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1.
Rev. colomb. gastroenterol ; 37(2): 201-205, Jan.-June 2022. graf
Article in English | LILACS | ID: biblio-1394949

ABSTRACT

Abstract The care of patients with enterocutaneous fistula constitutes a significant challenge owing to the alterations it usually brings about. For successful treatment, it is necessary to manage fluids and electrolytes adequately, provide practical nutritional support, and control sepsis until its eradication; thus, many fistulae close spontaneously. We present the case of a 36-year-old male patient with a four-month history of fecal-like umbilical secretion. When performing the fistulogram, we confirmed a fistulous tract of 9 cm, which ended at the level of the sigmoid colon, a rare location. In cases where the enterocutaneous fistula does not close, and surgical treatment is indicated, it is imperative to maximize perioperative care, decrease surgical time, choose the correct surgical technique, and prepare the patient for surgery to avoid complications with a fatal outcome.


Resumen La atención de los pacientes con fístula enterocutánea constituye un gran reto, por las alteraciones con las que suelen acompañarse. Para lograr un tratamiento exitoso es necesario realizar un adecuado manejo de los líquidos y electrolitos, brindar un apoyo nutricional eficaz y controlar la sepsis hasta lograr su erradicación; de esta manera, muchas fístulas cierran espontáneamente. Se expone el caso de un paciente de 36 años de edad, con un cuadro de secreción umbilical de aspecto fecaloideo de 4 meses de evolución. Al realizar la fistulografía se constató un trayecto fistuloso de 9 cm, el cual terminaba a nivel del colon sigmoide, localización poco frecuente. En los casos en que la fístula enterocutánea no cierre y tenga indicación de tratamiento quirúrgico, es necesario extremar los cuidados perioperatorios, minimizar el tiempo quirúrgico, elegir la técnica quirúrgica correcta y preparar al paciente para la cirugía, de modo que se eviten complicaciones que pueden tener un desenlace fatal.


Subject(s)
Humans , Male , Adult , Colon, Sigmoid , Diverticulitis, Colonic , Fistula , Therapeutics , Bodily Secretions , Perioperative Care , Disease Eradication
2.
Medicina UPB ; 41(1): 51-60, mar. 2022. tab
Article in Spanish | LILACS, COLNAL | ID: biblio-1362696

ABSTRACT

Helicobacter pylori es un carcinógeno tipo I resistente a múltiples antibióticos y con alta prioridad en salud pública. La infección por este microorganismo está influenciada por una interacción compleja entre la genética del huésped, el entorno y múltiples factores de virulencia de la cepa infectante. Afecta al 50 % de la población mundial, provocando afecciones gastroduodenales graves, la mayoría de forma asintomática. El 20 % de los individuos con H. pylori pueden desarrollar a través del tiempo lesiones gástricas preneoplásicas y el 2 % de ellos un cáncer gástrico. Las manifestaciones clínicas gastrointestinales y extragastrointestinales están asociadas a su virulencia y a la respuesta del sistema inmunológico con la liberación de citosinas proinflamatorias, tales como TNF-alfa, IL-6, IL-10 e IL-8, causantes de inflamación aguda y crónica. Múltiples factores de virulencia han sido estudiados como el gen A asociado a la citotoxina (CagA) y la citotoxina vacuolante (VacA), los cuales juegan un rol importante en la aparición del cáncer gástrico. Dada la resistencia cada vez mayor a los antibióticos utilizados, las líneas de estudio en el futuro inmediato deben estar encaminadas en establecer la utilidad de los nuevos antibióticos y la determinación de profagos colombianos en todo el país. Esta revisión tiene como objetivo hacer una puesta al día sobre las características del H. pylori, los mecanismos patogénicos, genes de virulencia, su asociación con el mayor riesgo de cáncer gástrico, farmacorresistencia microbiana y su erradicación.


