Indicators sandflies and environment associated to spatial landscaping change in Chocó Biosphere Reserve UNESCO.

BACKGROUND OBJECTIVES: Sandflies are vector insects associated with terrestrial forest ecosystems; in the Ecuadorian Andes, they participate in the transmission of human cutaneous leishmaniasis. This geographical area represents an opportunity to evaluate the role of sandflies as bioindicators of the degree of intervention of tropical humid forest ecosystems (THF) associated with changes in the ecology of the local landscape. METHODS: CDC-light traps were used for collecting adult sandflies in February 2020 in a humid tropical forest within the Chocó Biosphere Reserve. All species were identified using morphological keys. Analysis data about abundance, richness, species accumulation, diversity index, species composition communities, species sex proportion, spatial sandflies environmental, Renyi's Diversity Profile were performed to compare six spatial habitats in Mashpi locality, Ecuador. RESULTS: Sandflies were collected (n-1435); the main species are represented by Trichophoromyia reburra, Nyssomyia trapidoi, Psathyromyia aclydifera, Psychodopygus panamensis and Lutzomyia hartmanni. Only Th. reburra is associated with not intervened forest, while the other three species are associated with intervened forest within Mashpi in the Choco Biosphere Reserve. The secondary forest has major sandflies' richness, while the primary forest exhibits major abundance. INTERPRETATION CONCLUSION: Th. reburra is a sandfly restricted to the Andean Forest and is a bioindicator of the high environmental health quality of the forest, while Ny. trapidoi and Pa. aclydifera are bioindicators of environmental disturbances in the forest. Additionally, Ps. panamensis, Lu. hartmanni and Ny. trapidoi are bioindicators of human impact and the risk of leishmaniasis.

Indicators sand flies and environment associated to spatial landscaping change in Choco Biosphere Reserve UNESCO.

BACKGROUND OBJECTIVES: Sand flies are insects vector associated with terrestrial forest ecosystems; in the Ecuadorian Andes, they participate in the transmission of human cutaneous leishmaniasis. This geographical area is an opportunity to evaluate the role of sand flies as bioindicators od the degree of intervention of a tropical humid forest ecosystems (THF) associated with changes in the ecology of the local landscape. METHODS: CDC-light traps were used for collecting adults' sand flies in February 2020 in a humid tropical forest within Choco Biosphere Reserve. All species were identified using morphological keys. Analysis data about abundance, richness, species accumulation, diversity index, species composition communities, species sex proportion, spatial sand flies environmental, Renyi's Diversity Profile were performed to compare six spatial habitats in Mashpi locality, Ecuador. RESULTS: Sand flies were collected (n-1435); the main species are represented by Th. reburra Ny. trapidoi, Pa. aclydifera, Py. panamensis and Lu. hartmanni. Only Th. reburra is associated with not intervened forest, while the other 3 species are associated with intervened forest within Mashpi in the Choco Biosphere Reserve. The secondary forest has the major sandflies' richness, while the primary forest exhibits the major abundance. INTERPRETATION CONCLUSION: The results indicated that Th. reburra is a sandfly restricted to the Andean Forest and is a bioindicator of the high environmental health quality of the forest, while Ny. trapidoi and Pa. aclydifera are bioindicators of environmental disturbances in the forest. Additionally, Ps. panamensis, Lu. hartmanni and Ny. trapidoi are bioindicators of human impact and the risk of leishmaniasis.

High-resolution prediction models for Rhipicephalus microplus and Amblyomma cajennense s.l. ticks affecting cattle and their spatial distribution in continental Ecuador using bioclimatic factors.

In Ecuador, the main tick species affecting cattle are Rhipicephalus microplus and Amblyomma cajennense sensu lato. Understanding their spatial distribution is crucial. To assess their distribution, data from 2895 farms visited between 2012 and 2017 were utilized. Ticks were collected during animal inspections, with each farm's location georeferenced. Bioclimatic variables and vapor pressure deficit data were obtained from Climatologies at High resolution for the Earth´s Land Surface Areas (CHELSA) dataset. They were overlaid to develop predictive maps for each species using Random Forest (RF) models. The cross-validation results for RF prediction models showed high accuracy for both R. microplus and A. cajennense s.l. presence with values of accuracy = 0.97 and 0.98, sensitivity = 0.96 and 0.99, and specificity = 0.96 and 0.93, respectively. A carefully selected subset of bioclimatic variables was used to describe the presence of each tick species. Higher levels of precipitation had positive effect on the presence of R. microplus but a negative effect on A. cajennense s.l. In contrast, isothermality (BIO3) was more important for the presence of A. cajennense s.l. compared to R. microplus. As a result, R. microplus had a broader distribution across the country, while A. cajennense s.l. was mainly found in coastal areas with evident seasonality. The coexistence of both species in some regions could be attributed to transitional zones, whereas high altitudes limited tick presence. This information can aid in developing appropriate tick management plans, particularly considering A. cajennense s.l.'s broad host range species and R. microplus's specificity for cattle. Moreover, the predictive models can identify areas at risk of associated challenging hemoparasite, requiring special attention and mitigation measures.

