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1.
Front Public Health ; 11: 1094859, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36935657

RESUMEN

Malaria is a major public health threat worldwide, and it was also widely prevalent in the history in China, seriously endangering people's health and affecting socioeconomic development. China was certified malaria elimination in 2021 with unremitting efforts since the founding of the People's Republic of China in 1949. This great achievement has been another milestone in the fight against major infectious diseases following the elimination of smallpox, poliomyelitis, leprosy, filariasis, neonatal tetanus and blinding trachoma in China. This paper briefly introduces the malaria burden dynamics and the corresponding malaria transmission risk stratificantions, as well as systematically reviews the evolution of anti-malaria policies and measures from severe epidemic to elimination in China. Meanwhile, five key lessons in malaria control and elimination in China are also briefly summarized. All of the above provide evidences for promoting global malaria eradication and preventing reestablishment of malaria transmission, finally benefit all individuals still suffering from the scourge of malaria.


Asunto(s)
Antimaláricos , Enfermedades Transmisibles , Malaria , Recién Nacido , Humanos , Antimaláricos/uso terapéutico , Erradicación de la Enfermedad , Malaria/epidemiología , Malaria/prevención & control , China/epidemiología
2.
BMJ Open ; 12(7): e058397, 2022 07 18.
Artículo en Inglés | MEDLINE | ID: mdl-35851027

RESUMEN

INTRODUCTION: Malaria is one of the major public health problems in sub-Saharan Africa. It contributes significantly to maternal and fetal morbidity and mortality in affected countries. This study aims to evaluate the impact of enhanced case detection using molecular testing called loop-mediated isothermal amplification (LAMP) on birth outcomes in a prospective study design. METHODS AND ANALYSIS: A pragmatic randomised diagnostic outcomes trial will be conducted in several health institutes in different Ethiopian regions. Women (n=2583) in their first and second trimesters of pregnancy will be included in the study and individually randomised to the standard of care or enhanced case detection arms, and followed until delivery. Enrolment will encompass the malaria peak transmission seasons. In the standard of care arm, a venous blood sample will be collected for malaria diagnosis only in symptomatic patients. In contrast, in the intervention arm, mothers will be tested by a commercially available Conformité Européene (CE)-approved LAMP malaria test, microscopy and rapid diagnostic test for malaria regardless of their symptoms at each antenatal care visit. The primary outcome of the study is to measure birth weight. ETHICS AND DISSEMINATION: The study was approved by the following ethical research boards: Armauer Hansen Research Institute/ALERT Ethics Review Committee (FORM AF-10-015.1, Protocol number PO/05/20), the Ethiopia Ministry of Science and Higher Education National Research Ethics Review Committee (approval SRA/11.7/7115/20), the Ethiopia Food and Drug Administration (approval 02/25/33/I), UCalgary Conjoint Health Research Ethics Board (REB21-0234). The study results will be shared with the institutions and stakeholders such as the Ethiopia Ministry of Health, the Foundation for Innovative Diagnostics, WHO's Multilateral initiative on Malaria - Tropical Diseases Research (TDR-MIM), Roll Back Malaria and the Malaria in Pregnancy Consortium. The study results will also be published in peer-reviewed journals and presented at international conferences. TRIAL REGISTRATION NUMBER: NCT03754322.


Asunto(s)
Malaria , Tamizaje Masivo , Complicaciones Parasitarias del Embarazo , Femenino , Humanos , Malaria/diagnóstico , Malaria/terapia , Tamizaje Masivo/métodos , Técnicas de Diagnóstico Molecular , Técnicas de Amplificación de Ácido Nucleico , Ensayos Clínicos Pragmáticos como Asunto , Embarazo , Complicaciones Parasitarias del Embarazo/diagnóstico , Complicaciones Parasitarias del Embarazo/terapia , Estudios Prospectivos , Ensayos Clínicos Controlados Aleatorios como Asunto , Tecnología
3.
Bol. malariol. salud ambient ; 62(5): 879-889, 2022. ilus, tab
Artículo en Español | LILACS, LIVECS | ID: biblio-1417601

RESUMEN

Las enfermedades tropicales desatendidas (ETD) son aquellas que comúnmente se encuentran en varios países de bajos ingresos en África, Asia y América Latina, provocadas básicamente, por el escaso acceso la higiene, agua limpia o sistemas de alcantarillado. Las ETD comprenden una diversidad de enfermedades de alta prevalencia en los países tropicales causadas por una variedad de patógenos, incluyendo bacterias, virus, parásitos y hongos. La epidemiología de las ETD es bastante compleja y se relacionan con las condiciones ambientales del entorno. Muchas son transmitidas por vectores, tienen un origen zoonótico con reservorios animales bien caracterizados y están asociadas con ciclos de vida complejos. Todos estos factores hacen que su control en salud pública sea un desafío; desafío que se caracteriza por la falta de financiamiento en investigación y control. En ese sentido, la telemedicina, o el uso de las telecomunicaciones para brindar servicios de salud, es una tecnología que ha venido ganando cuerpo durante los últimos veinte años, ya que ayudan, con una relativa baja inversión, el acceso a la atención médica por parte de los más necesitados o que vieven en lugares remotos. Esta investigación se centra en el estudio y conocimiento de las las enfermedades olvidadas presentes en suramérica y cómo la telemedicina ha ayudado en su prevención, diágnótico y tratamiento(AU)


