Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 2.715
Filter
1.
PLoS Negl Trop Dis ; 15(3): e0009130, 2021 Mar.
Article in English | MEDLINE | ID: mdl-33661891

ABSTRACT

BACKGROUND: Rabies is a viral zoonosis that imposes a substantial disease and economic burden in many developing countries. Dogs are the primary source of rabies transmission; eliminating dog rabies reduces the risk of exposure in humans significantly. Through mass annual dog rabies vaccination campaigns, the national program of rabies control in Mexico progressively reduced rabies cases in dogs and humans since 1990. In 2019, the World Health Organization validated Mexico for eliminating rabies as a public health problem. Using a governmental perspective, we retrospectively assessed the economic costs, effectiveness, and cost-effectiveness of the national program of rabies control in Mexico, 1990-2015. METHODOLOGY: Combining various data sources, including administrative records, national statistics, and scientific literature, we retrospectively compared the current scenario of annual dog vaccination campaigns and post-exposure prophylaxis (PEP) with a counterfactual scenario without an annual dog vaccination campaign but including PEP. The counterfactual scenario was estimated using a mathematical model of dog rabies transmission (RabiesEcon). We performed a thorough sensitivity analysis of the main results. PRINCIPAL FINDINGS: Results suggest that in 1990 through 2015, the national dog rabies vaccination program in Mexico prevented about 13,000 human rabies deaths, at an incremental cost (MXN 2015) of $4,700 million (USD 300 million). We estimated an average cost of $360,000 (USD 23,000) per human rabies death averted, $6,500 (USD 410) per additional year-of-life, and $3,000 (USD 190) per dog rabies death averted. Results were robust to several counterfactual scenarios, including high and low rabies transmission scenarios and various assumptions about potential costs without mass dog rabies vaccination campaigns. CONCLUSIONS: Annual dog rabies vaccination campaigns have eliminated the transmission of dog-to-dog rabies and dog-mediated human rabies deaths in Mexico. According to World Health Organization standards, our results show that the national program of rabies control in Mexico has been highly cost-effective.

2.
Int J Infect Dis ; 105: 261-266, 2021 Feb 13.
Article in English | MEDLINE | ID: mdl-33592342

ABSTRACT

BACKGROUND: Evidence suggests that biological mechanisms involved in helminth infections and vitamin deficiencies increase susceptibility to other infections. The aim of this study was to investigate the associations of helminth co-infection and select micronutrient deficiencies with leprosy using a case-control design. METHODS: From 2016 to 2018, individuals aged ≥3 years were recruited at clinics in and around Governador Valadares, Minas Gerais, Brazil in three groups: cases of leprosy, household contacts and community-matched (non-contact) controls. Helminths were diagnosed through stool Kato Katz examination and serum reactivity to anti-soluble adult worm antigen preparation IgG4. Serum ferritin, 25-OH vitamin D and retinol concentrations were measured. Multi-variate logistic regression was conducted to identify associations with active leprosy. RESULTS: Seventy-nine cases of leprosy, 96 household contacts and 81 non-contact controls were recruited; 48.1% of participants were male with a median age of 40 years. Helminths were found in 7.1% of participants on Kato Katz test, all but one of which were Schistosoma mansoni, and 32.3% of participants were positive for S. mansoni serology. On multi-variate analysis, cases were more likely to be infected with helminths (diagnosed by stool) than household contacts [adjusted odds ratio (aOR) 8.69, 95% confidence interval (CI) 1.50-50.51]. Vitamin D deficiency was common, and was more likely in cases compared with non-contact controls (aOR 4.66, 95% CI 1.42,-15.33). Iron deficiency was not associated with leprosy, and vitamin A deficiency was not detected. CONCLUSION: These associations suggest that the immune consequences of schistosomiasis and vitamin D deficiency may increase the risk of active leprosy. Comorbid conditions of poverty deserve further study as addressing co-infections and nutritional deficiencies could be incorporated into programmes to improve leprosy control.