[Future type 2 diabetes mellitus scenario estimated with a predictive dynamic simulation model]. / Escenario futuro de la diabetes mellitus tipo 2 estimado con un modelo de simulación dinámico predictivo.

OBJECTIVE: Develop a predictive dynamic model to estimate future scenarios for the incidence rate of type 2 diabetes mellitus (T2DM). METHODS: A retrospective ecological study was conducted in 2013-2015 in the city of San Luis Potosí, Mexico. Secondary official data from the 58 municipalities making up the state of San Luis Potosí were analyzed. Linear correlation, multiple linear regression, and structural equations were carried out, and four predictive dynamic submodels were developed: T2DM, urban population, inhabited private dwellings that have television, and population aged 45-49 years. A holistic model was also developed. RESULTS: The structural model explains 27.2% of total variance in type 2 diabetes mellitus. Percentage of inhabited dwellings that have television weighs 4.46 non-standard units on diabetes; that of urban population, 2.84; and that of population aged 45-49 years, 156.69. Estimated scenarios for T2DM per 100 000 population for the years 2015, 2020, 2025, and 2030 were 1,052.4, 1,413.7, 1,850.1, and 2,351.1 respectively. CONCLUSION: The T2DM scenario shows exponential growth from 2000 to 2030. Risk factors according to the weight they represent in occurrence of the disease were: population aged 45-49 years, inhabited private dwellings that have television, and urban population.

[The burden of cervical cancer in patients with limited access to health services]. / Repercusión del cáncer cervicouterino en pacientes con limitaciones de acceso a los servicios de salud.

BACKGROUND: Cervical cancer is caused by high-risk HPV, a sexually transmitted virus. In Mexico, this disease represents a public health problem. San Luis Potosi is located within ten states with the highest rates in the country. Indigenous women of Mexico will likely to develop cervical cancer due to inequality in access to health services and their determinants. Epidemiological studies can be supported by investigations of diverse geographical nature to undertake the identification and analysis of spatial patterns of disease. OBJECTIVE: To locate by geographical distribution of Huasteca Potosina women high-risk HPV positive to observe the burden of disease in patients with limited access to health services and propose specific primary prevention activities was made with a sample of 605 women. Cervico-vaginal specimens were taken. High-risk HPV infection was determined by hybrid capture. Age and date of the last Papanicolaou were obtained through a structured poll. It was use descriptive statistics and georeference was made in a map using the software ILWIS 3.3. RESULTS: Countyes with the highest and lowest percentages of infection were found. The prevalence of infection with high-risk HPV was 9.9% and age groups with the highest percentages of infection were in 51-60 and 41-50 years. Most women had been made the Papanicolaou at time of the present study. CONCLUSIONS: Georeferenceas like epidemiological tool for generating risk profiles allowed suggest strategies for improve prevention, early detection and control of the cervical cancer.

[Performance of health staff in Papanicolauo test: theoretical knowledge and practical implementation]. / Desempeño del personal de salud en la toma de las citologías cervicales: conocimientos teóricos y ejecución práctica.