Helicobacter pylori is recognized as a class I carcinogen resistant to multiple antibiotics and with high priority in public health. The infection caused by this microorganism is influenced by a complex interaction between host genetics, environment, and multiple virulence factors of the infecting strain. It affects 50% of the world population, causing severe gastroduodenal conditions, most of them asymptomatic. Through time, 20% of individuals with H. pylori may develop preneoplastic gastric lesions and 2% of them develop gastric cancer. The gastrointestinal and extra-gastrointestinal clinical manifestations are associated with its virulence and the response of the immune system with the release of pro-inflammatory cytokines, such as TNF-alpha, IL-6, IL-10 and IL-8, which cause acute and chronic inflammation. Multiple virulence factors have been studied, such as cytotoxin-associated gene A (CagA) and vacuolating cytotoxin A (VacA), which play an important role in the development of gastric cancer. Due to the increasing antibiotics resistance, the research in the immediate future should be aimed at establishing the usefulness of the new antibiotics and the determination of Colombian prophages throughout the country. This paper aims to update the characteristics of H. pylori, its pathogenic mechanisms, virulence genes, its association with the increased risk of gastric cancer, microbial drug resistance, and eradication.


Helicobacter pylorié um carcinógeno tipo I resistente a múltiplos antibióticos e com alta prioridade na saúde pública. A infecção por este microrganismo está influenciada por uma interação complexa entre a genética do hospede, o entorno e múltiplos fatores de virulência da cepa infectante. Afeta a 50% da população mundial, provocando afeções gastroduodenais graves, a maioria de forma assintomática. 20% dos indivíduos com H. pylori podem desenvolver através do tempo lesões gástricas pré-neoplásicas e 2% deles um câncer gástrico. As manifestações clínicas gastrointestinais e extragastrointestinais estão associadas à sua virulência e à resposta do sistema imunológico com a liberação de citocinas pró-inflamatórias, tais como TNF-alfa, IL-6, IL-10 e IL-8, causantes de inflamação aguda e crónica. Múltiplos fatores de virulência hão sido estudados como o gene. A associado à citotoxina (CagA) e a citotoxina vacuolante (VacA), os quais jogam um papel importante no aparecimento do câncer gástrico. Dada a resistência cada vez maior aos antibióticos utilizados, as linhas de estudo no futuro imediato devem estar encaminhadas em estabelecer a utilidade dos novos antibióticos e a determinaçãode profagos colombianos em todo o país. Esta revisão tem como objetivo fazer uma atualização sobre as características do H. pylori, os mecanismos patogénicos, genes de virulência, sua associação com o maior risco de câncer gástrico, farmacorresistência microbiana e sua erradicação.


Subject(s)
Humans , Helicobacter pylori , Drug Resistance , Carcinogens , Virulence Factors , Disease Eradication , Immune System , Anti-Bacterial Agents
3.
Article in Chinese | WPRIM | ID: wpr-940942

ABSTRACT

Schistosomiasis is a parasitic disease that seriously hinders socioeconomic developments and threatens public health security. To achieve the global elimination of schistosomiasis as a public health problem by 2030, WHO released the guideline on control and elimination of human schistosomiasis on February, 2022, with aims to provide evidence-based recommendations for schistosomiasis morbidity control, elimination of schistosomiasis as a public health problem, and ultimate interruption of schistosomiasis transmission in disease-endemic countries. Following concerted efforts for decades, great achievements have been obtained for schistosomiasis control in China where the disease was historically highly prevalent, and the country is moving towards schistosomiasis elimination. This article reviews the successful experiences from the national schistosmiasis control program in China, and summarizes their contributions to the formulation and implementation of the WHO guideline on control and elimination of human schistosomiasis. With the progress of the "Belt and Road" initiative, the world is looking forward to more China's solutions on schistosomiasis control.