3.
Sci Total Environ ; 770: 145225, 2021 May 20.
Article in English | MEDLINE | ID: mdl-33513511

ABSTRACT

AIM: COVID-19 pandemic has posed an unprecedented pressure on health systems and economies worldwide. Delivery services have grown as an alternative source of revenue for many people. Consumers generally perceive that delivery services are safer than going into a restaurant, because they reduce exposure to other people and their risk of SARS-CoV-2 contagion. There are no studies analyzing viral load or the burden of COID-19 within this population. This study aims to describe the presence of SARS-CoV-2 among food delivery riders in the city of Quito, Ecuador. STUDY DESIGN: From July and August 2020, bike and motorbike riders self-employed in two of the main online delivery services in Quito, Ecuador, were invited for RT-PCR testing for SARS-CoV-2 detection during the compulsory lockdown due to the COVID-19 pandemic. The Center for Disease Control (CDC) 2019-Novel Coronavirus (2019-nCoV) RT-qPCR Diagnostic Panel was used to identify the presence of SARS-CoV-2 in nasopharyngeal swabs. All samples were processed in the BSL2 certified molecular biology laboratory at Universidad de Las Americas. RESULTS: A total of 22 out of 145 delivery workers (15.2%) tested positive for SARS-CoV-2. The majority of workers were men (n = 138), the average age of male workers was 32 years-old (±7.3) and 38 years-old (± 10.6) for females. The presence of mild symptoms was reported in only 9 subjects (6%). The calculated viral load was higher among males with 1.31E+08 copies/mL vs 2.30E+06 in females, although this difference was not statistically significant (p value: 0.68, [CI: -53 to -79]). CONCLUSIONS: The self-employed food delivery riders have a high incidence rate of SARS-CoV-2 infection in relation to the national average. It is important to point out that this is the first study of its kind in Latin-American and probably one of the very few in the world. The results emphasize the need for policy makers to look at the pandemic from as many population's sub-groups as possible. Delivery riders are a highly moving population that offer their services to a wide range of clients, including vulnerable populations such as the elderly or those less likely to leave their house for basic needs stoking.


Subject(s)
Adult , Aged , Communicable Disease Control , Ecuador/epidemiology , Female , Humans , Male , Pandemics , Prevalence
4.
Article in English | PAHO-IRIS | ID: phr-53141

ABSTRACT

[Extract]. Antimicrobial resistance (AMR) is one of the greatest global threats to human health. It is estimated that by 2050, AMR will lead to approximately 10 million annual deaths worldwide. Considering the impact of AMR on reproductive capacity and food production, in addition to its direct effect on infected people, the world's population could drop by between 11 and 444 million inhabitants by 2050 if AMR control is not achieved. As migrations and shared economies lead to the transmission of resistant bacteria across borders, the impacts of AMR become regionally significant. In the United States, methicillin-resistant Staphylococcus aureus caused 10 600 deaths in 2017. In Latin American and Caribbean countries, information is available from studies conducted in hospitals and other health facilities on the prevalence of antimicrobial-resistant pathogens. In many hospitals in Mexico, Peru, and Colombia, for example, resistance to third-generation cephalosporins and fluoroquinolones in Escherichia coli isolates is reaching almost 60%. Moreover, the dynamics of colonization and infection of multidrug-resistant organisms (such as carbapenemaseproducing Klebsiella pneumoniae) are unique in endemic areas of Latin America, favoring spread and dissemination. [...]


Subject(s)
Drug Resistance, Microbial , Drug Resistance , Evidence-Based Medicine , Evidence-Informed Policy , Escherichia coli , Klebsiella pneumoniae
5.
Vet Parasitol ; 287: 109258, 2020 Sep 30.
Article in English | MEDLINE | ID: mdl-33075729

ABSTRACT

Cystic echinococcosis (CE) is a parasitic zoonosis, caused by the larval stage of Echinococcus granulosus. This disease has a worldwide distribution and is considered an important zoonosis in Chile, especially in regions where raising livestock dominates. We aimed to describe the spatial distribution and risk factors for CE in cattle and sheep slaughtered in the Aysén Region, Chile between 2015 and 2016, to inform disease control in this hyper-endemic region. Clustering and hotspot analyses of CE at the farm-level were performed (Moran's global index, local indicator of spatial autocorrelation (LISA), and the scan statistic Poisson model), and we used spatial interpolation to display areas with a higher risk of CE. Mixed effects logistic regression models were fit to assess the association between municipality of origin and age of animals and CE detected at slaughter, with the farm of origin included as a random effect. Overall, data from 1532 cattle farms (1078 geocoded) and 30,805 cattle were analyzed, with a 64 % and 39 % CE prevalence at the farm and animal-level, respectively. For sheep farms, data from 381 (296 geocoded) farms and 58,223 sheep were analyzed, with a 71 % and 18 % CE prevalence at the farm and animal-level, respectively. Globally, the CE prevalence in both cattle and sheep farms was not clustered. However, we found 14 cattle and 23 sheep farms with high prevalence that were locally clustered. We also detected 6 and 11 clusters in cattle and sheep farms, respectively. Risk of reported CE varied according to municipalities of origin, and the age of animals. This study confirms that the Aysén region is a hyper-endemic region for CE. It demonstrates the usefulness of the traceability of animals slaughtered for understanding the epidemiology of CE. The results suggest that in this hyper-endemic region in which there are limited financial resources available, that intervention activities - at the beginning of a control program - should be focused on farms with high prevalence and identified disease clusters.