Neglected topical diseases (NTDs) are those that are commonly found in several low-income countries in Africa, Asia en Latin America, basically caused by poor access to hygiene, clean water, or sewage systems. NTDs comprise a diversity of highly prevalent diseases in tropical countries caused by a variety of pathogens, including bacteria, viruses, parasites, and fungi. The epidemiology of NTDs is quite complex and is related to the surrounding environmental conditions. Many are vector-borne, zoonotic in origin with well-characterized animal reservoirs, and associated with complex life cycles. All these factors make its control in public health a challenge; challenge that is characterized by the lack of funding for research and control. In this sense, telemedicine, or the use of telecommunications to provide health services, is a technology that has been gaining ground over the last twenty years, since it helps, with a relatively low investment, access to medical care by part of those most in need or who live in remote places. In this sense, telemedicine, or the use of telecommunications to provide health services, is a technology that has been gaining ground over the last twenty years, since it helps, with a relatively low investment, access to medical care by part of those most in need or who live in remote places. This research focuses on the study and knowledge of neglected diseases present in South America and how telemedicine has helped in their prevention, diagnosis, and treatment(AU)


Asunto(s)
Humanos , Masculino , Telemedicina , Tecnología de la Información , Enfermedades Desatendidas , Programas Nacionales de Salud , Bacterias , Tripanosomiasis Africana , Virus , Enfermedad de Chagas , Dengue , Lepra , Malaria
4.
Talanta ; 234: 122617, 2021 Nov 01.
Artículo en Inglés | MEDLINE | ID: mdl-34364426

RESUMEN

A group of infectious and parasitic diseases with prevalence in tropical and subtropical regions of the planet, especially in places with difficult access, internal conflicts, poverty, and low visibility from the government and health agencies are classified as neglected tropical diseases. While some well-intentioned isolated groups are making the difference on a global scale, the number of new cases and deaths is still alarming. The development and employment of low-cost, miniaturized, and easy-to-use devices as biosensors could be the key to fast diagnosis in such areas leading to a better treatment to further eradication of such diseases. Therefore, this review contains useful information regarding the development of such devices in the past ten years (2010-2020). Guided by the updated list from the World Health Organization, the work evaluated the new trends in the biosensor field applied to the early detection of neglected tropical diseases, the efficiencies of the devices compared to the traditional techniques, and the applicability on-site for local distribution. So, we focus on Malaria, Chagas, Leishmaniasis, Dengue, Zika, Chikungunya, Schistosomiasis, Leprosy, Human African trypanosomiasis (sleeping sickness), Lymphatic filariasis, and Rabies. Few papers were found concerning such diseases and there is no available commercial device in the market. The works contain information regarding the development of point-of-care devices, but there are only at proof of concepts stage so far. Details of electrode modification and construction of electrochemical biosensors were summarized in Tables. The demand for the eradication of neglected tropical diseases is increasing. The use of biosensors is pivotal for the cause, but appliable devices are scarce. The information present in this review can be useful for further development of biosensors in the hope of helping the world combat these deadly diseases.


Asunto(s)
Técnicas Biosensibles , Lepra , Malaria , Enfermedades Parasitarias , Infección por el Virus Zika , Virus Zika , Humanos , Enfermedades Desatendidas/diagnóstico , Enfermedades Parasitarias/diagnóstico , Enfermedades Parasitarias/epidemiología
5.
PLoS Negl Trop Dis ; 15(8): e0009434, 2021 08.
Artículo en Inglés | MEDLINE | ID: mdl-34449765

RESUMEN

Pyruvate kinase (PK), encoded by the PKLR gene, is a key player in glycolysis controlling the integrity of erythrocytes. Due to Plasmodium selection, mutations for PK deficiency, which leads to hemolytic anemia, are associated with resistance to malaria in sub-Saharan Africa and with susceptibility to intracellular pathogens in experimental models. In this case-control study, we enrolled 4,555 individuals and investigated whether PKLR single nucleotide polymorphisms (SNPs) putatively selected for malaria resistance are associated with susceptibility to leprosy across Brazil (Manaus-North; Salvador-Northeast; Rondonópolis-Midwest and Rio de Janeiro-Southeast) and with tuberculosis in Mozambique. Haplotype T/G/G (rs1052176/rs4971072/rs11264359) was associated with leprosy susceptibility in Rio de Janeiro (OR = 2.46, p = 0.00001) and Salvador (OR = 1.57, p = 0.04), and with tuberculosis in Mozambique (OR = 1.52, p = 0.07). This haplotype downregulates PKLR expression in nerve and skin, accordingly to GTEx, and might subtly modulate ferritin and haptoglobin levels in serum. Furthermore, we observed genetic signatures of positive selection in the HCN3 gene (xpEHH>2 -recent selection) in Europe but not in Africa, involving 6 SNPs which are PKLR/HCN3 eQTLs. However, this evidence was not corroborated by the other tests (FST, Tajima's D and iHS). Altogether, we provide evidence that a common PKLR locus in Africans contribute to mycobacterial susceptibility in African descent populations and also highlight, for first, PKLR as a susceptibility gene for leprosy and TB.