Subject(s)
China/epidemiology , Disease Eradication , Humans , Public Health , Schistosomiasis/prevention & control , World Health Organization
4.
Article in Chinese | WPRIM | ID: wpr-940940

ABSTRACT

On February 2022, WHO released the evidence-based guideline on control and elimination of human schistosomiasis, with aims to guide the elimination of schistosomiasis as a public health problem in disease-endemic countries by 2030 and promote the interruption of schistosomiasis transmission across the world. Based on the One Health concept, six evidence-based recommendations were proposed in this guideline. This article aims to analyze the feasibility of key aspects of this guideline in Chinese national schistosomiasis control program and illustrate the significance to guide the future actions for Chinese national schistosomiasis control program. Currently, the One Health concept has been embodied in the Chinese national schistosomiasis control program. Based on this new WHO guideline, the following recommendations are proposed for the national schistosomiasis control program of China: (1) improving the systematic framework building, facilitating the agreement of the cross-sectoral consensus, and building a high-level leadership group; (2) optimizing the current human and livestock treatments in the national schistosomiasis control program of China; (3) developing highly sensitive and specific diagnostics and the framework for verifying elimination of schistosomiasis; (4) accelerating the progress towards elimination of schistosomiasis and other parasitic diseases through integrating the national control programs for other parasitic diseases.


Subject(s)
China/epidemiology , Disease Eradication , Humans , Public Health , Schistosomiasis/prevention & control , World Health Organization
5.
Hist. ciênc. saúde-Manguinhos ; 28(3): 869-874, jul.-set. 2021.
Article in Spanish | LILACS | ID: biblio-1339968

ABSTRACT

Resumen Este artículo describe el inicio de las preocupaciones sanitarias vinculadas a las epidemias ocurridas durante el siglo XX en La Pampa, provincia argentina. Las epidemias, como las de la viruela, fueron un estímulo para estas políticas que frecuentemente tuvieron origen en Buenos Aires, la capital del país. El contagio de muchas epidemias dependía de carencias de infraestructura: agua, desagüe y desecho adecuado de basuras, de la ausencia de un número suficiente de trabajadores de salud, de la presencia de vectores transmisores de enfermedades como los mosquitos y, en última instancia, de la pobreza. La experiencia histórica descrita en este texto resalta la importancia de analizar el impacto del SARS-CoV-2 más allá de las grandes ciudades.


Abstract This article describes the emergence of health concerns relating to the epidemics that occurred during the twentieth century in La Pampa, a province in Argentina. Epidemics such as smallpox drove such policies, which frequently originated in Buenos Aires, the country's capital. The spread of many epidemics was due to shortages: water, sewage and adequate refuse disposal, an insufficient number of health care workers, the presence of disease transmission vectors such as mosquitos, and, ultimately, poverty. The historical experience described in this text highlights the importance of analyzing the impact of SARS-CoV-2 beyond the big cities.


Subject(s)
Humans , Animals , Male , Female , Child , History, 20th Century , Smallpox/history , Epidemics/history , COVID-19/history , Argentina/epidemiology , Poverty/history , Sewage , Water Supply/history , Smallpox/prevention & control , Smallpox/epidemiology , Indians, South American/history , Indians, South American/statistics & numerical data , Refuse Disposal/history , Vaccination/history , Vaccination/legislation & jurisprudence , Cities/history , Cities/epidemiology , Health Personnel/history , Health Personnel/statistics & numerical data , Disease Eradication/history , Disease Eradication/organization & administration , COVID-19/epidemiology , Health Policy/history , Health Policy/legislation & jurisprudence , Insect Vectors , Military Personnel/history
6.
urol. colomb. (Bogotá. En línea) ; 30(3): 194-198, 15/09/2021. ilus
Article in English | LILACS, COLNAL | ID: biblio-1369429

ABSTRACT

Introduction Glyphosate is an herbicide used to eradicate illicit crops; however, its use is controversial due to different health problems associated with it. The present study aims to evaluate the effects of glyphosate on human sperm in vitro. Methods Twenty-two semen samples from healthy normozoospermic men were included; 11 semen samples were incubated with Panzer (INVESA S.A., Antiquia, Colombia) and 11 with Roundup (Monsanto Company, MO, USA). The changes in motility and viability were observed. Functional seminal parameters were evaluated as well. Results The samples exposed to glyphosate showed less motility and viability; a decrease in the potential of the mitochondrial membrane was observed, and an increase in the lipoperoxidation of the membrane was evidenced. Conclusion Based on the present results, we concluded that glyphosate has cytotoxic potential for exposed people and may affect their fertility.