BACKGROUND: The quality of cervical cytology is one of the factors involved in the optimal performance of screening programs for cervical cancer in Mexico, so it is necessary to design indicators to improve the skills of health personnel in this procedure. OBJECTIVE: To evaluate the performance of the health workers to take the Pap smear. METHODOLOGY: cross-sectional study made in the period 2006-2007 in San Luis Potosí, Mexico, in 21 health centers in a health jurisdiction. We studied the universe of professionals who take the Pap: 100 nurses, doctors and interns. A knowledge test and a check list were applied. The correlation of Pearson, Student's t and ANOVA was used for data analysis. RESULTS: There is a correlation between knowledge and qualification in the take of the Pap smear (r = 0.340) (p = 0.001). Providers have a performance on average 62.2% in knowledge and 78.5% in practice. Doctors obtained higher score in the knowledge that the nurses (6.80) (p = 0.000) and trainees (4.14) (p = 0.014). In the practical implementation, there was no difference between the doctors and the nurses (2.68) (p = 0.718) but there was difference between the doctors and interns (6.47) (p = 0.036). To know one or more sections of the knowledge influences the qualification of the procedure. CONCLUSIONS: The performance of the service provider is regular. There is heterogeneity in the knowledge and practical skills. Educational interventions are needed to raise the skills.

[Health staff performance taking of smear: knowledge, skills and practice]. / Desempeño del personal de salud en la toma de las citologías cervicales: conocimientos teóricos y ejecución práctica.

BACKGROUND: The quality of cervical cytology is one of the factors involved in the optimal performance of screening programs for cervical cancer in México, so it is necessary to design indicators to improve the skills of health personnel in this procedure. OBJECTIVE: To evaluate the performance of the health workers to take the Pap smear. MATERIAL AND METHODS: Cross-sectional study made in the period 2006-2007 in San Luis Potosí, México, in 21 health centers in a health jurisdiction. We studied the universe of professionals who take the Pap: 100 nurses, doctors and interns. A knowledge test and a check list were applied. The correlation of Pearson, Student's t and ANOVA was used for data analysis. RESULTS: There is a correlation between knowledge and qualification in the take of the Pap smear (r = 0.340) (p = 001). Providers have a performance on average 62.2% in knowledge and 78.5% in practice. Doctors obtained knowledge that the nurses (6.80) (p = .000) and trainees (4.14) (p = 014). In the practical implementation, there was no difference between the doctors and the nurses (2.68) (p = .718) but there was difference between the doctors and interns (6.47) (p = .036). To know one or more sections of the knowledge influences the qualification of the procedure. CONCLUSIONS: The performance of the service provider is regular. There is heterogeneity in the knowledge and practical skills. Educational interventions are needed to raise the skills.

Molecular detection of rickettsial agents in Amblyomma maculatum ticks (Ixodida: Ixodidae) from Ecuador.

Rickettsiales are obligate intracellular bacteria that need vertebrates and arthropods to maintain their life cycles. Some species of the genera Anaplasma, Ehrlichia, and Rickettsia are transmitted by ticks to both animals and humans and can cause mild to severe and even fatal cases. In the Americas, there is substantial data on rickettsial agents, encompassing both clinical cases and the detection of these agents in ticks, but in Ecuador, the information about them remains poorly understood. Therefore, the objective of this study was to detect molecularly rickettsial agents in Amblyomma maculatum ticks in both parasitic and free-living phases collected from domestic animals and pasture in five localities across three coastal provinces of Ecuador. Rickettsia parkeri, Candidatus Rickettsia andeanae, and Ehrlichia sp. were recorded in A. maculatum for the first time in Ecuador. These records were made in a region where antibodies to the Spotted Fever Rickettsia Group were detected in humans. Additional studies are needed to characterize Ehrlichia sp. at a specific level. Furthermore, recognizing the specific Rickettsiales species circulating in the ticks and the hosts within a region is crucial for assessing potential contact risks.

Risk factors for the development of cervical cancer: analysis of the evidence.

Introduction: Cervical cancer (CC) is the fourth most prevalent female cancer globally. Understanding its epidemiology is crucial for devising practical strategies suited to geographic and social contexts to attain the global eradication of CC. Hence, this study examined the latest evidence of risk factors contributing to CC development. Methods: An independent literature search was conducted on PubMed using MESH terms. The primary sources were meta-analyses published from 2010 to 2023, which detail updated evidence on risk factors associated with CC. Additionally, the quality of the evidence was evaluated using the GRADE system and recommendations were made accordingly. Results: The main risk factors related to the cause of CC include co-infections with other sexually transmitted infections, genetic markers, cervicovaginal microbiota, nutritional factors, comorbidities that affect the immune response, smoking, and the use of hormonal contraceptives with a quality evidence based on the GRADE scale moderate. Conclusions: Since the necessary cause for CC is persistent cervicovaginal HPV, all the risk factors implicated in the causality of CC act as non-independent cofactors that increase the risk of CC. Thus, changes in public policies aimed at addressing these risk factors are highly recommended and can substantially decrease the risk of CC.