Asunto(s)
Malaria/genética , Polimorfismo de Nucleótido Simple , Piruvato Quinasa/genética , Adulto , Brasil , Estudios de Casos y Controles , Femenino , Frecuencia de los Genes , Predisposición Genética a la Enfermedad , Haplotipos , Humanos , Desequilibrio de Ligamiento , Modelos Logísticos , Masculino , Persona de Mediana Edad , Mozambique , Piruvato Quinasa/deficiencia , Adulto Joven
6.
BMJ Open ; 11(7): e044715, 2021 07 13.
Artículo en Inglés | MEDLINE | ID: mdl-34257091

RESUMEN

BACKGROUND: As infectious diseases approach global elimination targets, spatial targeting is increasingly important to identify community hotspots of transmission and effectively target interventions. We aimed to synthesise relevant evidence to define best practice approaches and identify policy and research gaps. OBJECTIVE: To systematically appraise evidence for the effectiveness of spatially targeted community public health interventions for HIV, tuberculosis (TB), leprosy and malaria. DESIGN: Systematic review. DATA SOURCES: We searched Medline, Embase, Global Health, Web of Science and Cochrane Database of Systematic Reviews between 1 January 1993 and 22 March 2021. STUDY SELECTION: The studies had to include HIV or TB or leprosy or malaria and spatial hotspot definition, and community interventions. DATA EXTRACTION AND SYNTHESIS: A data extraction tool was used. For each study, we summarised approaches to identifying hotpots, intervention design and effectiveness of the intervention. RESULTS: Ten studies, including one cluster randomised trial and nine with alternative designs (before-after, comparator area), satisfied our inclusion criteria. Spatially targeted interventions for HIV (one USA study), TB (three USA) and leprosy (two Brazil, one Federated States of Micronesia) each used household location and disease density to define hotspots followed by community-based screening. Malaria studies (one each from India, Indonesia and Kenya) used household location and disease density for hotspot identification followed by complex interventions typically combining community screening, larviciding of stagnant water bodies, indoor residual spraying and mass drug administration. Evidence of effect was mixed. CONCLUSIONS: Studies investigating spatially targeted interventions were few in number, and mostly underpowered or otherwise limited methodologically, affecting interpretation of intervention impact. Applying advanced epidemiological methodologies supporting more robust hotspot identification and larger or more intensive interventions would strengthen the evidence-base for this increasingly important approach. PROSPERO REGISTRATION NUMBER: CRD42019130133.


Asunto(s)
Infecciones por VIH , Lepra , Malaria , Tuberculosis , Brasil , Infecciones por VIH/epidemiología , Infecciones por VIH/prevención & control , Humanos , India , Indonesia , Kenia , Lepra/epidemiología , Lepra/prevención & control , Malaria/epidemiología , Malaria/prevención & control
7.
Malar J ; 20(1): 79, 2021 Feb 08.
Artículo en Inglés | MEDLINE | ID: mdl-33557847

RESUMEN

BACKGROUND: In parallel with the change of malaria policy from control to elimination and declines in the malaria burden in Greater Mekong Sub-region, the motivation and social role of malaria volunteers has declined. To address this public health problem, in Myanmar, the role and responsibilities of malaria volunteers have been transformed into integrated community malaria volunteers (ICMV), that includes the integration of activities for five additional diseases (dengue, lymphatic filariasis, tuberculosis, HIV/AIDS and leprosy) into their current activities. However, this transformation was not evidence-based and did not consider inputs of different stakeholders. Therefore, qualitative stakeholder consultations were performed to optimize future malaria volunteer models in Myanmar. METHODS: Semi-structured interviews were conducted with key health stakeholders from the Myanmar Ministry of Health and Sports (MoHS) and malaria implementing partners to obtain their perspectives on community-delivered malaria models. A qualitative descriptive approach was used to explore the experiences of the stakeholders in policymaking and programme implementation. Interview topic guides were used during the interviews and inductive thematic data analysis was performed. RESULTS: While ICMVs successfully provided malaria services in the community, the stakeholders considered the ICMV model as not optimal and suggested that many aspects needed to be improved including better training, supervision, support, and basic health staff's recognition for ICMVs. Stakeholders believe that the upgraded ICMV model could contribute significantly to achieving malaria elimination and universal health care in Myanmar. DISCUSSION AND CONCLUSION: In the context of high community demand for non-malaria treatment services from volunteers, the integrated volunteer service package must be developed carefully in order to make it effective in malaria elimination programme and to contribute in Myanmar's pathway to universal health coverage (UHC), but without harming the community. An evidenced-based, community-delivered and preferred model, that is also accepted by the MoHS, is yet to be developed to effectively contribute to achieving malaria elimination and UHC goals in Myanmar by 2030.