Introducción El glifosato es un herbicida utilizado ampliamente para la erradicación de cultivos ilícitos; sin embargo, su uso es polémico debido a diferentes problemas de salud asociados con él. El objetivo del presente estudio fue evaluar los efectos del glifosato sobre los espermatozoides humanos in vitro. Métodos Se incluyeron 22 muestras de semen de hombres sanos normozoospérmicos, de las cuales 11 se incubaron con Panzer y 11 con Roundup, y se evaluaron los cambios en la movilidad y la viabilidad espermática, además de valorar los parámetros seminales funcionales. Resultados Las muestras expuestas al glifosato presentaron una menor movilidad y viabilidad, una disminución en el potencial de la membrana mitocondrial, y un aumento en la lipoperoxidación de la membrana. Conclusiones El glifosato es potencialmente citotóxico para las personas que estén expuestas, y puede afectar su fertilidad.


Subject(s)
Humans , Male , Spermatozoa , Membrane Potential, Mitochondrial , Fertility , Semen , In Vitro Techniques , Mitochondrial Membranes , Disease Eradication
8.
Rev. cienc. salud (Bogotá) ; 18(3): 1-3, dic. 2020.
Article in Spanish | LILACS, COLNAL | ID: biblio-1289148

ABSTRACT

La malaria o paludismo sigue representando una carga de enfermedad para las comunidades de los diferentes territorios de Colombia, de los cuales Chocó, Nariño, Córdoba y Antioquia son los departamentos donde más casos se notifican (el 73 % de 77 172 casos de malaria no complicada en 2019); además, en el país se informaron 1342 casos graves (1). El Ministerio de Salud de Colombia se adhirió a la Iniciativa Regional para la Eliminación de la Malaria (IREM), creada en 2014. En diciembre de 2019, esta iniciativa priorizó acciones en 12 municipios de Chocó, Nariño y Valle del Cauca. Sin embargo, la situación social en los territorios indica que no están dadas las condiciones que permitan este logro en el país.


Malaria continues to represent a burden of disease for communities in the different territories of Colombia, of which Chocó, Nariño, Córdoba and Antioquia are the departments where most cases are reported (73% of 77 172 cases of uncomplicated malaria in 2019); in addition, 1342 severe cases were reported in the country (1). The Colombian Ministry of Health joined the Regional Initiative for the Elimination of Malaria (IREM), created in 2014. In December 2019, this initiative prioritized actions in 12 municipalities in Chocó, Nariño and Valle del Cauca. However, the social situation in the territories indicates that the conditions are not in place to allow this achievement in the country.


Subject(s)
Humans , Malaria , Disease Eradication
9.
Hist. ciênc. saúde-Manguinhos ; 27(supl.1): 145-164, Sept. 2020.
Article in English | LILACS | ID: biblio-1134088

ABSTRACT

Abstract From its inception, in 1948, the World Health Organization made control of malaria a high priority. Early successes led many to believe that eradication was possible, although there were serious doubts concerning the continent of Africa. As evidence mounted that eradicating malaria was not a simple matter, the malaria eradication programme was downgraded to a unit in 1980. Revived interest in malaria followed the Roll Back Malaria Initiative adopted in 1998. This article presents an historical account of the globally changing ideas on control and elimination of the disease and argues that insufficient attention was paid to strengthening health services and specialized human resources.


