas (GBP) da Registered Nurses Association of Ontario (RNAO) na prática clínica. O objetivo deste artigo é descrever a estratégia e refletir sobre o papel das redes sociais nas estratégias e nos resultados da implementação das recomendações do GBPs da RNAO. Tópicos de reflexão. Seguindo a metodología do modelo Best Practice Spotlight Organization, foi atribuído um papel essencial às enfermeiras de cada unidade por meio de treinamento, criação de equipes de implementação e divulgação do programa. O uso de novos registros e, sobretudo, o uso de redes sociais, obteve excelentes resultados de adesão dos profissionais ao programa, tanto quantitativa quanto qualitativamente. Conclusões. O uso das redes sociais como estratégia de disseminação na implementação das recomendações do GBPs da RNAO alcançou uma boa recepção pelos profissionais, pois mostra um alto nível de participação e é uma ferramenta útil como estratégia de disseminação. É necessário mais tempo para monitorar o uso das redes sociais e seu possível impacto na implementação de evidências e na melhoria dos resultados de saúde de pacientes e organizações de saúde. Cómo citar: Bujalance Hoyos J, Grinspun D, Pérez Jiménez MT, Viñas Vera C, Jiménez Fernández MS, García Sánchez JA. Las redes sociales en la estrategia de implementación de evidencias en la práctica clínica: experiencia del Hospital Regional Universitario de Málaga, España. MedUNAB. 2020;23(1):107-117. doi:10.29375/01237047.3571

Distribution and abundance of phlebotominae, vectors of leishmaniasis, in Argentina: spatial and temporal analysis at different scales.

The spatial-temporal analysis of the abundance of insects, vectors of tegumentary leishmaniasis (TL) and visceral leishmaniasis (VL), was performed in Argentina using spatial-temporal increasing scales. In the microscale (microfocal), the effect of the primary vegetation-crop interface in vector abundance was observed, and also how the shelters, food sources, and other environmental characteristics contribute to habitat microheterogeneity and so to a microheterogeneous vector distribution. In the mesoscale (locality or epidemic focus), the results from different foci of TL (rural and periurban) and VL (urban) suggested a metapopulation structure determined partially by quantifiable habitat variables that could explain the increase of risk associated to an increase of vector-human contact due to climatic or anthropogenic changes. In the macroscale (regional), captures of vectors and records of human cases allowed the construction of risk maps and predictive models of vector distribution. In conclusion, in order to obtain valid results transferrable to control programs from spatial studies, special attention should be paid in order to assure the consistency between the spatial scales of the hypotheses, data, and analytical tools of each experimental or descriptive design.

Phlebotominae fauna in a recent deforested area with American tegumentary leishmaniasis transmission (Puerto Iguazú, Misiones, Argentina): seasonal distribution in domestic and peridomestic environments.

Phlebotominae sand flies have been involved as vectors of Leishmania. In Argentina, Nyssomyia neivai and Nyssomyia whitmani are involved as the main vectors of American Tegumentary Leishmaniasis (ATL). In the northeastern border of the country, an outbreak of ATL during 2004-2005 was associated with deforestation and subsequent settlement of farmers close to the edge of the forest. The aim of this work was to study the community composition of sand flies along time in farms located near primary and secondary forest in two environments: houses and pigsties. The association of abundance with temperature and precipitation was also evaluated for the most prevalent species. A total of 23,659 Phlebotominae belonging to the genera Nyssomyia, Migonemyia, Pintomyia, Evandromyia, Micropygomyia, Sciopemyia, Dampfomyia, Psathyromyia and Brumptomyia were captured. Ny. whitmani, which was the most abundant species, and Migonemyia migonei, which was the second most abundant species, were present throughout the year. Both species were positively associated with temperature, mostly up to 31-47 days, and with precipitation at 31 days before the sampling day. The abundance was higher in pigsties than in houses, but the time pattern was positively associated between both environments. These results confirm that Ny. whitmani is the dominant species in the study area and its presence throughout the year indicates a potential long period of ATL transmission. The presence of Mg. migonei as the second species in abundance is relevant, because it has been described as a secondary vector of the parasites of ATL and a putative vector of the agent of American Visceral Leishmaniasis. We discuss the role of the pigsty as the environment that attract more sandflies, taking into account the number of sand flies captured there, the distance from the home, and the association of sand fly abundance with each of the two environments.

Leishmaniasis and climate change-case study: Argentina.

Vector-borne diseases closely associated with the environment, such as leishmaniases, have been a usual argument about the deleterious impact of climate change on public health. From the biological point of view interaction of different variables has different and even conflicting effects on the survival of vectors and the probability transmission of pathogens. The results on ecoepidemiology of leishmaniasis in Argentina related to climate variables at different scales of space and time are presented. These studies showed that the changes in transmission due to change or increase in frequency and intensity of climatic instability were expressed through changes in the probability of vector-human reservoir effective contacts. These changes of contact in turn are modulated by both direct effects on the biology and ecology of the organisms involved, as by perceptions and changes in the behavior of the human communities at risk. Therefore, from the perspective of public health and state policy, and taking into account the current nonlinear increased velocity of climate change, we concluded that discussing the uncertainties of large-scale models will have lower impact than to develop-validate mitigation strategies to be operative at local level, and compatibles with sustainable development, conservation biodiversity, and respect for cultural diversity.

Lutzomyia longipalpis spatial distribution and association with environmental variables in an urban focus of visceral leishmaniasis, Misiones, Argentina.

This study describes the spatial distribution pattern of Lu. longipalpis abundance in Posadas-Garupá, Argentina, where four cases of human Visceral Leishmaniasis had been recorded. A total of 2428 Lu. longipalpis were captured in 42% of the 305 sites sampled with CDC light traps, its abundance shows spatial autocorrelation ranging up to 590 m (semivariogram model), with six downtown 'islands' of vector highest abundance (>or=60 individuals). A significant association between Lu. longipalpis and the presence of chickens was observed (odds ratio 3.26). The best stepwise multiple regression using Generalized Linear Models explained 31% of the deviance for Lu. longipalpis abundance, including as explanatory variables: (a) negatively: households with 'lack of building material and with economic deprivation', (b) positively: surface covered by trees and bushes at 50 meters of the house, and households without electrical lighting. In conclusion, Lu. longipalpis in a recent settled focus of visceral leishmaniasis was urbanized with a highly heterogeneous spatial distribution within the cities, with the vectors concentrated in limited 'islands' of high abundance, in the downtown relatively more affluent and dense populated areas, but also more heterogeneous with patches that had higher tree coverage and poor urban services. These results once validated will contribute to the control strategy design through risk maps, in order to prioritize areas for prevention and control, and setting the appropriate scale for intervention.