Asunto(s)
Agentes Comunitarios de Salud/psicología , Malaria Falciparum/prevención & control , Malaria Vivax/prevención & control , Participación de los Interesados/psicología , Voluntarios/psicología , Agentes Comunitarios de Salud/estadística & datos numéricos , Malaria , Malaria Falciparum/psicología , Malaria Vivax/psicología , Mianmar , Investigación Cualitativa , Voluntarios/estadística & datos numéricos
8.
Pathog Glob Health ; 114(6): 302-308, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-32726193

RESUMEN

Neglected tropical diseases affect over 1 billion people, and cause 170,000 deaths each year. They result in disability, stigma and disfigurement, and also push families into poverty. Tropical infections can involve the kidney, presenting as a wide variety of ways, varying from transient urinary abnormalities to severe acute kidney injury (AKI). It is important to assess renal function in patients with tropical infections for earlier detection of AKI, appropriate treatment and prevention of Chronic Kidney Disease (CKD) outcome in some of them. There was an exponential increase in research on new kidney biomarkers that were earlier and specific for renal damage but few in the scope of tropical infections. In this review, we focus on kidney biomarkers that are being studied in some of the most prevalent tropical infections such as visceral leishmaniasis, leptospirosis, malaria, schistosomiasis and leprosy. Further studies are needed to evaluate the usefulness of renal biomarkers in the early diagnosis of renal diseases associated with tropical infections.


Asunto(s)
Enfermedades Renales/microbiología , Enfermedades Renales/parasitología , Riñón/patología , Lesión Renal Aguda , Biomarcadores , Humanos , Leishmaniasis Visceral/diagnóstico , Lepra/diagnóstico , Leptospirosis/diagnóstico , Malaria/diagnóstico , Enfermedades Desatendidas/diagnóstico , Esquistosomiasis/diagnóstico
10.
Am J Trop Med Hyg ; 100(1): 97-107, 2019 01.
Artículo en Inglés | MEDLINE | ID: mdl-30457088

RESUMEN

We compared the efficacy of three intervention packages for active case detection (ACD) of visceral leishmaniasis (VL)/post-kala-azar dermal leishmaniasis (PKDL) combined with sandfly control around an index case. The packages were 1) no kala-azar transmission activity involving indoor residual spraying (IRS) with deltamethrin, peri-domestic deployment of larvicide with temephos, and house-to-house search for cases; 2) fever camp (FC) plus durable wall lining (DWL) with deltamethrin; and 3) FC plus insecticide (deltamethrin) impregnated bed-nets (ITN) around an index case. Fever camp includes 1-day campaign at the village level to screen and diagnose VL, PKDL, leprosy, malaria, and tuberculosis among residents with chronic fever or skin disease. Efficacy was measured through yield of new cases, vector density reduction, and mortality at 1, 3, 6, 9, and 12 months following intervention. Fever camp + DWL was the most efficacious intervention package with 0.5 case detected per intervention, 79% reduction in vector density (incidence rate ratio [IRR] = 0.21, P = 0.010), and 95.1% (95% confidence interval: 93.4%, 96.8%) sandfly mortality at 12 months. No kala-azar transmission activity was efficacious for vector control (74% vector reduction, IRR = 0.26, P < 0.0001 at 9 months; and 84% sandfly mortality at 3 months), but not for case detection (0 case per intervention). Fever camp + ITN was efficacious in detection of VL/PKDL cases (0.43 case per intervention), but its efficacy for vector control was inconsistent. We recommend index case-based FC for ACD combined with DWL or IRS plus larvicide for sandfly control during the consolidation and maintenance phases of the VL elimination program of the Indian subcontinent.


Asunto(s)
Control de Insectos/métodos , Leishmaniasis Visceral/diagnóstico , Leishmaniasis Visceral/prevención & control , Adolescente , Adulto , Animales , Bangladesh , Niño , Preescolar , Análisis por Conglomerados , Vectores de Enfermedades , Femenino , Fiebre/complicaciones , Humanos , Mosquiteros Tratados con Insecticida , Insecticidas , Lepra/diagnóstico , Malaria/diagnóstico , Masculino , Phlebotomus , Tuberculosis/diagnóstico , Adulto Joven
11.
Rio de Janeiro; s.n; 2019. 245 p. ilus..
Tesis en Portugués | LILACS, BDENF - Enfermería | ID: biblio-1095946