Resumo Desde sua origem, em 1948, a Organização Mundial da Saúde priorizou o controle da malária. Os primeiros êxitos induziram à crença na viabilidade da erradicação, apesar de sérias dúvidas quanto ao continente africano. À medida que se somavam comprovações de que a erradicação da malária não seria simples, o projeto com essa finalidade foi rebaixado a uma unidade em 1980. O reavivamento do interesse na malária ocorreu após a iniciativa Roll Back Malaria, criada em 1998. Este artigo apresenta um panorama histórico das mudanças nas ideias, em âmbito global, ligadas ao controle e à eliminação da doença e defende a tese de que a atenção dada ao fortalecimento dos serviços de saúde e a recursos humanos especializados foi insuficiente.


Subject(s)
Humans , History, 20th Century , History, 21st Century , World Health Organization/history , Communicable Disease Control/history , Mosquito Control/history , Malaria/history , Communicable Disease Control/methods , Mosquito Control/methods , Africa , Disease Eradication/history , Goals , Malaria/prevention & control
10.
Rev. colomb. gastroenterol ; 35(3): 351-361, jul.-set. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1138793

ABSTRACT

Resumen Helicobacter pylori (H. pylori) es un bacilo gramnegativo microaerófilo, capaz de colonizar la mucosa gástrica. Este microorganismo infecta a más de la mitad de la población mundial, por lo que se ha convertido en la infección bacteriana más común. La prevalencia de la infección y de las enfermedades asociadas a ella es alta, sobre todo en países en vías de desarrollo. El tratamiento recomendado para la erradicación es la triple terapia; sin embargo, su eficacia ha disminuido por el desconocimiento del patrón de susceptibilidad bacteriano por parte del personal médico y dada la aparición de cepas resistentes. La resistencia en H. pylori se asocia con la capacidad de adaptación de la bacteria a ambientes hostiles y al uso de los antibióticos. En Colombia, existen reportes acerca de que H. pylori presenta resistencia a amoxicilina, metronidazol, claritromicina, furazolidona, levofloxacina y tetraciclina. Los estudios del patrón de susceptibilidad determinaron que la frecuencia de resistencia de H. pylori es variable y demuestran la falta de datos en la mayoría del territorio del país. Sobre la base de lo anterior, el objetivo de esta revisión es describir los porcentajes de resistencia de H. pylori a los antibióticos amoxicilina, metronidazol, claritromicina, furazolidona, levofloxacina y tetraciclina, usados en el tratamiento de la infección en los estudios realizados en Colombia.


Abstract Helicobacter pylori (H. pylori) is a microaerophilic gram-negative bacillus that colonizes the gastric mucosa. It infects more than half the world's population, making it the most common bacterial infection. The prevalence of infection and associated diseases is high in developing countries. The recommended treatment for its eradication is triple therapy; however, its efficacy has decreased due to the lack of knowledge of the bacterial susceptibility pattern among the medical staff and the emergence of resistant strains. H. pylori susceptibility is associated with the bacteria's ability to adapt to hostile environments and the use of antibiotics. In Colombia, it has been reported that H. pylori is resistant to amoxicillin, metronidazole, clarithromycin, furazolidone, levofloxacin, and tetracycline. Studies on the susceptibility pattern have determined that the frequency of H. pylori susceptibility is variable and demonstrate the lack of data in most of the Colombian territory. With this in mind, the objective of this review is to describe the percentage of resistance to amoxicillin, metronidazole, clarithromycin, furazolidone, levofloxacin and tetracycline, which are used for the treatment of H. pylori infection, according to studies conducted in Colombia.