6.
BMC Infect Dis ; 20(1): 778, 2020 Oct 20.
Article in English | MEDLINE | ID: mdl-33081712

ABSTRACT

BACKGROUND: International organizations advocate for the elimination of dog-mediated rabies, but there is only limited guidance on interpreting surveillance data for managing elimination programmes. With the regional programme in Latin America approaching elimination of dog-mediated rabies, we aimed to develop a tool to evaluate the programme's performance and generate locally-tailored rabies control programme management guidance to overcome remaining obstacles. METHODS: We developed and validated a robust algorithm to classify progress towards rabies elimination within sub-national administrative units, which we applied to surveillance data from Brazil and Mexico. The method combines criteria that are easy to understand, including logistic regression analysis of case detection time series, assessment of rabies virus variants, and of incursion risk. Subjecting the algorithm to robustness testing, we further employed simulated data sub-sampled at differing levels of case detection to assess the algorithm's performance and sensitivity to surveillance quality. RESULTS: Our tool demonstrated clear epidemiological transitions in Mexico and Brazil: most states progressed rapidly towards elimination, but a few regressed due to incursions and control lapses. In 2015, dog-mediated rabies continued to circulate in the poorest states, with foci remaining in only 1 of 32 states in Mexico, and 2 of 27 in Brazil, posing incursion risks to the wider region. The classification tool was robust in determining epidemiological status irrespective of most levels of surveillance quality. In endemic settings, surveillance would need to detect less than 2.5% of all circulating cases to result in misclassification, whereas in settings where incursions become the main source of cases the threshold detection level for correct classification should not be less than 5%. CONCLUSION: Our tool provides guidance on how to progress effectively towards elimination targets and tailor strategies to local epidemiological situations, while revealing insights into rabies dynamics. Post-campaign assessments of dog vaccination coverage in endemic states, and enhanced surveillance to verify and maintain freedom in states threatened by incursions were identified as priorities to catalyze progress towards elimination. Our finding suggests genomic surveillance should become increasingly valuable during the endgame for discriminating circulating variants and pinpointing sources of incursions.


Subject(s)
Disease Eradication/methods , Dog Diseases/epidemiology , Dog Diseases/prevention & control , Infection Control/methods , Rabies virus/genetics , Rabies/epidemiology , Rabies/prevention & control , Algorithms , Animals , Brazil/epidemiology , Dogs , Genomics/methods , Humans , Latin America/epidemiology , Mass Vaccination , Mexico/epidemiology , Rabies/transmission , Rabies/virology , Retrospective Studies , Vaccination Coverage
7.
PLoS Negl Trop Dis ; 14(9): e0008625, 2020 09.
Article in English | MEDLINE | ID: mdl-32956390

ABSTRACT

BACKGROUND: Efforts to control soil-transmitted helminth (STH) infections have intensified over the past decade. Field-survey data on STH prevalence, infection intensity and drug efficacy is necessary to guide the implementation of control programs and should be of the best possible quality. METHODOLOGY: During four clinical trials designed to evaluate the efficacy of albendazole against STHs in Brazil, Ethiopia, Lao PDR and Tanzania, quality control (QC) was performed on the duplicate Kato-Katz thick smears and the data entry. We analyzed datasets following QC on both fecal egg counts (FECs) and data entry, and compared the prevalence of any STH infection and moderate-to-heavy intensity (MHI) infections and the drug efficacy against STH infections. RESULTS: Across the four study sites, a total of 450 out of 4,830 (9.3%) Kato-Katz thick smears were re-examined. Discrepancies in FECs varied from ~3% (hookworms) to ~6.5% (Ascaris lumbricoides and Trichuris trichiura). The difference in STH prevalence and prevalence of MHI infections using the datasets with and without QC of the FECs did not exceed 0.3%, except for hookworm infections in Tanzania, where we noted a 2.2 percentage point increase in MHI infections (pre-QC: 1.6% vs. post-QC: 3.8%). There was a 100% agreement in the classification of drug efficacy of albendazole against STH between the two datasets. In total, 201 of the 28,980 (0.65%) data entries that were made to digitize the FECs were different between both data-entry clerks. Nevertheless, the overall prevalence of STH, the prevalence of MHI infections and the classification of drug efficacy remained largely unaffected. CONCLUSION/SIGNIFICANCE: In these trials, where staff was informed that QC would take place, minimal changes in study outcomes were reported following QC on FECs or data entry. Nevertheless, imposing QC did reduce the number of errors. Therefore, application of QC together with proper training of the personnel and the availability of clear standard operating procedures is expected to support higher data quality.


Subject(s)
Albendazole/therapeutic use , Helminthiasis/drug therapy , Quality Control , Ancylostomatoidea , Animals , Ascaris , Brazil/epidemiology , Clinical Trials as Topic , Ethiopia/epidemiology , Feces/parasitology , Guidelines as Topic , Helminthiasis/epidemiology , Helminthiasis/transmission , Hookworm Infections/drug therapy , Hookworm Infections/epidemiology , Humans , Laos/epidemiology , Parasite Egg Count , Prevalence , Soil/parasitology , Tanzania/epidemiology , Trichuris
8.
Arq. bras. med. vet. zootec. (Online) ; 72(4): 1353-1362, July-Aug. 2020. tab, graf
Article in Portuguese | LILACS, VETINDEX | ID: biblio-1131515

