Did the COVID-19 quarantine policies applied in Cochabamba, Bolivia mitigated cases successfully? an interrupted time series analysis.

BACKGROUND: The COVID-19 pandemic prompted varied policy responses globally, with Latin America facing unique challenges. A detailed examination of these policies' impacts on health systems is crucial, particularly in Bolivia, where information about policy implementation and outcomes is limited. OBJECTIVE: To describe the COVID-19 testing trends and evaluate the effects of quarantine measures on these trends in Cochabamba, Bolivia. METHODS: Utilizing COVID-19 testing data from the Cochabamba Department Health Service for the 2020-2022 period. Stratified testing rates in the health system sectors were first estimated followed by an interrupted time series analysis using a quasi-Poisson regression model for assessing the quarantine effects on the mitigation of cases during surge periods. RESULTS: The public sector reported the larger percentage of tests (65%), followed by the private sector (23%) with almost double as many tests as the public-social security sector (11%). In the time series analysis, a correlation between the implementation of quarantine policies and a decrease in the slope of positive rates of COVID-19 cases was observed compared to periods without or with reduced quarantine policies. CONCLUSION: This research underscores the local health system disparities and the effectiveness of stringent quarantine measures in curbing COVID-19 transmission in the Cochabamba region. The findings stress the importance of the measures' intensity and duration, providing valuable lessons for Bolivia and beyond. As the global community learns from the pandemic, these insights are critical for shaping resilient and effective health policy responses.

Main findings: The findings highlight the importance of stringent quarantine measures in managing infectious disease outbreaks, offering valuable insights for policymakers worldwide in strategizing effective public health interventions.Added knowledge: By providing a detailed analysis of testing disparities and quarantine policies' effectiveness within a specific Latin American context, our research fills a critical gap in understanding their impacts on health system responses and disease control.Global health impact for policy and action: The findings highlight the importance of stringent quarantine measures in managing infectious disease outbreaks, offering valuable insights for policymakers worldwide in strategizing effective public health interventions.

Assessment of the foot-and-mouth disease surveillance system in Brazil.

In 2021, the 88th General Session of the World Assembly of National Delegates to the World Organisation for Animal Health (OIE) recognized the estates of Acre, Paraná, the Rio Grande do Sul, and Rondônia as being free of foot-and-mouth disease (FMD) without vaccination. The certification was also extended to some cities in Amazonas and Mato Grosso. The new national strategic plan for 2026, which focuses on creating and maintaining sustainable conditions to expand FMD-free zones without vaccination, imposes new challenges and requires continuous evaluation of the FMD surveillance system. The objective of this research was to evaluate the FMD surveillance system in Brazil using quantitative models through Bayesian network approaches. The research was conducted using the Continental Surveillance and Information System (SivCont) database for Official Veterinary Services in Brazil, which refers to notified vesicular syndromes. The data on states, reported diseases, source of notification, disease confirmation, and timeliness (TL in days) of the delay by owners in notifying (TL.1) after a suspected case of the disease, and the response of Brazilian Veterinary Services after being notified (TL.2), were analysed. The collected data were analysed using Bayesian networks. It was observed that diseases with symptoms identical to FMD are the most notified events. TL.1 was long (mean of 18.96, CI: 18.33-19.59), and a low number of notifications was observed throughout the study period, which increases the chances of disseminating FMD in the population. Meanwhile, TL.2 suggests appropriate effectiveness of the Veterinary Services responding to suspected cases of FMD with interventions in less than 24 h (mean of 1, CI: 0.68-1.31). This study evaluated the performance of Brazilian Veterinary Services facing the report of vesicular diseases in the period 2004-2018. The results can help the states improve the surveillance system and the transition to the vaccination stop. Furthermore, the analytical method presented in the paper could serve as a model for other countries to evaluate the effectiveness of FMD surveillance systems.

First molecular evidence of Mycoplasma haemocanis and 'Candidatus Mycoplasma haematoparvum' infections and its association with epidemiological factors in dogs from Cuba.