Subject(s)
Humans , Tetracycline , Efficacy , Helicobacter pylori , Clarithromycin , Levofloxacin , Furazolidone , Amoxicillin , Metronidazole , Prevalence , Disease Susceptibility , Disease Eradication
12.
Caracas; Observatorio Nacional de Ciencia, Tecnología e Innovación; ago. 2020. 46-56 p. ilus.(Observador del Conocimiento. Revista Especializada de Gestión Social del Conocimiento, 5, 3).
Monography in Spanish | LILACS, LIVECS | ID: biblio-1120112

ABSTRACT

A más de cuatro meses de la pandemia que azota al planeta, existe la urgente necesidad de proyectar cómo la transmisión del nuevo SARS-CoV-2 se desarrollará en los meses venideros. En el interés de modelar el comportamiento del SARS-CoV-2 en la República Bolivariana de Venezuela, desde el Observatorio Nacional de Ciencia, Tecnología e Innovación (ONCTI), realizamos análisis estadísticos a objeto de pronosticar con base en los valores de las series de tiempo de contagios de la Covid-19 de procedencia comunitaria, la Estimación Promedio de Contagios Comunitarios. Dichos análisis han permitido evidenciar que la inédita dinámica de propagación de esta pandemia dependerá de la estacionalidad, la duración en encontrarse una vacuna de inmunidad y de los otros factores como, por ejemplo, la erradicación de procedencia de los contagios de orígenes transnacionales o importados. De allí que, utilizando datos que reflejan el comportamiento del SARS-CoV-2 durante los primeros 120 días de pandemia en la República Bolivariana de Venezuela, medimos cómo estos factores afectan la transmisión comunitaria. Para ello construimos un modelo matemático que permitió observar el comportamiento de la transmisión de SARS-CoV-2; y proyectamos qué tan recurrentes serán los brotes de SARS-CoV-2 durante las próximas 3 semanas, los cuales probablemente ocurrirán después del brote de la ola pandémica inicial(AU)


More than four months after the start of the pandemic that plagues the planet, there is an urgent need to project how the transmission of the new SARS-CoV-2 will develop in the upcoming months. Intending to model the behavior of SARS-CoV2 in the Bolivarian Republic of Venezuela, the Observatorio Nacional de Ciencia y Tecnologia (ONTIC) carried out statistical analysis to forecast based on the values of the time series of Covid-19 infections of communitarian origin, the Estimate Average of Community Contagions. These analyzes have shown that the unprecedented spread's dynamics of this pandemic will depend on seasonality, the finding of a vaccine, and other factors such as, for example, the eradication of origin of contagions of transnational or imported origin. Hence, using data that reflects the behavior of SARS-CoV2 during the first 120 days of the pandemic in the Bolivarian Republic of Venezuela, we measure how these factors affect communitarian transmission. To do this, we built a mathematical model that allowed us to observe the behavior of SARS-CoV-2 transmission, projecting how recurrent outbreaks of SARS-CoV-2 will appear over the next 3 weeks, which are likely to occur after the first wave of the pandemic(AU)


Subject(s)
Humans , Time Series Studies , Coronavirus Infections , Severe Acute Respiratory Syndrome , Pandemics , Disease Eradication/methods , Models, Theoretical
13.
Rev. cuba. invest. bioméd ; 39(1): e590, ene.-mar. 2020. graf
Article in Spanish | LILACS, CUMED | ID: biblio-1126580

ABSTRACT

Introducción: El helminto Angiostrongylus cantonensis es un parásito habitual en los pulmones de la rata y puede ocasionar meningoencefalitis eosinofílica en el hombre cuando se pone en contacto con las larvas por ingestión accidental. En Cuba es endémico y el riesgo de contraerlo aumenta con la entrada del caracol gigante africano en el país. Objetivo: Describir las acciones desarrolladas por las autoridades sanitarias locales para el control del caracol gigante africano entre 2016 y 2018 y la aparición de un paciente en 2018 con meningoencefalitis eosinofílica causada por Angiostrongylus cantonensis vinculado epidemiológicamente con la presencia de este caracol. Métodos: Se realizó un estudio cualitativo a partir de un grupo focal con el que se trabajó ante la aparición del caracol gigante africano en un área de salud del municipio San Miguel del Padrón. Se realiza una encuesta semi-estructurada. Resultados: Se trazaron las estrategias para la erradicación de la especie invasora a partir de un trabajo comunitario. Dos años después, se observa nuevamente el caracol gigante africano y un paciente con meningoencefalitis eosinofílica epidemiológicamente asociado a Angiostrongylus cantonensis. Conclusiones: Las acciones realizadas entre 2016 y 2018 resultaron ser insuficientes por el nuevo avistamiento del caracol en el área, con el agravante de encontrar un paciente con meningoencefalitis eosinofílica epidemiológicamente asociado con el molusco(AU)


