Correction to "Cuban Abdala vaccine: Effectiveness in preventing severe disease and death from COVID-19 in Havana, Cuba; A cohort study" [The Lancet Regional Health - Americas 2022; 16: 100366] https://doi.org/10.1016/j.lana.2022.100366.

[This corrects the article DOI: 10.1016/j.lana.2022.100366.].

Cuban Abdala vaccine: Effectiveness in preventing severe disease and death from COVID-19 in Havana, Cuba; A cohort study.

Background: COVID-19 vaccines have proven safe and efficacious in reducing severe illness and death. Cuban protein subunit vaccine Abdala has shown safety, tolerability and efficacy (92·3% [95% CI: 85·7‒95·8]) against SARS-CoV-2 in clinical trials. This study aimed to estimate Abdala's real-world vaccine effectiveness (VE). Methods: This retrospective cohort study in Havana analyzed Cuban Ministry of Public Health databases (May 12-August 31, 2021) to assess VE in preventing severe illness and death from COVID-19 (primary outcomes). Cox models accounting for time-varying vaccination status and adjusting by demographics were used to estimate hazard ratios. A subgroup analysis by age group and a sensitivity analysis including a subgroup of tested persons (qRT-PCR) were conducted. Daily cases and deaths were modelled accounting for different VE. Findings: The study included 1 355 638 persons (Mean age: 49·5 years [SD: 18·2]; 704 932 female [52·0%]; ethnicity data unavailable): 1 324 vaccinated (partially/fully) and 31 433 unvaccinated. Estimated VE against severe illness was 93·3% (95% CI: 92·1-94·3) in partially- vaccinated and 98·2% (95% CI: 97·9-98·5) in fully-vaccinated and against death was 94·1% (95% CI: 92·5-95·4) in partially-vaccinated and 98·7% (95% CI: 98·3-99·0) in fully-vaccinated. VE exceeded 92·0% in all age groups. Daily cases and deaths during the study period corresponded to a VE above 90%, as predicted by models. Interpretation: The Cuban Abdala protein subunit vaccine was highly effective in preventing severe illness and death from COVID-19 under real-life conditions. Funding: Cuban Ministry of Public Health. Genetic Engineering and Biotechnology Centre.

COVID-19 in Cuba: Assessing the National Response.

The COVID-19 pandemic exhibits different characteristics in each country, related to the extent of SARS-CoV-2 local transmission, as well as the speed and effectiveness of epidemic response implemented by authorities. This study presents a descriptive epidemiological analysis of the daily and cumulative incidence of confi rmed cases and deaths in Cuba from COVID-19 in the fi rst 110 days after fi rst-case confi rmation on March 11, 2020. During this period, 2340 cases (20.7 x 100,000 population) were confi rmed, of which 86 patients died (case fatality 3.67%; 52 men and 34 women). Mean age of the deceased was 73.6 years (with a minimum of 35 years and a maximum of 101), with the average age of men lower than that of women. More than 70% of all deceased had associated noncommunicable diseases. The incidence curve ascended for fi ve weeks and then descended steadily. The average number of confi rmed cases and deaths for the last week included (June 23-28, 2020) were 25 and 1 respectively; the curve always moved within the most favorable forecast zone of available mathematical models and the effective reproductive number fell below 1 after the fi fth week following the onset of the epidemic.

Liver Stiffness Reference Values for Healthy Cuban Adults.

INTRODUCTION: Reference values for liver stiffness for healthy individuals vary worldwide. Different optimal cutoff values correspond to the stages of fibrosis in chronic liver disease. OBJECTIVES: Characterize the distribution of liver stiffness in Cuban adults without liver disease and its association with age, serum uric acid and body mass index. METHODS: A cross-sectional study was performed of 110 plasma donors recruited from the Havana Province Blood Bank January 2016 through February 2017. Measurements of liver stiffness were performed using a FibroScan elastography device on the same day of laboratory analyses and abdominal ultrasound. The Pearson coefficient was used to assess correlations, and the reference range was calculated using the mean and its 95% confidence interval. RESULTS: Liver stiffness values observed ranged from 2.2-6.3 kPa. The reference range (95% CI) for the 110 subjects without known liver disease was 4.2-4.6 kPa (mean 4.4). A positive correlation was observed between liver stiffness measurements and body mass index (r = 0.255, p ⟨0.01) and serum uric acid (r = 0.266, p ⟨0.01). There was no correlation between liver stiffness and age. Liver stiffness in women was similar to that of men, 4.3 (2.4-6.1) and 4.5 (2.2-6.3) kPa, respectively (p = 0.086). CONCLUSIONS: Liver stiffness in Cuban adults without liver disease ranges from 2.2-6.3 kPa. The reference range is 4.2-4.6 kPa. Body mass index and serum uric acid levels are positively associated with liver stiffness. CONTRIBUTION OF THIS RESEARCH: This is the first Cuban study using FibroScan to measure liver stiffness; its results will enable better assessment of liver disease in clinical practice.