ABSTRACT

Objetivou-se avaliar características de virulência, perfil de resistência antimicrobiana e padrão de similaridade genética de 71 cepas de Salmonella Minnesota isoladas na cadeia produtiva de frangos de corte, entre 2009 e 2010, em duas unidades de uma empresa (A e B). Os isolados foram sorotipificados e submetidos ao teste de susceptibilidade antimicrobiana pelo teste de difusão em disco. Utilizando-se PCR, foi avaliada a presença dos genes invA, lpfA, agfA e sefA e os genes de resistência aos betalactâmicos (bla TEM , bla SHV e bla CTX-M ). A relação filogenética foi determinada por RAPD-PCR. Os maiores percentuais de resistência foram para tetraciclina e sulfonamida. Foram reconhecidos oito perfis de resistência aos antimicrobianos entre as cepas isoladas na indústria A, e 11 perfis de resistência na indústria B. Do total de cepas, 100% foram positivas para o gene invA, 98,6% para o gene agfA, 49,3% para o gene lpfA e nenhuma para o gene sefA. Três cepas foram positivas para o gene bla TEM (4,2%) e 11 (15,5%) para o gene bla CTX-M . A avaliação filogenética demonstrou a presença de sete clusters com similaridade superior a 80% e três perfis distintos. Com base no dendrograma, observou-se a disseminação de um mesmo perfil em ambas as empresas.(AU)


The aim of this study was to evaluate virulence characteristics, antimicrobial resistance profile and the pattern of genetic similarity of 71 strains of Salmonella Minnesota isolated in the production chain of broilers between 2009 and 2010, into two units of a company (A and B). Isolates were serotyped and submitted to antimicrobial susceptibility by disk diffusion test. Using PCR, the presence of genes invA, lpfA, agfA and sefA and the genes conferring resistance to beta-lactam (blaTEM, blaSHV and blaCTX-M) were evaluated. The phylogenetic relationship was determined by the RAPD-PCR method. The highest percentages of resistance were to tetracycline and sulfonamide. Eight antimicrobial resistance profiles were recognized among strains isolated in industry A, and 11 resistance profiles in industry B. Of all strains of both industries, 100% were positive for the invA gene, 98.6% to agfA gene, 49.3% for lpfA gene, and no strain showed the sefA gene. Three strains were positive for the gene blaTEM (4.2%), 11 (15.5%) for the blaCTX-M gene. Phylogenetic evaluation showed the presence of seven clusters with similarity greater than 80% and three distinct profiles. Based on the dendrogram we observed the spread with similar profiles in both companies.(AU)


Subject(s)
Humans , Animals , Poultry , Salmonella , Salmonella Infections, Animal/epidemiology , Chickens , Virulence Factors , Virulence , Zoonoses/prevention & control , Polymerase Chain Reaction , Disease Susceptibility
9.
Sex., salud soc. (Rio J.) ; (35): 58-81, maio-ago. 2020.
Article in Spanish | LILACS | ID: biblio-1139643

ABSTRACT

Resumen El objetivo de este trabajo es analizar las vinculaciones entre las identidades de género y las lógicas de la organización social del cuidado, relacionadas con los riesgos ambientales-sanitarios a partir de los significados y prácticas relativas a la producción agrícola basada en plaguicidas en la pampa húmeda argentina. Realizamos dos trabajos de campo etnográficos de largo alcance y analizamos, por una parte, el proceso de identificación y denuncia de los riesgos relativos a los plaguicidas por mujeres y su relación con la construcción social de femineidades y con la organización generizada del cuidado. En segundo lugar, indagamos un posible vínculo entre la exposición a los plaguicidas y una estrategia de reafirmación de la virilidad.


Abstract This paper analyzes the connections between gender identities and the logics surrounding the social organization of care related to the environmental and health risks that stem from meanings and practices of pesticide-based agricultural production in the Argentine Pampas. After conducting two long-reach ethnographic field-work, we explore the process of women's identifying and denouncing of pesticides related risks and its relationship both with the social construction of femininities and with the gendered organization of care. Furthermore, we study a possible link between the exposure to pesticides and a strategy of reaffirmation of virility.


Resumo O objetivo deste trabalho é analisar as vinculações entre as identidades de gênero e as lógicas da organização social do cuidado, em relação com os riscos ambientais-sanitáriosa partir dos significados e práticas relativas à produção agrícola baseada em pesticidas nos pampas da Argentina. Realizamos dois trabalhos de campo etnográficos de amplo alcance e analisamos, por um lado, o processo de identificação e denúncia dos riscos relacionados coma construção social de feminilidades e com a organização generificada do cuidado. Por outro lado, indagamos sobre um vínculo possível entre a exposição aos pesticidas e uma estratégia de reafirmação da virilidade.