Introduction: Helmint Angiostrongylus cantonensis is a natural parasite in the lungs of ratas. Ocassionally it can produced an eosinophilic meningoencephalitis in men by larvae accidental ingestion. Methods: A qualitative study was performed from a focal group by a semi-structural survey in a health area from San Miguel del Padrón municipality. Objectives: To describe the actions developed by the local sanitarian authorities for the control of African giant snails between 2016 and 2018 and the appearance of a patient suffering from eosinophilic meningoencephalitis due to Angiostrongylus cantonensis linked to the presence of this snail. Results: It has been established an eradication strategy for the elimination of this invasive species based on a community work. Two years later, it was observed again the giant African snail in the area with a patient suffering from Angiostrongylus cantonensis eosinophilic meningoencephalitis epidemiologically associated. Conclusions: The 2016 actions were not efficient due to the emerging vector and the further finding of a patient linked with the parasite(AU)


Subject(s)
Humans , Snails , Introduced Species , Angiostrongylus cantonensis/pathogenicity , Evaluation Studies as Topic , Disease Eradication/methods , Meningoencephalitis/etiology , Meningoencephalitis/prevention & control
14.
Rio de Janeiro; Fiocruz; 2020. 228 p. il, fots, mapas^c23 cm.(Coleção história e saúde).
Monography in Portuguese | LILACS | ID: biblio-1369911

ABSTRACT

Mostra uma trajetória ampliada do Anopheles gambiae no Brasil. evidencia a importância de compreender seu percurso desde sua chegada em 1930, considerando o processo histórico que o fez ser inicialmente entendido como um problema emergencial local, tratado de maneira paleativa para, posteriormente, ser enquadrado em um experimento de demonstração em saúde pública tendo em vista sua erradicação


Subject(s)
Vector Control of Diseases , Disease Eradication , Malaria/epidemiology , Anopheles , Brazil
16.
Cad. Saúde Pública (Online) ; 36(supl.2): e00145720, 2020.
Article in Portuguese | LILACS, SES-SP | ID: biblio-1132880

ABSTRACT

O objetivo deste artigo é rever o "estado da arte" dos avanços, obstáculos e estratégias para atingir a erradicação global da pólio. As ações de controle da poliomielite iniciaram na década de 1960 com o advento das duas vacinas antipoliomielíticas, a vacina oral da pólio (VOP) e a vacina inativada da pólio (VIP). No período de 1985 a 2020, são implementadas estratégias para atingir a meta de erradicação do poliovírus selvagem (WPV). Após o sucesso da interrupção da transmissão autóctone do WPV na região da Américas, foi lançada a meta da erradicação global. Descrevemos o processo de erradicação em quatro tempos: (1) O advento das vacinas VIP e VOP iniciou a era do controle da poliomielite; (2) A utilização massiva e simultânea da VOP teve impacto significativo sobre a transmissão do poliovírus selvagem no final da década de 1970 no Brasil; (3) Políticas públicas (nacionais e internacionais) decidem pela erradicação da transmissão autóctone do poliovírus selvagem nas Américas e definem as estratégias epidemiológicas para interromper a transmissão; e (4) A implantação das estratégias de erradicação interrompeu a transmissão autóctone do WPV em quase todas as regiões do mundo, exceto no Paquistão e Afeganistão, onde, em 2020, cadeias de transmissão do WPV1 desafiam as estratégias de contenção do vírus. Por outro lado, a persistência e a disseminação da circulação do poliovírus derivado da VOP, em países com baixa cobertura vacinal, somadas às dificuldades para substituir a VOP pela VIP constituem, atualmente, os obstáculos para a erradicação a curto prazo. Finalmente, discutimos as estratégias para superar os obstáculos e os desafios na era pós-erradicação.