Factores de riesgo para el cáncer colorrectal / Risk factors for colorectal cancer

El cáncer colorrectal (CCR) es una de las neoplasias más frecuentes en nuestro medio, en los últimos años hemos asistido a un avance muy significativo en el conocimiento de los mecanismos que participan en su desarrollo y progresión. Ese avance abarca desde la identificación de diversos factores genéticos o moleculares implicados en la fisiopatología de esta neoplasia, hasta la caracterización de múltiples aspectos epidemiológicos involucrados en su génesis. Se realizó un estudio de casos y controles sobre factores de riesgo del CCR, en pacientes adultos (92 casos y 184 controles), diagnosticados en el Instituto de Gastroenterología. Se aplicó una encuesta para recoger estos posibles factores y determinar su relación con el CCR. El análisis de estos resultados demostró que los factores de riesgo de más sólida causalidad son: hábito de fumar, índice cintura-cadera, consumo de vegetales, inactividad física y antecedentes patológicos personales de pólipos y de otros tumores malignos. Predominó la localización hacia colon izquierdo (descendente, sigmoide y recto) en ambos sexos. Se observó predominio del tipo ulcerado, en ambos sexos y el tipo histológico más frecuente fue el adenocarcinoma(AU)

The colorectal carcinoma (CLC) is one of the more frequent neoplasia in our practice, in past years there was a significant advance in the knowledge of mechanisms implicated in its development and progression. Such advance embraces from the identification of different genetic factors or molecular involved in its genesis. A case-control study was conducted on the CLC risk factors in adult patients (92 cases and 184 controls), diagnosed in the Institute of Gastroenterology. A survey was applied to collect these possible factors and to determine its relation to CLC. Analysis of these results showed that the risk factors with a great solid causality are: smoking, hip-waist index, vegetable consumption, physical inactivity and personal pathologic backgrounds of polyps and of other malignant tumors. There was predominance to left colon (descending, sigmoid and rectum) in both sexes. There was also predominance of the ulcerated type in both sexes, and the more frequent histological type was the adenocarcinoma(AU)

Factores de riesgo para el cáncer colorrectal / Risk factors for colorectal cancer

El cáncer colorrectal (CCR) es una de las neoplasias más frecuentes en nuestro medio, en los últimos años hemos asistido a un avance muy significativo en el conocimiento de los mecanismos que participan en su desarrollo y progresión. Ese avance abarca desde la identificación de diversos factores genéticos o moleculares implicados en la fisiopatología de esta neoplasia, hasta la caracterización de múltiples aspectos epidemiológicos involucrados en su génesis. Se realizó un estudio de casos y controles sobre factores de riesgo del CCR, en pacientes adultos (92 casos y 184 controles), diagnosticados en el Instituto de Gastroenterología. Se aplicó una encuesta para recoger estos posibles factores y determinar su relación con el CCR. El análisis de estos resultados demostró que los factores de riesgo de más sólida causalidad son: hábito de fumar, índice cintura-cadera, consumo de vegetales, inactividad física y antecedentes patológicos personales de pólipos y de otros tumores malignos. Predominó la localización hacia colon izquierdo (descendente, sigmoide y recto) en ambos sexos. Se observó predominio del tipo ulcerado, en ambos sexos y el tipo histológico más frecuente fue el adenocarcinoma

The colorectal carcinoma (CLC) is one of the more frequent neoplasia in our practice, in past years there was a significant advance in the knowledge of mechanisms implicated in its development and progression. Such advance embraces from the identification of different genetic factors or molecular involved in its genesis. A case-control study was conducted on the CLC risk factors in adult patients (92 cases and 184 controls), diagnosed in the Institute of Gastroenterology. A survey was applied to collect these possible factors and to determine its relation to CLC. Analysis of these results showed that the risk factors with a great solid causality are: smoking, hip-waist index, vegetable consumption, physical inactivity and personal pathologic backgrounds of polyps and of other malignant tumors. There was predominance to left colon (descending, sigmoid and rectum) in both sexes. There was also predominance of the ulcerated type in both sexes, and the more frequent histological type was the adenocarcinoma

Valor de la ecografía abdominal en el diagnóstico de la cirrosis hepática / Value of abdominal echography in the diagnosis of liver cirrhosis