Subject(s)
Humans , Male , Female , Pesticides , Poisoning/prevention & control , Occupational Risks , Agricultural Workers' Diseases/prevention & control , Agriculture , Gender Identity , Argentina , Women, Working , Risk Factors , Agrochemicals , Impacts on Health , Cultural Factors , Men , Anthropology, Cultural
10.
PLoS Negl Trop Dis ; 14(6): e0008375, 2020 06.
Article in English | MEDLINE | ID: mdl-32603324

ABSTRACT

BACKGROUND: Acute gastroenteritis (AGE) is a major cause of morbidity and mortality in children aged less than 5 years in low- and middle-income countries where limited access to potable water, poor sanitation, deficient hygiene, and food product contamination are prevalent. Research on the changing etiology of AGE and associated risk factors in Latin America, including Colombia, is essential to understand the epidemiology of these infections. The primary objectives of this study were to describe etiology of moderate to severe AGE in children less than 5 years of age from Bucaramanga, Colombia, a middle-income country in Latin American, and to identify the presence of emerging E. coli pathotypes. METHODOLOGY/PRINCIPAL FINDINGS: This was a prospective, matched for age, case-control study to assess the etiology of moderate to severe AGE in children less than 5 years of age in Bucaramanga, Colombia, South America. We tested for 24 pathogens using locally available diagnostic testing, including stool culture, polymerase chain reaction, microscopy and enzyme-linked immunoassay. Adjusted attributable fractions were calculated to assess the association between AGE and each pathogen in this study population. The study included 861 participants, 431 cases and 430 controls. Enteric pathogens were detected in 71% of cases and in 54% of controls (p = <0.001). Co-infection was identified in 28% of cases and in 14% of controls (p = <0.001). The adjusted attributable fraction showed that Norovirus GII explained 14% (95% CI: 10-18%) of AGE, followed by rotavirus 9.3% (6.4-12%), adenovirus 3% (1-4%), astrovirus 2.9% (0.6-5%), enterotoxigenic Escherichia coli (ETEC) 2.4% (0.4-4%), Cryptosporidium sp. 2% (0.5-4%), Campylobacter sp. 2% (0.2-4%), and Salmonella sp.1.9% (0.3 to 3.5%). Except for Cryptosporidium, all parasite infections were not associated with AGE. Three emergent diarrheagenic E. coli pathotypes were identified in cases (0.7%), including an enteroaggregative/enterotoxigenic E.coli (EAEC/ETEC), an enteroaggregative/enteropathogenic E.coli (EAEC/EPEC), and an emergent enteroinvasive E. coli with a rare O96:H19. No deaths were reported among cases or controls. CONCLUSIONS/SIGNIFICANCE: Norovirus and rotavirus explained the major proportion of moderate to severe AGE in this study. Higher proportion of infection in cases, in the form of single infections or co-infections, showed association with AGE. Three novel E. coli pathotypes were identified among cases in this geographic region.


Subject(s)
Gastroenteritis/epidemiology , Gastroenteritis/etiology , Gastroenteritis/microbiology , Gastroenteritis/virology , Adenoviridae , Adenoviridae Infections/complications , Adenoviridae Infections/epidemiology , Astroviridae Infections/complications , Astroviridae Infections/epidemiology , Caliciviridae Infections/complications , Caliciviridae Infections/epidemiology , Campylobacter , Campylobacter Infections/complications , Campylobacter Infections/epidemiology , Case-Control Studies , Child, Preschool , Coinfection/microbiology , Coinfection/virology , Colombia/epidemiology , Cryptosporidiosis/complications , Cryptosporidiosis/epidemiology , Cryptosporidium , Diarrhea/epidemiology , Diarrhea/etiology , Diarrhea/microbiology , Diarrhea/virology , Enterotoxigenic Escherichia coli , Escherichia coli Infections/complications , Escherichia coli Infections/epidemiology , Female , Humans , Infant , Infant, Newborn , Male , Norovirus , Polymerase Chain Reaction , Rotavirus , Rotavirus Infections/complications , Rotavirus Infections/epidemiology , Salmonella , Salmonella Infections/complications , Salmonella Infections/epidemiology
11.
PLoS Negl Trop Dis ; 14(7): e0008478, 2020 07.
Article in English | MEDLINE | ID: mdl-32692739

ABSTRACT

A canine rabies epidemic started in early 2015 in Arequipa, Peru and the rabies virus continues to circulate in the dog population. Some city residents who suffer dog bites do not seek care or do not complete indicated post-exposure prophylaxis (PEP) regimens, increasing the risk of human rabies. The objectives of our study are to qualitatively assess knowledge about rabies, and preventive practices, such as rabies vaccine administration, following a dog bite. We conduct eight focus group discussions in peri-urban and urban communities with 70 total participants. In our results, we observe low awareness of rabies severity and fatality, and different practices following a dog bite, depending on the community type: for example, whereas participants in the urban communities report cleaning the wound with hydrogen peroxide rather than soap and water, participants in peri-urban areas cover the wound with herbs and hair from the dog that bit them. Misconceptions about rabies vaccines and mistreatment at health centers also commonly prevent initiating or completing PEP. We identify important behavioral and structural barriers and knowledge gaps that limit evidence-based preventive strategies against rabies and may threaten successful prevention of dog-mediated human rabies in this setting.