Haemotrophic mycoplasmas (haemoplasmas) are unculturable, epicellular, cell wall-less gram-negative bacteria distributed worldwide, which infect several mammalian species. In dogs, Mycoplasma haemocanis and 'Candidatus Mycoplasma haematoparvum' have been reported as causative agents of infectious anaemia, especially in splenectomised or immunocompromised animals. The present cross-sectional study aims to assess the prevalence, risk factors, and molecular characterization of canine haemoplasmas in Cuba. A total of 391 dog blood samples and 247 tick samples were tested for the presence of canine haemoplasmas by species-specific quantitative TaqMan® real-time PCR assays. Overall, 17.9% (70/391; 95% CI: 14.1-21.7) blood samples were PCR-positive for at least one canine haemoplasmas species, where 15.1% (59/391; 95% CI: 11.5-18.7) for Mycoplasma haemocanis, 4.4% (17/391; 95% CI: 2.3-6.4) for 'Candidatus Mycoplasma haematoparvum', and 1.5% (6/391; 95% CI: 0.3-2.8) were co-infected. All collected ticks were identified morphologically as Rhipicephalus sanguineus sensu lato, and none of the tested tick samples was found PCR-positive for the presence of Mycoplasma haemocanis and 'Candidatus Mycoplasma haematoparvum'. Risk factors for canine haemoplasmas species infection included the presence of tick infestation, crossbreeding and living in kennels, while no association was found with the occurrence of anaemia. Phylogenetic analyses based on the 16S rRNA gene sequences of Mycoplasma haemocanis and 'Candidatus Mycoplasma haematoparvum' revealed >99% identity to other isolates distributed worldwide, indicating low genetic variability amongst these canine haemoplasmas species. To the best of the authors´ knowledge, this is the first molecular evidence of Mycoplasma haemocanis and 'Candidatus Mycoplasma haematoparvum' infections in dogs from Cuba.

"The devil is in the detail": geographical inequalities of femicides in Ecuador.

BACKGROUND: Femicide is a very important public health problem in Ecuador. Since regional and country-level femicide rates can obscure significant variations at the sub-national level, it is important to provide information at the lowest relevant level of disaggregation to be able to develop targeted preventive policies. The aim of this study was to assess the spatial distribution of the femicide rate and to examine its spatial clustering at the canton level in Ecuador in the period 2018-2019. METHODS: Data on cases were collected by a national network of non-governmental organizations. Two age-disaggregated analyses were done, one for the 15 to 24 years-olds and the other for the female population of 15 and older. Age-specific population data were obtained from the National Institute of Statistics for the study period. Standardized mortality ratios for mapping the mortality were calculated using hierarchical Bayesian models and spatial scan statistics were applied to identify local clusters. Thematic maps of age-specific femicide rates were also constructed. RESULTS: During the two-year period, 61 and 183 women were killed in the age ranges 15-24 and 15 years and older, respectively. The annual rate of femicides in Ecuador was 1.0 and 0.8 per 100,000 in the female population aged 15-24 and 15+, respectively, with substantial variations among cantons. The spatial analysis contributed to visualize high risk cantons, which were mainly located in a small area in the central part of the country (for those 15+) but especially in the Amazon region, for both of the studied age groups. CONCLUSIONS: This study has shown the usefulness of applying spatial analysis to the problem of femicides in Ecuador. The study has revealed important variations among cantons but also a spatial clustering, mainly in the Amazon region of the country. The results should help policymakers to focus on current prevention programmes for violence against women into these high-risk areas. Continuous monitoring of femicides at low-level geographical areas is highly recommended.

Molecular detection and characterization of Hepatozoon canis in stray dogs from Cuba.

Canine hepatozoonosis caused by Hepatozoon canis is a worldwide distributed tick-borne disease of domestic and wild canids that is transmitted by ingestion of Rhipicephalus sanguineus sensu lato (s.l.) ticks. The present study was aimed to determine the prevalence of Hepatozoon infections in 80 stray dogs from Havana Province in Cuba, and to confirm the species identity and phylogenetic relationships of the causative agent. Samples were screened by microscopical examination of thin blood smears for the presence of Hepatozoon spp. gamonts and by genus-specific SYBR green-based real-time PCR assay targeting the 18S rRNA gene. Direct microscopy examination revealed Hepatozoon gamonts in the peripheral blood of 8 dogs (10.0%; 95% CI: 4.80-18.0%), while 38 animals (47.5%; 95% CI: 36.8-58.4%) were PCR-positive, including all microscopically positive dogs. Hence, the agreement between the two detection methods was 'poor' (κ = 0.20). Hematological parameters did not differ significantly between PCR-positive and PCR-negative dogs (p > 0.05). The DNA sequences of the 18S rRNA gene of the Hepatozoon spp. from Cuban dogs showed a nucleotide identity >99% with those of 18S rRNA sequences of Hepatozoon canis isolates from Czech Republic, Brazil and Spain. Phylogenetic analysis revealed that obtained sequences clustered within the Hepatozoon canis clade, different from the Hepatozoon felis or Hepatozoon americanum clades. The present study represents the first molecular characterization of Hepatozoon canis in stray dogs within Cuba.