Drivers and evolution of acaricide resistance and multi-resistance in two Ecuador's subtropical livestock farming areas.

The management of cattle ticks, particularly Rhipicephalus microplus, poses a global challenge in subtropical regions like Ecuador due to its impact on meat and milk productivity, leading to economic losses. Misuse of acaricides has resulted in resistance and multi-resistance, diminishing their effectiveness. This study evaluated resistance to amitraz, alpha-cypermethrin, and ivermectin using the Larval Packet test, laboratory-reared tick larvae collected from cattle were tested. Data on farm management and tick control practices were gathered via a questionnaire in Northwest Pichincha and Quijos River Valley over two years. Resistance rates in the first year (2020-2021) were 67.21% for amitraz, 57.38% for ivermectin, and 67.21% for alpha-cypermethrin. One year later (2021-2022), resistance levels were 59.57% for amitraz, 57.45% for ivermectin, and 68.09% for alpha-cypermethrin, with multi-resistance rates at 67.21% and 65.96% respectively. No significant differences were found between years or locations. Analysis of larval survival data determined lethal doses for tested acaricides. The study emphasizes the association between the lack of acaricide rotation, the incorrect dosage, and the absence of non-chemical measures in tick management could be associated with the development of resistances in ticks. Likewise, this study promotes the need for collaborative efforts to improve control practices and maintain acaricide efficacy.

A NEW PHYTOTELM PLANT, CRINUM MOOREI (ASPARAGALES: AMARYLLIDACEAE), FOR THE AMERICAS AND ITS MOSQUITO INHABITANT (DIPTERA: CULICIDAE) IN ECUADOR.

A new phytotelm plant for the Americas is recorded for San Miguel de los Bancos, Pichincha Province, Ecuador. In the leaf axils of Crinum moorei Hook. f. (Amaryllidaceae) were collected larvae and pupae of a common mosquito, Wyeomyia (Dendromyia) complosa (Dyar) (Diptera: Culicidae: Sabethini). This plant is a South African native, introduced into several countries, but never reported as a habitat for immature mosquitoes. We provide notes about its botanical and ecological characteristics, and also of the mosquito associated at this locality.

Una nueva planta phytotelma para el continente Americano es registrada en San Miguel de los Bancos, Provincia de Pichincha, Ecuador. En las axilas de Crinum moorei Hook, f. (Amaryllidaceae) fueron colectadas larvas y pupas de la especie de mosquito Wyeomyia (Dendromyia) complosa (Dyar) (Diptera: Culicidae: Sabethini). Esta planta es nativa de Africa del Sur, y ha sido introducida en varios países, pero nunca había sido señalada como hábitat para las fases inmaduras de mosquitos. Se hacen comentarios botánicos acerca de la planta así como también del mosquito asociado en la localidad.

Case report: First report on human infection by tick-borne Babesia bigemina in the Amazon region of Ecuador.

Babesiosis is a protozoan disease acquired by the bite of different species of ticks. More than 100 Babesia spp. infect wild and domestic animals worldwide, but only a few have been documented to infect humans. Generally, babesiosis is asymptomatic in immunocompetent persons; however, in immunocompromised can be life-threatening. A 13-year-old boy from the Amazon region presented with a 3-month evolution of fever, chills, general malaise, and arthralgia accompanied by anemia and jaundice. In the last 4 years was diagnosed with chronic kidney failure. By nested-PCR using 18S RNA ribosomal gene as target and DNA sequencing, the phylogenetic analysis showed Babesia bigemina as the causative agent in the blood. Treatment with oral quinine plus clindamycin for six continuous weeks was effective with no relapse occurring during 12 months of follow-up. This is the second human case in Ecuador but the first caused by the zoonotic B. bigemina which confirms the existence of active transmission that should alert public health decision-making authorities on the emergence of this zoonosis and the need for research to determine strategies to reduce tick exposure.

An economic evaluation of cattle tick acaricide-resistances and the financial losses in subtropical dairy farms of Ecuador: A farm system approach.