Subject(s)
Dog Diseases/virology , Post-Exposure Prophylaxis , Rabies Vaccines/immunology , Rabies/veterinary , Animals , Bites and Stings/complications , Dog Diseases/epidemiology , Dog Diseases/prevention & control , Dogs , Female , Focus Groups , Health Knowledge, Attitudes, Practice , Humans , Male , Peru/epidemiology , Rabies/epidemiology , Rabies/prevention & control , Rabies Vaccines/administration & dosage , Urban Population , Wounds and Injuries/therapy
14.
Rev. cir. (Impr.) ; 72(3): 217-223, jun. 2020. tab
Article in Spanish | LILACS | ID: biblio-1115545

ABSTRACT

Resumen Introducción: Es importante mantener programas de vigilancia bacteriana para disminuir resistencia y definir esquemas farmacológicos adecuados. Los pacientes con abdomen agudo representan un grupo microbiológico especial. Objetivos: Hacer una revisión de agentes patógenos en pacientes adultos operados en nuestro Servicio de Urgencia por patología abdominal con líquido libre y analizar los resultados obtenidos de cultivos respecto a las cepas y la susceptibilidad a los antibióticos. Materiales y Método: Estudio de cohorte prospectiva con estadística descriptiva. Se incluyen pacientes consecutivos, mayores de 18 años, operados por abdomen agudo que presentan líquido libre intraperitoneal entre noviembre de 2017 y abril de 2018. Se excluyen casos con terapia antimicrobiana, hospitalización y/o cirugía en los 3 meses previos. Se registran los cultivos positivos, cepas aisladas, susceptibilidad antimicrobiana, datos demográficos y evolución clínica. Resultados: De 63 pacientes 55% fueron hombres, edad promedio 52,2 años. Las patologías más frecuentes fueron de origen apendicular (62%) y de causa entérica (30%). En un 44% el cultivo fue positivo y en 36% con más de un germen. Escherichia coli fue el patógeno más frecuente (64,2%) seguidos de Enterococcus faecium y Streptococcus anginosus (7,1%). De los otros patógenos cultivados sólo se observó resistencia múltiple en un caso aislado de Morganella Morganii. Conclusiones: Estos datos constituyen la realidad microbiológica local en abdomen agudo. La Escherichia Coli sigue siendo el germen más frecuente, debe enfrentarse con profilaxis y tratamiento antibiótico adecuado. Es necesario mantener vigilancia microbiología local para un manejo acorde.


Introduction: It is important to maintain bacterial surveillance programs to decrease resistance and define adequate pharmacological schemes. Patients with abdomen represent a special microbiological group. Objetives: Make a review of pathogens in adult patients operated in our Emergency Service for abdominal pathology with free fluid and analyze the results obtained from cultures with respect to the strains and susceptibility to antibiotics. Materials and Method: Prospective cohort study with descriptive statistics. We include consecutive patients, older than 18 years old, operated on by abdomen who present free intraperitoneal fluid between November 2017 and April 2018. Cases with antimicrobial therapy, hospitalization and/or surgery 3 months prior are excluded. Positive cultures, isolated strains, antimicrobial susceptibility, demographic data and clinical evolution are recorded. Results: Of 63 patients, 55% were men and the average age was 52.2 years. The most frequent pathologies were of appendicular origin (62%) and of enteric origin (30%). In 44% the crop was positive and in 36% with more than one germ. Escherichia coli was the most frequent pathogen (64.2%) followed by Enterococcus faecium and Streptococcus anginosus (7.1%). Of the others, cultivated pathogens have only observed multiple resistance in an isolated case of Morganella Morganii. Conclusions: These data include the local microbiological reality in acute abdomen. Escherichia coli is still the most frequent germ that must be faced with the profile and the appropriate treatment. It is necessary to maintain local microbiology surveillance for a proper management.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Bacterial Infections/drug therapy , Abdomen, Acute/surgery , Abdomen, Acute/complications , Anti-Bacterial Agents/therapeutic use , Bacterial Infections/etiology , Bacterial Infections/prevention & control , Ascitic Fluid , Ciprofloxacin/therapeutic use , Enterococcus faecium/drug effects , Streptococcus anginosus , Escherichia coli/drug effects , Abdomen, Acute/pathology , Metronidazole
15.
Transbound Emerg Dis ; 67(6): 2679-2691, 2020 Nov.
Article in English | MEDLINE | ID: mdl-32438530

ABSTRACT

We conducted a cross-sectional survey to better understand the barriers to attendance at canine rabies vaccination campaigns in Haiti. A structured community-based questionnaire was conducted over a 15-day period during May-June 2017, focused on socio-economic status correlated with participation at canine rabies vaccination campaigns. Questions phrased as a bidding game were asked to determine individuals' willingness to pay (WTP) for dog rabies vaccination and willingness to walk (WTW) to fixed-point vaccination campaigns. The Kaplan-Meier estimator was applied to determine relationships between survey variables. Logistic regression was used to examine factors associated with participants' WTP and WTW. A total of 748 households from eight communities were surveyed. Respondents were predominantly female (54.4%) and had a median age of 45 years. The total number of owned dogs reported from households was 926, yielding a human-to-dog ratio in dog-owning households of 5.2:1. The majority of dogs (87.2%) were acquired for security, and 49% were allowed to roam freely; 42.0% of dog owners reported that they were unable to manage (or restrain) their dogs using a leash. Seventy per cent of dog owners were willing to pay up to 15.9 gourdes (0.25 USD) and/or walk up to 75 m to vaccinate their dogs. Households that owned free-roaming dogs, owned dogs for the purpose of companionship and owned dogs that they were unable to walk on a leash were associated with a higher WTP for vaccination. Living in Artibonite Department, having a middle or higher household income, and owning a dog for security purpose were associated with a higher WTW for vaccination. Low leash use and propensity for dogs to roam freely are barriers to successful fixed-point vaccination methods in Haiti, and alternative methods such as door to door (DD), capture-vaccinate-release (CVR) or oral vaccination should be explored. There may be some prospect for fee-for-service vaccination in Haiti; however, this programme should be introduced as a supplement, rather than a replacement for free rabies vaccination programmes so that mass dog vaccination is not discouraged.