RESUMEN

As doenças negligenciadas são caracterizadas por um grupo de enfermidades infecciosas que atingem principalmente a população de baixa renda nos países em desenvolvimento, com poucos investimentos em pesquisa e tecnologia para avançar no controle, na prevenção e tratamento medicamentoso. São assim denominadas também pelo fato de não despertarem o interesse econômico e financeiro das grandes indústrias farmacêuticas proporcionando a continuidade do ciclo da pobreza e diminuição da qualidade de vida das pessoas. O objetivo geral foi analisar as representações sociais acerca das doenças negligenciadas para os profissionais de saúde com ênfase nas dimensões conceitual e prática destas representações. Trata-se de uma pesquisa de natureza qualitativa, com sustentação na Teoria das Representações Sociais, em suas abordagens processual e estrutural, realizada com 90 profissionais de saúde que atuam em instituições de atenção primária e secundária à saúde, no município de Jequié/BA. A pesquisa aconteceu em três fases distintas, a saber: na primeira fase aplicou-se a técnica de evocações livres, com uso do termo indutor: doenças negligenciadas, sendo analisadas pela técnica do quadrante de quatro casas, com auxílio do EVOC, versão 2005; na segunda etapa, retornou-se ao campo de pesquisa, para aplicar ao um total de 27 participantes do mesmo grupo anterior, os instrumentos de testes de centralidade: a constituição de pares pareados e os esquemas cognitivos de base. Foram analisados pela análise de similitude e pelos índices de valência, respectivamente. Na terceira fase aplicou-se o instrumento da entrevista em profundidade, para 27 profissionais de saúde, sendo analisados com auxílio do IRAMUTEQ através da análise lexical mecanizada. Na análise estrutural, identificou-se o núcleo central, com os elementos descaso e ignorância, que organizaram as representações sociais dos profissionais de saúde em um contínuo que foi da dimensão individual à político-social, perpassando pelas dimensões socioindividual e imagética. Com relação ao conteúdo, no âmbito da abordagem processual, encontrou-se um corpus geral constituído por 27 entrevistas, separados em 1.076 segmentos de textos (ST) com aproveitamento de 1.043 STs (96,93 %). Emergiram 38.421 ocorrências (palavras, formas ou vocábulos), sendo 2.349 palavras distintas e 978 com uma única ocorrência. O conteúdo analisado foi categorizado em 07 classes distintas que evidenciaram as dimensões teórica e prática das representações sociais. As representações sociais dos profissionais de saúde sobre as doenças negligenciadas possuem uma atitude normativa, apesar de conviverem cotidianamente em seu ambiente de trabalho com estas enfermidades. Isto implicou na construção de julgamentos com elementos negativos, por parte dos profissionais de saúde, sobre as condutas e práticas dos sujeitos que compõem a tríade (indivíduo, equipe de saúde e gestores) no enfrentamento das doenças negligenciadas. Conclui-se que, as representações sociais dos profissionais de saúde acerca das doenças negligenciadas gerenciam e influenciam suas práticas de cuidado, modificando a realidade que os cerca e protagonizando novos saberes e conhecimentos indispensáveis para o controle, a prevenção e o tratamento destas entidades mórbidas.


Neglected diseases are characterized by a group of infectious diseases that mainly affect low-income people in developing countries, with little investment in research and technology to enhance their control, prevention and drug treatment. Their denomination is due to the fact that they do not arouse the economic and financial interest of the big pharmaceutical industries, maintaining the continuity of the poverty cycle and diminishing the quality of life of the people. Our general objective was to analyze the social representations about neglected diseases in health professionals, with emphasis on the conceptual and practical dimensions of these representations. It is a research of a qualitative nature, supported by the Theory of Social Representations, in its procedural and structural approaches, carried out with 90 health professionals who work in primary and secondary health care institutions, in the municipality of Jequié, Bahia, Brazil. The research was carried out in three distinct phases: in the first stage we used the technique of free evocations, with the inductor term: neglected diseases, being analyzed by the four quadrants technique, with the help of EVOC, 2005 version; in the second stage, we returned to the field of research, to apply to a total of 27 participants of the same previous group the instruments of the centrality tests: the constitution of matched pairs and the basic cognitive schemes. They were analyzed by the similitude analysis and by the valence indices, respectively. In the third phase, we applied the instrument of the in-depth interview to 27 health professionals, being analyzed with the help of IRAMUTEQ through the mechanized lexical analysis. In the structural analysis, the central nucleus was identified, with the elements neglect and ignorance, which organized the social representations of health professionals in a continuum that went from the individual to the social-political dimension, spanning the social-individual and imagery dimensions. Regarding the content, in the scope of the procedural approach, a general corpus was composed of 27 interviews, separated into 1,076 text segments (TS) from which 1,043 TS (96.93%) were used. 38,421 occurrences (words, forms or terms) emerged, being 2,349 distinct words and 978 with a single occurrence. The analyzed content was categorized into 07 distinct classes that showed the theoretical and practical dimensions of social representations. The social representations of the health professionals on neglected diseases show that they have a normative attitude, although they interact daily with these diseases in their work environment. This implied the construction of judgments with negative elements, by the health professionals, about the behaviors and practices of the subjects that make up the triad (individual, health team and managers) in coping with neglected diseases. It is concluded that the social representations of the health professionals on neglected diseases manage and influence their care practices, modifying the reality that surrounds them and playing a leading role in new and indispensable knowledge for the control, prevention and treatment of these morbid entities.