Estimates of economic losses in cattle due to tick infestations in subtropical areas are limited, such as in Ecuador. Ticks affect animal production and health, but those direct effects are difficult to estimate since financial exercises carried out in farms consider both costs of the inputs and revenues. This study aims to quantify the costs of inputs involved in milk production and to know the role of acaricide treatment in the production costs on dairy farms in subtropical zones using a farming system approach. Regression and classification trees were used to study the relationship between tick control, acaricide resistance and the presence of high level of tick infestation in the farm system. Even though there was no significant direct association between high levels of tick infestation and the presence of acaricide resistance in ticks, a more complex structure for resistances operates in the manifestation of high tick infestation involving levels of farm technology and no acaricide resistance. Farms with higher levels of technology allocate a lower percentage of sanitary expenses to control ticks (13.41%) in comparison to semi-technified (23.97%) and non-technified farms (32.49%). Likewise, more technified and bigger herds have a lower annual expenditure on acaricide treatment (1.30% of the production budget equivalent to 8.46 USD per animal) compared to non-technified farms where it can represent more than 2.74% of the production budget and where the absence of cypermethrin resistance increases the treatment cost to 19.50 USS per animal annually. These results can motivate the development of information campaigns and control programmes targeted to the reality of small and medium farms that are the most affected in terms of the money they invest in controlling ticks.

From roads to biobanks: Roadkill animals as a valuable source of genetic data.

To protect biodiversity we must understand its structure and composition including the bacteria and microparasites associated with wildlife, which may pose risks to human health. However, acquiring this knowledge often presents challenges, particularly in areas of high biodiversity where there are many undescribed and poorly studied species and funding resources can be limited. A solution to fill this knowledge gap is sampling roadkill (animals that die on roads as a result of collisions with circulating vehicles). These specimens can help characterize local wildlife and their associated parasites with fewer ethical and logistical challenges compared to traditional specimen collection. Here we test this approach by analyzing 817 tissue samples obtained from 590 roadkill vertebrate specimens (Amphibia, Reptilia, Aves and Mammalia) collected in roads within the Tropical Andes of Ecuador. First, we tested if the quantity and quality of recovered DNA varied across roadkill specimens collected at different times since death, exploring if decomposition affected the potential to identify vertebrate species and associated microorganisms. Second, we compared DNA stability across taxa and tissues to identify potential limitations and offer recommendations for future work. Finally, we illustrate how these samples can aid in taxonomic identification and parasite detection. Our study shows that sampling roadkill can help study biodiversity. DNA was recovered and amplified (allowing species identification and parasite detection) from roadkill even 120 hours after death, although risk of degradation increased overtime. DNA was extracted from all vertebrate classes but in smaller quantities and with lower quality from amphibians. We recommend sampling liver if possible as it produced the highest amounts of DNA (muscle produced the lowest). Additional testing of this approach in areas with different environmental and traffic conditions is needed, but our results show that sampling roadkill specimens can help detect and potentially monitor biodiversity and could be a valuable approach to create biobanks and preserve genetic data.

The Associated Decision and Management Factors on Cattle Tick Level of Infestation in Two Tropical Areas of Ecuador.

Decision-making on tick control practices is linked to the level of knowledge about livestock farming and to the social context in which individuals practice them. Tick infestation is one of the main problems in tropical livestock production. The objective of this study was to characterize tick-control related practices in two tropical livestock areas and their potential association with the level of tick infestation. A total of 139 farms were included in this survey. To determine this association, a multivariate logistic regression model was used. A stepwise model selection procedure was used and model validation was tested. Cattle husbandry as a main activity, the use of external paddocks, the use of amitraz, and the lack of mechanization on the farm were related with high tick infestation. On the other hand, owner involvement in the preparation of acaricide solution was identified as a protective factor against high tick infestation. At animal level, age (old), body condition status (thin), and lactation were also associated with high tick infestations, while Bos primigenius indicus cattle and their crosses reduced the probability of high tick infestations. The factors studied, such as herd size, education level of the owners, and veterinary guidance, varied from farm to farm. Nonetheless, these differences did not generate changes in the level of tick infestation. According to the area under the receiver operating characteristic curve (AUC-ROC), the model at farm level predicts a high level of infestation, with an accuracy of 72.00% and high sensitivity. In addition, at animal level, crossbreeding with indicus cattle and breeding selection for host resistance will be useful against high tick infestation. Likewise, the implementation of programs of capacitation and research on tick control for farmers, cowboys, and vets in these areas is necessary.

Computer System for the Capture and Preparation of Cytopathological Reports for Cervical Cancer Detection and His Utility in Training for Health Personnel.