Molecular Diagnosis, Prevalence and Importance of Zoonotic Vector-Borne Pathogens in Cuban Shelter Dogs-A Preliminary Study.

The present study aimed to determine the prevalence of zoonotic vector-borne pathogens, including Anaplasma platys, Anaplasma phagocytophilum, Borrelia burgdorferi sensu lato, Ehrlichia canis and Rickettsia spp. in shelter dogs from Cuba. Blood samples were collected from 100 shelter dogs and examined by molecular methods. Overall, 85 (85%; 95% CI: 77.88-92.12) dogs tested positive for at least one vector-borne pathogen using species-specific qPCR assays. Among the positive samples, E. canis was the most prevalent 62% (95% CI: 52.32-71.68), followed by A. platys 40% (95% CI: 30.23-49.77) and Rickettsia felis 27% (95% CI: 18.15-35.85), whereas 36% (95% CI: 26.43-45.57) showed co-infections. All samples were negative for A. phagocytophilum and B. burgdorferi s.l. The presence of 248 Rhipicephalus sanguineus ticks collected from the dogs was not statistically associated with the occurrence of infections. Thrombocytopenia was the most frequent haematological alteration found in PCR-positive dogs; it was statistically associated with the presence of E. canis, as well as co-infections (p < 0.05). The phylogenetic analyses of A. platys and E. canis based on 16S rRNA, groEL and gltA genes showed a low genetic diversity between Cuban strains. The present study demonstrates the high prevalence of vector-borne pathogens with zoonotic potential in shelter dogs from Cuba.

Seroprevalence and risk factors of bovine leptospirosis in the province of Manabí, Ecuador.

Leptospirosis is a zoonotic disease with worldwide distribution. The disease affects dairy and beef cattle, causing infertility, abortion, and reduced milk yield. A cross-sectional study was conducted to determine the seroprevalence of leptospirosis in cattle and the associated risk factors in the province of Manabí, Ecuador. Serum samples from 749 animals from 55 cattle herds were analyzed using the microscopic agglutination test (MAT). Animals were considered positive when titers were ≥ 1:100. The association between the potential risk factors and the positive Leptospira result was modeled at both animal and herd level using a generalized linear model with a binomial distribution and logarithmic link. The seroprevalence was 56.21% at the individual level and 98.18% at the herd level. The most prevalent serovars were Pomona (28.57%) and Icterohaemorragiae (22.30%). At the animal level, only the age was associated with leptospirosis seropositivity. Seroprevalence in animals over three years of age was 1.197 (95% confidence intervals (CI), 1.032 - 1.390), higher compared to animals up to three years old. The seroprevalence of Leptospira spp. was higher in farms with no veterinary assistance (PR = 1.209; 95%CI 1.053 - 1.388) and without a vaccination program against Leptospira (PR = 1.399; 95%CI 1.09 - 1.794). In addition, herds from Junín canton had a significantly higher seroprevalence of Leptospira spp (PR = 1.548; 95%CI 1.213 - 1.977) compared to the Bolívar canton, which had the lowest seroprevalence. In conclusion, more than half of the animals were positive to Leptospiraspp, and almost all herds had at least one positive animal. Furthermore, veterinary assistance and vaccination of cattle must be considered as essential aspects of the disease control program.

Classical Swine Fever in a Cuban Zone Intended for Eradication: Spatiotemporal Clustering and Risk Factors.

Classical Swine Fever (CSF) is an endemic disease in Cuba, and an eradication strategy by zones is planned by the Official Veterinary Service. The aim of this study was to identify high-risk areas of CSF and the risk factors associated with the disease occurrence in the Pinar del Río province, one of the prioritized areas in the eradication strategy. The outbreak occurrence at district level was analyzed through a 7-year period (2009 to 2015). A high-risk cluster (RR = 5.13, 95% CI 3.49-7.56) was detected during the last 2 years of the study period in the eastern half of the province, with 38 out of 97 districts included. The rate of CSF-affected holdings had a significant increase during 2014-2015 and seems to have occurred mainly in the high-risk cluster area. Swine population density by district (heads/km2) and road length (km) by district were associated with the disease outbreak occurrence. These results provide new insights into the knowledge of the epidemiology of the disease in Cuban endemic conditions and can contribute to improving the control and the eradication strategy in this situation.

