ABSTRACT
The decision in 1987 by the pharmaceutical firm Merck & Co. to provide Mectizan (ivermectin) free of charge to river blindness control programs has challenged the international public health community to find effective ways to distribute the drug to rural populations most affected by onchocerciasis. In the Americas, PAHO responded to that challenge by calling for the elimination of all morbidity from onchocerciasis from the Region by the year 2007 through mass distribution of ivermectin. Since 1991, a multinational, multiagency partnership (consisting of PAHO, the endemic countries, nongovernmental development organizations, the Centers for Disease Control and Prevention in Atlanta, Georgia, as well as academic institutions and funding agencies) has developed the political, financial, and technical support needed to move toward the realization of that goal. This partnership is embodied in the Onchocerciasis Elimination Program for the Americas (OEPA), which is supported by the River Blindness Foundation (RBF) and now by the Carter Center. OEPA was conceived as a means of maintaining a regional initiative to eliminate what is otherwise a low priority disease. Since its inception in 1993, the OEPA has provided more than US$2 million in financial, managerial, and technical assistance to stimulate and/or support programs in Brazil, Colombia, Ecuador, Guatemala, Mexico and Venezuela, so as to take full advantage of the Merck donation. Now halfway into a five-year, US$ 4 million grant provided through the Inter-American Development Bank, the OEPA's capacity to support the regional initiative is assured through 1999
La decisión tomada en 1987 por la Merck & Co., fabricante de productos farmacéuticos, de proveer Mectizan® (ivermectina) gratuitamente a los programas de control de la oncocercosis ha obligado a la comunidad sanitaria internacional a buscar formas de distribuir el medicamento a las poblaciones rurales que se ven más afectadas por la enfermedad. En las Américas, la OPS respondió al reto con un llamado a eliminar de la Región toda morbilidad por oncocercosis para el año 2007 mediante la distribución de ivermectina al público. Desde 1991, una alianza multinacional de diversas entidades (la OPS, países con oncocercosis endémica, agencias de desarrollo no gubernamentales, los Centros para el Control y la Prevención de Enfermedades en Atlanta, Georgia, instituciones académicas y agencias de financiamiento) ha generado el apoyo político, económico y técnico necesario para tratar de alcanzar esa meta. Esta alianza está representada por el Programa de Eliminación de la Oncocercosis en las Américas (OEPA), subvencionado por la Fundación Ceguera de los Ríos y actualmente por el Centro Carter. El OEPA se creó como iniciativa de alcance regional destinada a eliminar una enfermedad que no merece atención prioritaria. Desde su aparición en 1993, el OEPA ha aportado más de US$ 2 millones en ayuda económica, administrativa y técnica para fomentar y subvencionar programas en Brasil, Colombia, Ecuador, Guatemala, México y Venezuela, logrando así aprovechar al máximo la donación de la Merck & Co. Ahora que hemos llegado a la mitad de una subvención de 5 años y US$ 4 millones aportada por el Banco Interamericano de Desarrollo, se sabe que el OEPA tiene la capacidad para apoyar la iniciativa regional hasta fines de 1999
Subject(s)
Onchocerciasis , Ivermectin/pharmacology , Economic Cooperation , Technical Cooperation , Rural Population , Health Policy , Latin AmericaABSTRACT
The presence of an autoimmune process mediated by antibodies in Chagas'disease was evaluated by studying EVI antibodies, immune complexes (Clq binding) and anti-DNA antibodies in serum samples from patients with Chagasic infection (Group I), Chagasic infection and Chagasic cardiomyopathy (Group II) and normal Venezuelan blood back donors (Group III). The study was performed on both single serum samples and those obtained longitudinally. With simgle samples the incidence of positivity for EVI antibodies was higher in Group II patients (87.5%) than in Group I (66.6%). However, with the serum samples from a longitudinal study the incidence of patients with persistently positive EVI antibodies was the same in both groups (43%). No relationship coul be established between the incidence of EVI antibodies and eiter the clinical status or the detection of circulating parasites by xenodiagnosis. The immunoglobulin fraction carryng the EVI antibodies was identified as IgG.Higher values of circulating immune comlexes were found in serum samples from patients with Chagasic cardiomyopathy. However no patient from the longitudinal study showed a persistently high Clq binding activity. The levels of anti-DNA antibodies were not different between the groups studied. It was concluded that no evidence was found to link the presence of EVI or other auto-reactive antibodies with heart damage in Chagas'disease
Subject(s)
Humans , Autoantibodies/biosynthesis , Chagas Disease/immunologyABSTRACT
Se estudia una nueva tecnica de xenodiagnostico artificial, comparando la efectividad de diversos tipos de membranas y de anticoagulantes para favorecer la alimentacion, a temperatura ambiente, de ninfas de Rhodnius prolixus