16.
Epidemiol Serv Saude ; 29(2): e2019252, 2020.
Article in English, Portuguese | MEDLINE | ID: mdl-32401911

ABSTRACT

OBJECTIVE: to describe schistosomiasis control actions and its epidemiological situation in Pernambuco, Brazil, 2010-2016. METHODS: this was a descriptive study using data from the Schistosomiasis Surveillance and Control Program Information System for 116 municipalities, including indicators related to control actions (population surveyed, tests performed, treatment coverage) and epidemiological actions (positivity, parasite load, other helminthiases). RESULTS: Health Regions II, III, IV, V and XII, which are traditionally endemic, registered higher average percentages for control actions (population surveyed [6.5%, 6.0%, 2.0%, 12.0%, and 13.0%], tests performed [75.0%, 75.5%, 74.0%, 74.0%, and 68.5%], and treatment coverage [71.0%, 82.5%, 82.0%, 91.0%, and 73.0%], respectively), and higher average percentages for epidemiological variables (positivity [3.5%, 8.0%, 1.0%, 2.0%, and 6.5%], high parasite load [0.1%, 0.7%, 0.02%, 0.03%, and 0.5%], and other helminthiases [4.0%, 11.0%, 4.0%, 6.0%, and 8.0%], respectively). CONCLUSION: control actions need to be expanded in traditionally endemic regions.

17.
Rev Bras Epidemiol ; 23: e200024, 2020.
Article in English, Portuguese | MEDLINE | ID: mdl-32401920

ABSTRACT

BACKGROUND: Pesticide poisoning causes high morbidity and mortality. Surveillance is required for post-marketing monitoring of these products. AIM: To assess poisonings and associated factors with lethality by pesticides. METHOD: This is a case-control study based on the cases of pesticide poisoning assisted in 2017 by Brazilian Poison Control Centers. Patients who died were the cases and the survivors, the control. The odds ratio (OR) of death and 95% confidence interval (CI) were calculated. From the regression model, a predictive model of death was developed, stratified by age, gender and occupational context to investigate the risk of agricultural workers poisoned by extremely hazardous agents. RESULTS: 3,826 patients poisoned by pesticides were identified, of which 146 died. Older people (OR = 4.94; 95%CI 2.49 - 9.80), males (OR = 1.68; 95%CI 1.15 - 2.46), agricultural workers (OR = 2.20; 95%CI 1.15 - 4.24), suicide attempts (OR = 13.27; 95%CI 6.48 - 27.19) and exposure to extremely hazardous products (OR = 2.77; 95%CI 1.84 - 4.16) odds of death from pesticide poisoning. CONCLUSION: Out of 100 pesticides poisoning, four died. Elderly, males, working in the agricultural sector, suicide attempts and extremely hazardous products had a higher risk of death.


Subject(s)
Pesticides/poisoning , Poisoning/mortality , Adolescent , Adult , Age Distribution , Age Factors , Agricultural Workers' Diseases/mortality , Brazil/epidemiology , Case-Control Studies , Child , Child, Preschool , Farmers/statistics & numerical data , Female , Humans , Infant , Logistic Models , Male , Middle Aged , Occupational Exposure/adverse effects , Occupational Exposure/statistics & numerical data , Risk Factors , Sex Distribution , Sex Factors , Suicide, Attempted/statistics & numerical data , Young Adult
18.
Am J Trop Med Hyg ; 103(1): 455-464, 2020 07.
Article in English | MEDLINE | ID: mdl-32372750

ABSTRACT

Approximately two billion people lack access to microbiologically safe drinking water globally. Boiling is the most popular household water treatment method and significantly reduces diarrheal disease, but is often practiced inconsistently or ineffectively. The use of low-cost technologies to improve boiling is one approach with potential for increasing access to safe drinking water. We conducted household trials to evaluate the feasibility and acceptability of water pasteurization indicators (WAPIs) in the Peruvian Amazon in 2015. A total of 28 randomly selected households were enrolled from a rural and a peri-urban community. All households trialed two WAPI designs, each for a 2-week period. Ninety-six percent of participants demonstrated the correct use of the WAPIs at the end of each trial, and 88% expressed satisfaction with both WAPI models. Ease of use, short treatment time, knowledge of the association between WAPI use and improved health, and the taste of treated water were among the key factors that influenced acceptability. Ease of use was the key factor that influenced design preference. Participants in both communities preferred a WAPI with a plastic box that floated on the water's surface compared with a WAPI with a wire that was dipped into the pot of drinking water while it was heating (77% versus 15%, P < 0.001); we selected the box design for a subsequent randomized trial of this intervention. The high feasibility and acceptability of the WAPIs in this study suggest that these interventions have potential to increase access to safe water in resource-limited settings.