Development and application of a multiplex TaqMan® real-time qPCR assay for the simultaneous detection of Anaplasma marginale and Theileria annulata and molecular characterization of Anaplasma marginale from cattle in Western Cuba.

Anaplasmosis and theileriosis are considered the most important tick-borne diseases for livestock production worldwide, causing significant economic losses in tropical and subtropical regions. The present study was aimed to develop a multiplex TaqMan® qPCR assay to simultaneously detect Anaplasma marginale and Theileria annulata and to applied it to investigate naturally infected cattle in Cuba. The assay was highly specific, sensible, and efficient; it was more sensitive than a well-established nested PCR and detected 1 DNA copy of each target. Consistent repeatability and reproducibility within and between multiplex qPCR runs was shown. A total of 223 blood samples collected in western Cuba were analyzed for haemoparasites infection in cattle. The multiplex qPCR assay detected A. marginale in 213 samples (95.5%; CI: 95%; 91.9%-97.5%), but all samples were negative for T. annulata. Additionally, the genetic diversity of A. marginale was assessed using 16S rRNA, MSP1a and MSP4 nucleotide and protein sequences. The MSP1a tandem repeats ranged from three to five, and twelve different MSP1a tandem repeats of A. marginale were found, which presented genotypes C, E, and G in the 5'UTR microsatellite region. Phylogenetic analysis using the msp4 gene showed that Cuban strains were closely related to others previously reported in Mexico, Brazil and Asian countries. The multiplex qPCR described here proved to be a rapid, specific and cost-effective mean for the simultaneous detection of A. marginale and T. annulata. Further epidemiological studies using this assay will improve the surveillance of the associated diseases in regions where they are endemic.

Positive selection pressure on E2 protein of classical swine fever virus drives variations in virulence, pathogenesis and antigenicity: Implication for epidemiological surveillance in endemic areas.

Classical swine fever (CSF), caused by CSF virus (CSFV), is considered one of the most important infectious diseases with devasting consequences for the pig industry. Recent reports describe the emergence of new CSFV strains resulting from the action of positive selection pressure, due mainly to the bottleneck effect generated by ineffective vaccination. Even though a decrease in the genetic diversity of the positively selected CSFV strains has been observed by several research groups, there is little information about the effect of this selective force on the virulence degree, antigenicity and pathogenicity of this type of strains. Hence, the aim of the current study was to determine the effect of the positive selection pressure on these three parameters of CSFV strains, emerged as result of the bottleneck effects induced by improper vaccination in a CSF-endemic area. Moreover, the effect of the positively selected strains on the epidemiological surveillance system was assessed. By the combination of in vitro, in vivo and immunoinformatic approaches, we revealed that the action of the positive selection pressure induces a decrease in virulence and alteration in pathogenicity and antigenicity. However, we also noted that the evolutionary process of CSFV, especially in segregated microenvironments, could contribute to the gain-fitness event, restoring the highly virulent pattern of the circulating strains. Besides, we denoted that the presence of low virulent strains selected by bottleneck effect after inefficient vaccination can lead to a relevant challenge for the epidemiological surveillance of CSF, contributing to under-reports of the disease, favouring the perpetuation of the virus in the field. In this study, B-cell and CTL epitopes on the E2 3D-structure model were also identified. Thus, the current study provides novel and significant insights into variation in virulence, pathogenesis and antigenicity experienced by CSFV strains after the positive selection pressure effect.

Spatiotemporal Analysis of Glanders in Brazil.

In Brazil, glanders remains a serious problem, with the obligatory sacrifice of disease-positive animals without compensation. Each year, glanders cases are reported in several regions of the country, causing severe economic losses and trade restrictions. The present study describes and discusses the occurrence of glanders foci in Brazil during a 12-year period from 2005 to 2016. The highest frequency of reported affected holdings during the study period was in the northeast region. Moreover, during this period, the disease incidence in Brazil showed an overall increasing tendency. The number of affected holdings significantly increased during the last four years of the period, and more cases were noted during the months of May and June. Spatiotemporally, there are four high-risk glanders clusters: (1) cluster A (relative risk [RR = 6.51, P < .0001) involved the northeast region from March 2008 to February 2014; (2) cluster B (RR = 17.37, P < .0001) involved a southeast region state from March 2013 to June 2015; (3) cluster C (RR = 6.92, P < .0001) involved the states in the midwest, southeast, and south regions of Brazil from March 2015 to May 2016; and (4) cluster D (RR = 19.07, P < .0001) involved a north region state from October 2015 to April 2016. Only two states of the north region (Acre and Amapá) did not experience glanders during the study period.