Las enfermedades descuidadas son caracterizadas por un grupo de enfermedades infecciosas que afectan principalmente a la populación de baja renta en los países en desarrollo, con pocas inversiones en investigación y tecnología para avanzar en el control, en la prevención y tratamiento medicamentoso. Son así denominadas también por el hecho de no despertar el interés económico y financiero de las grandes industrias farmacéuticas proporcionando la continuidad del ciclo de pobreza y la disminución de la calidad de vida de las personas. El objetivo general fue analizar las representaciones sociales acerca de las enfermedades descuidadas para los profesionales de la salud con énfasis en las dimensiones conceptual y práctica de estas representaciones. Se trata de una investigación de naturaleza cualitativa, sustentada en la Teoría de las Representaciones Sociales, en sus abordajes procesual y estructural, realizada con 90 profesionales de la salud que actúan en instituciones de atención primaria y secundaria a la salud, en el municipio de Jequié, Bahia, Brasil. La investigación aconteció en tres fases distintas, a saber: en la primera fase se aplicó la técnica de evocaciones libres, con uso del término inductor: enfermedades descuidadas, siendo analizadas por la técnica del cuadrante de cuatro casas, con auxilio del EVOC, versión 2005; en la segunda etapa, se retornó al campo de investigación, para aplicar a un total de 27 participantes del mismo grupo anterior los instrumentos de pruebas de centralidad: la constitución de pares pareados y los esquemas cognitivos de base. Fueron analizados por el análisis de similitud y por los índices de valencia, respectivamente. En la tercera fase, se aplicó el instrumento de la entrevista en profundidad, para 27 profesionales de la salud, siendo analizado con auxilio del IRAMUTEQ a través del análisis lexical mecanizado. En el análisis estructural, se identificó el núcleo central, con los elementos descaso e ignorancia, que organizaron las representaciones sociales de los profesionales de la salud en un continuo que fue de la dimensión individual a la político-social, pasando por las dimensiones socio individual e imagética. Con relación al contenido, en el ámbito del abordaje procesual, se encontró un corpus general constituido por 27 entrevistas, separadas en 1.076 segmentos de textos (ST) con aprovechamiento de 1.043 STs (96,93 %). Emergieron 38.421 ocurrencias (palabras, formas o vocablos), siendo 2.349 palabras distintas y 978 con una única ocurrencia. El contenido analizado fue categorizado en 07 clases distintas que evidenciaron las dimensiones teórica y práctica de las representaciones sociales. Las representaciones sociales de los profesionales de la salud sobre las enfermedades descuidadas tienen una actitud normativa, a pesar de convivir cotidianamente en su ambiente de trabajo con estas enfermedades. Esto implicó la construcción de juicios con elementos negativos, por parte de los profesionales de la salud, sobre las conductas y prácticas de los sujetos que componen la tríade (individuo, equipo de salud y gestores) en el enfrentamiento de las enfermedades descuidadas. Se concluye que las representaciones sociales de los profesionales de la salud acerca de las enfermedades descuidadas gerencian e influencian sus prácticas de cuidado, modificando la realidad que los rodea y protagonizando nuevos saberes y conocimientos indispensables para el control, la prevención y el tratamiento de esas entidades mórbidas.


Asunto(s)
Humanos , Enfermería , Personal de Salud , Enfermedades Desatendidas/enfermería , Esquistosomiasis , Tuberculosis , Investigación Metodológica en Enfermería , Leishmaniasis , Enfermedad de Chagas , Dengue , Lepra , Malaria
12.
Semin Immunol ; 39: 22-29, 2018 10.
Artículo en Inglés | MEDLINE | ID: mdl-30366662

RESUMEN

Lipopolysaccharide (LPS) is a well-defined agonist of Toll-like receptor (TLR) 4 that activates innate immune responses and influences the development of the adaptive response during infection with Gram-negative bacteria. Many years ago, Dr. Edgar Ribi separated the adjuvant activity of LPS from its toxic effects, an effort that led to the development of monophosphoryl lipid A (MPL). MPL, derived from Salmonella minnesota R595, has progressed through clinical development and is now used in various product-enabling formulations to support the generation of antigen-specific responses in several commercial and preclinical vaccines. We have generated several synthetic lipid A molecules, foremost glucopyranosyl lipid adjuvant (GLA) and second-generation lipid adjuvant (SLA), and have advanced these to clinical trial for various indications. In this review we summarize the potential and current positioning of TLR4-based adjuvant formulations in approved and emerging vaccines.


Asunto(s)
Adyuvantes Inmunológicos/farmacología , Compuestos de Alumbre/farmacología , Glucósidos/farmacología , Inmunogenicidad Vacunal , Lípido A/análogos & derivados , Tuberculosis/prevención & control , Adyuvantes Inmunológicos/química , Compuestos de Alumbre/química , Animales , Glucósidos/química , Infecciones por VIH/inmunología , Infecciones por VIH/prevención & control , Infecciones por VIH/virología , Humanos , Inmunidad Celular/efectos de los fármacos , Inmunidad Humoral/efectos de los fármacos , Leishmaniasis/inmunología , Leishmaniasis/parasitología , Leishmaniasis/prevención & control , Lepra/inmunología , Lepra/parasitología , Lepra/prevención & control , Lípido A/química , Lípido A/farmacología , Liposomas/administración & dosificación , Liposomas/química , Liposomas/inmunología , Malaria/inmunología , Malaria/parasitología , Malaria/prevención & control , Ratones , Esquistosomiasis/inmunología , Esquistosomiasis/parasitología , Esquistosomiasis/prevención & control , Linfocitos T Colaboradores-Inductores/efectos de los fármacos , Linfocitos T Colaboradores-Inductores/inmunología , Linfocitos T Colaboradores-Inductores/microbiología , Receptor Toll-Like 4/agonistas , Receptor Toll-Like 4/genética , Receptor Toll-Like 4/inmunología , Tuberculosis/inmunología , Tuberculosis/microbiología , Vacunas/administración & dosificación , Vacunas/química , Vacunas/inmunología
13.
Acta Trop ; 170: 16-42, 2017 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-28232069