Health information systems and training are tools that support process management. The current study describes the results of the implementation of technological innovation in the process of the capture and preparation of cytopathological reports. The electronic system was structured based on national standards regarding cervical cancer control. PHP was used to design the software and MYSQL was used for the structure of the database. The total number of health personnel assigned to the cytology department participated, along with a pathologist, who made the records of the patients who came for cervical cytology to a university health center in San Luis Potosi, Mexico. The system was evaluated based on the indicators of structure, process, and results. Structure: comply with the official Mexican regulations for the registration of cervical cancer and electronic health information systems. Process: all records were legible and accurate, with varying percentages of completeness in the patient identification sections (46%) and alternate contact data (80%). Result: percentages above 80% were obtained in the satisfaction of the professionals who used the system. The system was effective as it yielded readable and accurate data that made the process of information capture and delivery of cervical screening results more efficient and faster.

Spatial-Temporal Analysis of Lutzomyia trapidoi and Lutzomyia reburra (Diptera: Phlebotominae), in Rural Tourist Locations, Biosphere Reserve and Leishmaniasis Endemic Area, Ecuador.

This research represents the first attempt to assess the spatial and temporal distribution based on micro-meso scales on two species with different host preference habits (anthropophilic vs zoophilic), in the major Leishmaniasis endemic area in Ecuador, tourist locations, and Biosphere reserve. Phlebotomine species, Lutzomyia trapidoi (Fairchild) and Lutzomyia reburra (Fairchild and Hertig), were analyzed by trap/habitat/month/locality/altitude, through the Poisson generalized regression model. Our data reveal a bimodal pattern for both species related with low precipitations and preference for forest habitat. Altitude, proximity to the forest, and the river were the variables that determine the hypervolume of the spatial distribution of relative abundance, where the overlap of these two species increases the risk of translocation and circulation of the etiological agent of leishmaniasis in sylvatic environments to rural-tourist-biosphere reserve areas and vice versa. The ecological characteristics of these two phlebotomines could explain the permanence of the major active and endemic focus of cutaneous leishmaniasis in the North-Western Ecuador a key aspect in tourism health-security in alternative tourism.

New Records of Ticks of Genus Amblyomma Koch, 1844 (Acari: Ixodidae) for Ecuador.

PURPOSE: In Ecuador, knowledge of the diversity and geographic distribution of ticks, as well as their importance as vectors, is scarce. Within the family Ixodidae, the genus Amblyomma is the most diverse and parasitizes wild and domestic animals. This genus is represented by 19 species in Ecuador, 12 of which occur in the continental territory and 7 in the Galapagos Islands. In this way, the objective of this work was to update the diversity of ticks reported for Ecuador on wild and domestic animals. METHODS: The specimens were collected manually on mammals and birds, in four localities belonging to the Sierra and Amazon of Ecuador and were kept in tubes with 96% ethyl alcohol. After that, all specimens were separated into immatures, males and females and were identified using their morphological characters. RESULTS: This study records Amblyomma coelebs Neumann, 1899, Amblyomma longirostre (Koch, 1844) Neumann, 1905 and Amblyomma varium Koch, 1844 for the first time in Ecuador. Thus, the genus Amblyomma is currently represented by 22 species. In addition, their hosts, distribution, and importance are also discussed. CONCLUSIONS: Knowing the diversity of ticks that wildlife possesses, its interrelation with the domestic fauna, and the possible pathogens that could be transmitting could significantly contribute to wildlife's conservation.

Histopathological Diagnosis of Cervical Biopsies: Reduction of Sampling Errors with the Evaluation of a Third Histologic Level.