El objetivo de este artículo es revisar el "estado de la cuestión" de los avances, obstáculos y estrategias para alcanzar la erradicación global de la polio. Las acciones de control de la poliomielitis se iniciaron en la década de 1960, con el advenimiento de las dos vacunas antipoliomielíticas, la vacuna oral de la polio (VOP) y la vacuna inactivada de la polio (VIP). En el período de 1985 a 2020, se implementan estrategias para alcanzar la meta de la erradicación del virus de la polio salvaje (WPV). Tras el éxito de la interrupción de la transmisión autóctona del WPV en la región de las Américas, se lanzó la meta de la erradicación global. Describimos el proceso de erradicación en cuatro tiempos: (1) El advenimiento de las vacunas VIP y VOP inició la era del control de la poliomielitis; (2) La utilización masiva y simultánea de la VOP tuvo un impacto significativo sobre la transmisión del virus de la polio salvaje, al final de la década de 1970, en Brasil; (3) Políticas públicas (nacionales e internacionales) deciden la erradicación de la transmisión autóctona del virus de la polio salvaje en las Américas y definen las estrategias epidemiológicas para interrumpir la transmisión; y (4) La implantación de las estrategias de erradicación interrumpió la transmisión autóctona del WPV en casi todas las regiones del mundo, excepto en Paquistán y Afganistán, donde, en 2020, cadenas de transmisión del WPV1 desafían las estrategias de contención del virus. Por otro lado, la persistencia y la diseminación de la circulación del virus de la polio, derivado de la VOP, en países con baja cobertura de vacunas, sumadas a las dificultades para substituir la VOP por la VIP constituyen, actualmente, los obstáculos para la erradicación a corto plazo. Finalmente, discutimos las estrategias para superar los obstáculos y los desafíos en la era poserradicación.


This article's objective is to review the "state of the art" in the progress, obstacles, and strategies for achieving global polio eradication. Poliomyelitis control measures began in the 1960s with the advent of two vaccines, the oral polio vaccine (OPV) and the inactivated polio vaccine (IPV). From 1985 to 2020, strategies were implemented to reach the goal of eradication of wild poliovirus (WPV). Following the success with the interruption of indigenous WPV transmission in the Americas, the goal of global eradication was launched. We describe the process of eradication in four historical stages: (1) The advent of the inactivated and oral polio vaccines launched the age of poliomyelitis control; (2) The massive and simultaneous use of OPV had a significant impact on WPV transmission in the late 1970s in Brazil; (3) Domestic and international public policies set the goal of eradication of indigenous WPV transmission in the Americas and defined the epidemiological strategies to interrupt transmission; and (4) The implementation of eradication strategies interrupted indigenous WPV transmission in nearly all regions of the world except Pakistan and Afghanistan, where in 2020 the WPV1 transmission chains have challenged the strategies for containment of the virus. Meanwhile, the persistence and dissemination of circulation of OPV-derived poliovirus in countries with low vaccination coverage, plus the difficulties in replacing OPV with IPV, are currently the obstacles to eradication in the short term. Finally, we discuss the strategies for overcoming the obstacles and challenges in the post-eradication era.


Subject(s)
Humans , Poliomyelitis/prevention & control , Poliomyelitis/epidemiology , Immunization Programs , Brazil/epidemiology , Poliovirus Vaccine, Oral , Afghanistan , Disease Eradication
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