RESUMEN

The study of neglected diseases has not received much attention, especially from public and private institutions over the last years, in terms of strong support for developing treatment for these diseases. Support in the form of substantial amounts of private and public investment is greatly needed in this area. Due to the lack of novel drugs for these diseases, nanobiotechnology has appeared as an important new breakthrough for the treatment of neglected diseases. Recently, very few reviews focusing on filiarasis, leishmaniasis, leprosy, malaria, onchocerciasis, schistosomiasis, trypanosomiasis, and tuberculosis, and dengue virus have been published. New developments in nanocarriers have made promising advances in the treatment of several kinds of diseases with less toxicity, high efficacy and improved bioavailability of drugs with extended release and fewer applications. This review deals with the current status of nanobiotechnology in the treatment of neglected diseases and highlights how it provides key tools for exploring new perspectives in the treatment of a wide range of diseases.


Asunto(s)
Portadores de Fármacos/uso terapéutico , Nanopartículas/uso terapéutico , Enfermedades Desatendidas/tratamiento farmacológico , Medicina Tropical , Portadores de Fármacos/administración & dosificación , Portadores de Fármacos/efectos adversos , Portadores de Fármacos/farmacocinética , Humanos , Leishmaniasis/tratamiento farmacológico , Lepra/tratamiento farmacológico , Liposomas/farmacocinética , Liposomas/uso terapéutico , Malaria/tratamiento farmacológico , Nanopartículas/administración & dosificación , Nanopartículas/efectos adversos , Oncocercosis/tratamiento farmacológico , Esquistosomiasis/tratamiento farmacológico , Tripanosomiasis/tratamiento farmacológico , Tuberculosis/tratamiento farmacológico
14.
Washington, D.C; OPS; 2016-11.
en Español | PAHO-IRIS | ID: phr-31399

RESUMEN

[Prologo]. Este informe revela que varios países de las Américas han eliminado con éxito la transmisión de varias EID en todos sus territorios o parte de ellos, lo que muestra qué debe y puede lograr cada país de la Región donde las enfermedades infecciosas desatendidas son endémicas. Sin embargo, para que las Américas puedan alcanzar las metas regionales y mundiales de eliminar más de una docena de EID, cada país donde exista esa endemicidad debe efectuar ahora un esfuerzo concertado a fin de conseguir que enérgicas medidas de salud pública lleguen a quienes más las necesiten. Es preciso adoptar medidas para tratar a todos los niños en riesgo de contraer infecciones helmintiásicas transmitidas por el contacto con el suelo; proteger a cada niño y madre embarazada de las picaduras de mosquitos que transmiten la malaria y de otros insectos que transmiten la enfermedad de Chagas y la leishmaniasis; tratar eficiente y oportunamente a los niños pequeños y sus familiares con medicamentos de gran calidad y seguros contra las enfermedades infecciosas desatendidas; y garantizar que todas las personas que lleguen a un hospital con leishmaniasis, esquistosomiasis, fascioliasis o tracoma causante de ceguera reciban una atención adecuada para que abandonen el hospital curadas y con buena salud y sus familias puedan seguir fácilmente su progreso con el apoyo de unidades locales de atención de salud.


Asunto(s)
Enfermedades Transmisibles , Enfermedades Desatendidas , Enfermedad de Chagas , Esquistosomiasis , Filariasis Linfática , Lepra , Malaria , Oncocercosis , Tracoma , Determinantes Sociales de la Salud
15.
Washington, D.C; PAHO; 2016-09.
en Inglés | PAHO-IRIS | ID: phr-31250

RESUMEN

Neglected infectious diseases (NID), which include Chagas disease, fascioliasis, soil-transmitted helminthiases, leprosy, leishmaniasis, lymphatic filariasis, onchocerciasis, plague, human rabies transmitted by dogs, schistosomiasis, congenital syphilis, neonatal tetanus and trachoma, affect the poorest of the poor. These diseases impose a nearly indescribable set of burdens on communities and individuals, not only because of the pain and suffering they cause, but also because of the loss of income and the chronic stigma and discrimination associated with their sequelaes, irreversible in many cases. These can include blindness, chronic anemia, tissue loss and physical disfigurement, and permanent disability leading affected families to an even more challenging and limited quality of life-style...


Asunto(s)
Enfermedades Transmisibles , Enfermedades Desatendidas , Enfermedad de Chagas , Esquistosomiasis , Filariasis Linfática , Malaria , Lepra , Oncocercosis
16.
Bull Hist Med ; 89(2): 293-321, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-26095967

RESUMEN

This article explores the medical conceptualization of the causes of diseases in nineteenth-century Colombia. It traces the history of some of the pathologies that were of major concern among nineteenth-century doctors: periodic fevers (yellow fever and malaria), continuous fevers (typhoid fever), and leprosy (Greek elephantiasis). By comparing the transforming conceptualizations of these diseases, this article shows that their changing pattern, the idea of climatic determinism of diseases (neo-Hippocratism and medical geography), the weak standing of the medical community in Colombian society, as well as Pasteurian germ practices were all crucial in the uneven and varied reshaping of their understanding.