AIM: Cervical cancer (CC) is considered as a major public health problem; this disease affects mainly vulnerable women in poverty, causing a negative effect on a country's workforce. OBJECTIVE: To determine the histopathological diagnosis variation after examining three more levels of cervical biopsy paraffin blocks from patients with HPVI, CIN and CC. MATERIALS AND METHODS: A quantitative, retrospective correlational study was performed in a hospital with a second level of health care. We worked with 152 paraffin blocks of CIN (CIN, I, II and III) and cervical cancer samples. Currently, CIN I is considered as a set of low-grade injuries (low-grade squamous intraepithelial lesions, LSIL), while CIN II, CIN III and cancer in situ are considered as high-grade lesions (high-grade squamous intraepithelial lesions, HSIL). A slab was prepared with the 50micron block, which was subsequently cut into 5 microns; later, the same thing was done at two more levels to reevaluate the histopathological diagnosis and correlate it with the initial diagnosis issued by the institution. RESULTS: During the examination of the additional block levels, a difference was observed from the initial diagnosis: of 32 cases of HPV diagnosis, there were 17 changes to CIN I; of 31 cases of CIN I, there were 4 changes to CIN II; of 30 cases of CIN II, there were 8 changes to CIN III and 1 change to invasive cancer; of 29 cases of CIN III, there were 9 changes to cancer in situ; and finally, of 14 cases of cancer in situ, there was 1 change to invasive cancer. After the statistical analysis, a value of p <0.05 was obtained, which indicated that the differences were statistically significant. CONCLUSION: By modifying the histopathological study technique, guidelines can be given to generate a more accurate diagnosis with a more solid base, and thus, a more appropriate and timely treatment can be offered to avoid the development of cervical cancer.

Intervención educativa basada en metodologías B-learning para mejorar las citologías cervicales: experiencias de enfermeras / Intervenção educacional através do B-learning para melhorar a citologia cervical: experiências de enfermeiras / Educational intervention through B-learning to improve cervical cytology: experiences of nurses

Resumen Objetivo analizar las experiencias de enfermeras en la toma de las citologías cervicales y otros factores organizacionales durante una intervención educativa asistida por metodologías B-learning. Método estudio cualitativo realizado en San Luis Potosí, México. Participaron 15 enfermeras. La recolección de datos se hizo a través de entrevistas semiestructuradas con base en una sistematización de experiencias. Para el análisis de la información se utilizó el programa Taguette y como referente teórico las metodologías B-learning. Resultados se identificaron debilidades en factores relacionados con la accesibilidad de las usuarias al servicio, insumos, infraestructura, bioseguridad, capacitación del personal de salud, entrega de resultados a las pacientes y conocimiento del programa por parte de las usuarias. Conclusiones e implicaciones para la práctica el cáncer cervical es un problema de salud pública. La citología cervical es la prueba de tamizaje más utilizada; sin embargo, existen limitantes en la calidad, por lo que se proponen acciones para mejorar los conocimientos y habilidades del personal de enfermería que tiene como función la toma. La intervención educativa fue efectiva para fomentar el aprendizaje integral sobre la toma de las citologías cervicales y permitió al personal de enfermería compartir sus experiencias.

Resumo Objetivo analisar as experiências das enfermeiras na realização de esfregaços cervicais e outros fatores organizacionais durante uma intervenção educacional assistida por metodologias de b-learning. Método estudo qualitativo realizado em San Luis Potosí, México. Participaram 15 enfermeiras. A coleta de dados foi feita por meio de entrevistas semiestruturadas a partir de uma sistematização de experiências. Para a análise das informações, utilizou-se o programa Taguette e metodologias de b-learning como referencial teórico. Resultados foram identificadas fragilidades em fatores relacionados com a acessibilidade dos usuários ao serviço, insumos, infraestrutura, biossegurança, capacitação da equipe de saúde, entrega de resultados aos pacientes e conhecimento do programa pelos usuários. Conclusões e implicações para a prática o câncer do colo do útero é um problema de saúde pública. A citologia cervical é o teste de triagem mais utilizado; no entanto, existem limitações na qualidade, por isso são propostas ações para aprimorar os conhecimentos e habilidades das enfermeiras que estejam desempenhando essa função. A intervenção educacional foi eficaz para promover o aprendizado integral sobre a realização do esfregaço cervical e permitiu que as enfermeiras compartilhassem suas experiências.

Abstract Objective to analyze the nursing staff's experiences in taking cervical smears and other organizational factors during an educational intervention assisted by B-learning methodologies. Method a qualitative study was carried out in San Luis Potosí, Mexico, with 15 nurses. Data collection was done through semi-structured interviews based on a systematization of experiences. The Taguette program and B-learning methodologies as theoretical references were used to analyze the information. Results weaknesses were identified in factors related to the accessibility of users to the service, supplies, infrastructure, biosafety, training of health personnel, delivery of results to patients, and knowledge of the program by the users. Conclusions and implications for practice cervical cancer is a public health problem. Cervical cytology is the most widely used screening test; however, there are limitations in quality, so actions are proposed to improve the knowledge and skills of the nursing staff in their functions. The educational intervention effectively promoted comprehensive learning about taking cervical smears and allowed the nursing staff to share their experiences.