La ecografía es una de las pruebas formadoras de imágenes más empleadas en el estudio de las enfermedades hepáticas, destacándose por ser inocua, accesible y de bajo costo. La presente investigación se desarrolló con el objetivo general de evaluar la ecografía abdominal en el diagnóstico de la cirrosis hepática. Para ello se realizó un estudio analítico de validación de esta prueba diagnóstica en la detección de dicha enfermedad, en el período comprendido desde julio de 2008 hasta enero de 2010, en el Instituto de Gastroenterología. A los pacientes con hepatopatía crónica incluidos en el estudio, previo a la realización de la laparoscopia y/o biopsia de hígado indicadas por su especialista, se les practicó una ecografía abdominal con doppler. La muestra quedó conformada por 173 pacientes 103 con la enfermedad y 70 sin la misma. Se estudiaron variables biológicas, ecográficas signos sugestivos de cirrosis hepática, laparoscópicas e histológicas, determinándose además la sensibilidad, especificidad, valor predictivo positivo y negativo, exactitud y odds ratio diagnósticas, así como el índice J de Youden Predominó el sexo masculino y las edades comprendidas entre los 48 y 57 años. Los signos ecográficos que prevalecieron fueron superficie hepática irregular o nodular, borde romo y ecoestructura hepática heterogénea, seguidos de dilatación de la vena porta y el aumento de tamaño del lóbulo caudado del hígado. La prueba en estudio resultó de alto valor S=94,2 por ciento; E=88,6 por ciento y seguridad VPP=92,4 por ciento; VPN=91,2 por ciento en el diagnóstico de la cirrosis hepática (AU)

The echography is one of the image-forming tests more used in the study of liver diseases, standing out for being innocuous, accessible and low cost. The current research was developed with the general objective of evaluating the abdominal echography in the diagnosis of liver cirrhosis LC. For this, an analytical study was conducted to validate this diagnostic test in the detection of this disease in the period between July 2008 and January 2010, at the Institute of Gastroenterology. Patients with chronic liver disease included in the study, underwent abdominal echography with, prior to the completion of thelaparoscopy and/or liver biopsy indicated by their specialist. The sample consisted of 173 patients 103 with the disease and 70 without it. It was studied biological variables, ecographic suggestive signs of liver cirrhosis, laparoscopic and histological, it was also determined the sensitivity, specificity, positive and negative predictive value, accuracy and diagnostic odds ratio, as well as Youden's J index. There was predominance of the masculine sex and ages between 48 and 57. The ecographic signs that prevailed were irregular or nodular liver surface, blunt edge and heterogeneous liver echostructure, followed by dilation of the portal vein and the increase of the Caudate lobe of liver. The studied test resulted in high-value S=94,2 per cent, E=88,6 per cent and security VPP=92,4 per cent, VPN=91,2 per cent in the diagnosis of liver cirrhosis.Subjects Headings: ULTRASONOGRAPHY; LIVER CIRRHOSIS

Prevalencia de la sífilis en embarazadas de seis ciudades Brasileñas / No disponible

Objetivos: Estimar la prevalencia de sífilis en gestantes de seis ciudades de Brasil y su asociación con variables socioeconómicas, demográficas y de comportamiento. Métodos: Estudio multicéntrico, transversal, que incluyó gestantes atendidas en consultorios prenatales de la atención primaria de salud entre los años 2004 y 2005. Se realizó examen de tamizaje para sífilis usando RPR y examen confirmatorio (ELISA) en la s que resultaron positivas. Se aplicó un cuestionario para colectar informaciones sociodemográficas, clínica-obstétricas, y de la actividad sexual de las voluntarias. Para le análisis estadístico y evaluar los factores de riesgo asociados a la sífilis se realizó análisis bivariado y multivariado por regresión logística múltiple y las pruebas “t” de Studen, Chi2 y test exacto de Fischer. Resultados: Fueron enroladas 3.303 gestantes, cuya edad media fue 23,8 años (± 6,9). La prevalencia de sífilis fue 2,6%. Más de 90% de las gestantes con sífilis presentaban infección latente. El riesgo de tener sífilis fue ocho veces mayor para las gestantes que refirieron haber tenido más de una pareja sexual en el último año. Otros predictores de la infección treponémica fueron: edad mayor de 40 años, nivel de escolaridad baja, tener antecedentes de úlceras genitales, y haber tenido pareja sexual con úlcera genital. Conclusiones: Se observó, en las gestantes brasileras una prevalencia de sífilis elevada. El principal factor de riesgo para esta infección fue tener más de una pareja sexual en los últimos 12 meses (AU)

No disponible

Sífilis congénita en comunidades indígenas de difícil acceso: desafío a superar mediante uso de la tecnología / No disponible

No disponible

Rapid tests for diagnosing syphilis: validation in an STD clinic in the Amazon Region, Brazil.