Subject(s)
Drinking Water/microbiology , Pasteurization/standards , Adolescent , Adult , Aged , Dysentery/prevention & control , Escherichia coli/isolation & purification , Feasibility Studies , Female , Humans , Middle Aged , Pasteurization/instrumentation , Pasteurization/methods , Peru , Water Microbiology , Water Supply , Young Adult
19.
Parasit Vectors ; 13(1): 171, 2020 Apr 06.
Article in English | MEDLINE | ID: mdl-32252808

ABSTRACT

BACKGROUND: Fascioliasis is a snail-borne zoonotic trematodiasis emerging due to climate changes, anthropogenic environment modifications, and livestock movements. Many areas where Fasciola hepatica is endemic in humans have been described in Latin America altitude areas. Highest prevalences and intensities were reported from four provinces of the northern Bolivian Altiplano, where preventive chemotherapy is ongoing. New strategies are now incorporated to decrease infection/re-infection risk, assessment of human infection sources to enable efficient prevention measures, and additionally a One Health initiative in a selected zone. Subsequent extension of these pilot interventions to the remaining Altiplano is key. METHODS: To verify reproducibility throughout, 133 specimens from 25 lymnaeid populations representative of the whole Altiplano, and 11 used for population dynamics studies, were analyzed by rDNA ITS2 and ITS1 and mtDNA cox1 and 16S sequencing to assess their classification, variability and geographical spread. RESULTS: Lymnaeid populations proved to belong to a monomorphic group, Galba truncatula. Only a single cox1 mutation was found in a local population. Two cox1 haplotypes were new. Comparisons of transmission foci data from the 1990's with those of 2018 demonstrated an endemic area expansion. Altitudinal, northward and southward expansions suggest movements of livestock transporting G. truncatula snails, with increasing temperatures transforming previously unsuitable habitats into suitable transmission areas. Transmission foci appear to be stable when compared to past field observations, except for those modified by human activities, including construction of new roads or control measures undertaken in relation to fascioliasis. CONCLUSIONS: For a One Health initiative, the control of only one Fasciola species and snail vector species simplifies efforts because of the lower transmission complexity. Vector monomorphism suggests uniformity of vector population responses after control measure implementation. Hyperendemic area outer boundary instability suggests a climate change impact. All populations outside previously known boundaries were close to villages, human dwellings and/or schools, and should therefore be considered during disease control planning. The remarkable southward expansion implies that a fifth province, Aroma, should now be included within preventive chemotherapy programmes. This study highlights the need for lymnaeid molecular identification, transmission foci stability monitoring, and potential vector spread assessment.


Subject(s)
Disease Vectors , Ecosystem , Fasciola hepatica/genetics , Fascioliasis/epidemiology , Lymnaea/parasitology , One Health , Animals , DNA, Mitochondrial/genetics , DNA, Ribosomal Spacer/genetics , Endemic Diseases , Fascioliasis/parasitology , Geography , Haplotypes , Humans , Phylogeny , Prevalence
20.
Poult Sci ; 99(4): 2120-2124, 2020 Apr.
Article in English | MEDLINE | ID: mdl-32241497

ABSTRACT

Poultry litter reuse in Brazil is a common practice to reduce broiler production costs. Quicklime and shallow fermentation treatments are methods used to reduce microbial contamination and infestation of insects such as Alphitobius diaperinus (Panzer). The aim of this study was to evaluate the physicochemical parameters of reused poultry litter to better characterize the effects of quicklime and shallow fermentation on Salmonella and A. diaperinus control. Ammonia and humidity concentrations significantly increased on the litter treated with shallow fermentation and pH when treated with virgin and hydrated quicklime. For A. diaperinus control, shallow fermentation with 2 and 3 L of water and 3 L plus 600g of quicklime/m2 eliminated 100% of the insects. Results of assessed physicochemical parameters indicated that the treatments with quicklime and shallow fermentation are inefficient to control Salmonella spp. because they do not reach the indexes required for this pathogen elimination, mainly ammonia and pH. Ammonia index produced by microbial fermentation in shallow fermentation treatment eliminates A. diaperinus.


Subject(s)
Anti-Bacterial Agents/pharmacology , Calcium Compounds/pharmacology , Coleoptera/drug effects , Insect Control , Oxides/pharmacology , Poultry Diseases/prevention & control , Salmonella Infections, Animal/prevention & control , Animals , Anti-Bacterial Agents/administration & dosage , Brazil , Calcium Compounds/administration & dosage , Communicable Disease Control/methods , Fermentation , Housing, Animal , Oxides/administration & dosage , Salmonella/drug effects
SELECTION OF CITATIONS
SEARCH DETAIL
...