Asunto(s)
Causalidad , Geografía Médica/historia , Microbiología/historia , Colombia , Historia del Siglo XIX , Humanos , Lepra/historia , Malaria/historia , Fiebre Tifoidea/historia , Fiebre Amarilla/historia
17.
Trans R Soc Trop Med Hyg ; 109(6): 408-15, 2015 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-25918216

RESUMEN

BACKGROUND: We assessed the feasibility and results of active case detection (ACD) of visceral leishmaniasis (VL), post kala-azar dermal leishmaniasis (PKDL) and other febrile diseases as well as of bednet impregnation for vector control. METHODS: Fever camps were organized and analyzed in twelve VL endemic villages in Bangladesh, India, and Nepal. VL, PKDL, tuberculosis, malaria and leprosy were screened among the febrile patients attending the camps, and existing bednets were impregnated with a slow release insecticide. RESULTS: Among the camp attendees one new VL case and two PKDL cases were detected in Bangladesh and one VL case in Nepal. Among suspected tuberculosis cases two were positive in India but none in the other countries. In India, two leprosy cases were found. No malaria cases were detected. Bednet impregnation coverage during fever camps was more than 80% in the three countries. Bednet impregnation led to a reduction of sandfly densities after 2 weeks by 86% and 32%, and after 4 weeks by 95% and 12% in India and Nepal respectively. The additional costs for the control programmes seem to be reasonable. CONCLUSION: It is feasible to combine ACD camps for VL and PKDL along with other febrile diseases, and vector control with bednet impregnation.


Asunto(s)
Erradicación de la Enfermedad/organización & administración , Enfermedades Endémicas/prevención & control , Fiebre/prevención & control , Mosquiteros Tratados con Insecticida/estadística & datos numéricos , Leishmaniasis Cutánea/prevención & control , Leishmaniasis Visceral/prevención & control , Lepra/prevención & control , Malaria/prevención & control , Tuberculosis/prevención & control , Animales , Bangladesh/epidemiología , Estudios de Factibilidad , Fiebre/epidemiología , Humanos , India/epidemiología , Control de Insectos , Insecticidas , Leishmaniasis Cutánea/epidemiología , Leishmaniasis Visceral/epidemiología , Lepra/epidemiología , Malaria/epidemiología , Nepal/epidemiología , Prevalencia , Desarrollo de Programa , Psychodidae , Tuberculosis/epidemiología
18.
Sensors (Basel) ; 15(3): 6947-95, 2015 Mar 23.
Artículo en Inglés | MEDLINE | ID: mdl-25806872

RESUMEN

This paper reviews a number of biomedical engineering approaches to help aid in the detection and treatment of tropical diseases such as dengue, malaria, cholera, schistosomiasis, lymphatic filariasis, ebola, leprosy, leishmaniasis, and American trypanosomiasis (Chagas). Many different forms of non-invasive approaches such as ultrasound, echocardiography and electrocardiography, bioelectrical impedance, optical detection, simplified and rapid serological tests such as lab-on-chip and micro-/nano-fluidic platforms and medical support systems such as artificial intelligence clinical support systems are discussed. The paper also reviewed the novel clinical diagnosis and management systems using artificial intelligence and bioelectrical impedance techniques for dengue clinical applications.


Asunto(s)
Ingeniería Biomédica/instrumentación , Impedancia Eléctrica , Técnicas Analíticas Microfluídicas/instrumentación , Medicina Tropical/instrumentación , Enfermedad de Chagas/diagnóstico , Enfermedad de Chagas/patología , Fiebre Hemorrágica Ebola/diagnóstico , Fiebre Hemorrágica Ebola/patología , Humanos , Leishmaniasis/diagnóstico , Leishmaniasis/patología , Lepra/diagnóstico , Lepra/patología , Malaria/diagnóstico , Malaria/patología , Esquistosomiasis/diagnóstico , Esquistosomiasis/patología
20.
Recurso Educacional Abierto en Portugués | CVSP - Brasil | ID: una-1841

RESUMEN

Curso da atenção domiciliar que apresenta as principais situações clínicas comuns em adultos, descrevendo o manejo dos pacientes na atenção domiciliar e reforçando o papel do cuidador como parte fundamental da equipe de cuidado. São apresentadas as seguintes situações clínicas: asma, doença pulmonar obstrutiva crônica, pneumonia, coronariopatia, doença vascular periférica, insuficiência cardíaca, hanseníase, SIDA, malária, tuberculose, infecção do trato urinário, osteomielite, pós-operatório em ortopedia, transtornos psiquiátricos, abordagem ao usuário de álcool e outras drogas, esclerose múltipla e esclerose lateral amiotrófica. Em cada uma das situações são tratados os aspectos conceituais, o diagnóstico, o manejo na atenção domiciliar, as orientações que devem ser fornecidas ao cuidador, o plano de alta na atenção domiciliar e quando referenciar para outros serviços.


Asunto(s)
Atención Domiciliaria de Salud , Enfermedades Respiratorias , Enfermedades Cardiovasculares , Malaria , Lepra , Tuberculosis , Osteomielitis , Alcoholismo , Esclerosis Múltiple , Esclerosis Amiotrófica Lateral , Atención a la Salud , Atención a la Salud
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