Correct, early diagnosis and treatment of syphilis are essential for its control. Traditional diagnostic tests depend on specialized equipment, installations, and human resources. In the search for quick, simple tests, a project was conducted on the validation and reproducibility of four different tests, previously assessed by WHO reference laboratories. The study also verified the operational characteristics and acceptance by patients and health professionals. Samples obtained at an STD clinic were from 541 and 248 patients with 51 and 52 positive results according to FTA-Abs (gold standard) in studies 1 and 2, respectively. The sensitivity varied from 84 to 96%, specificity was greater than 98%, and PPV was >90%. Reproducibility was >97% and kappa index 0.94, comparing the results obtained by different health workers. The tests took less than 20 minutes to perform, and more than 90% of patients agreed to wait up to two hours for the results. The tests presented the necessary requirements for use in diagnosis of syphilis, thus providing an additional option for controlling this disease.

Intervenção de base comunitária para a prevenção das DST/Aids na região amazônica, Brasil / Community-based intervention to control STD/AIDS in the Amazon region, Brazil / Community-based intervention to control STD/AIDS in the Amazon region, Brazil

OBJETIVO: Descrever estudo de caso de intervenção de base comunitária, desenvolvido na perspectiva construcionista-emancipatória, para o controle das DST/Aids. MÉTODOS: Estudo descritivo desenvolvido no município de Manacapuru, Amazonas, de 1997-2004, sobre a utilização de procedimentos desenhados em colaboração com agentes governamentais, profissionais de saúde e comunidade. Foram levantados dados sobre a dinâmica da prostituição e a venda de preservativos na cidade, características comportamentais, avaliação do processo e da assistência às DST/Aids. Sincronicamente, estabeleceram-se ações de prevenção e assistência na rede pública de saúde às DST, centro de testagem, sistema de vigilância epidemiológica, e capacitação de trabalhadoras do sexo. RESULTADOS: Observou-se o fortalecimento das trabalhadoras do sexo como multiplicadoras e sua legitimação como cidadãs e agentes de saúde em projetos com travestis, homossexuais e escolares. Houve incremento da venda de preservativos na cidade, da utilização de preservativos entre trabalhadoras do sexo, redução das DST bacterianas e estabilização da ocorrência de infecção pelo HIV/Aids e sífilis congênita. A sustentabilidade do programa de intervenção estudado, organizado no âmbito do Sistema Único de Saude, foi estimulada pela pactuação política garantindo sede e orçamento regulamentado em lei municipal, e pelo debate permanente dos resultados do processo e programa. CONCLUSÕES: O estudo fortaleceu a noção de que o controle efetivo das DST/Aids depende de uma abordagem sinérgica que combine intervenções no plano individual (biológica-comportamental), sociocultural e programático.

OBJECTIVE: To describe a case study of community-based intervention, developed in a constructionist-emancipatory framework to control STD/AIDS. METHODS: Descriptive study developed in the town of Manacapuru, in the state of Amazonas, from 1997 to 2004, focusing on procedures designed in collaboration with government agents, health professionals and the community. Data on the dynamics of prostitution and condom sales in this town, preventive practices and STD/AIDS care and process assessment were collected. Actions targeting STD prevention and care in the public healthcare system, a testing center, an epidemiological surveillance system and sex workers' qualification were established concomitantly. RESULTS: It was observed the strengthening of sex workers as peer educators and their legitimization as citizens and health agents in projects involving transvestites, homosexuals and students. There was an increase in condom sales in town, as well as in condom use among sex workers; reduction in bacterial STD; and stabilization of the incidence of HIV/AIDS infections and congenital syphilis. The sustainability of the intervention program studied, organized within the sphere of action of the Sistema Único de Saúde (National Health System), was promoted by a political pact, which guaranteed headquarters and municipal law-regulated budget, as well as by the constant debate over the process and program results. CONCLUSIONS: The study strengthened the notion that effective control of STD/AIDS depends on a synergic approach that combines interventions on individual (biological-behavioral), sociocultural and programmatic levels.

Intervenção de base comunitária para a prevenção das DST/Aids na região amazônica, Brasil / Community-based intervention to control STD/AIDS in the Amazon region, Brazil

OBJETIVO: Descrever estudo de caso de intervenção de base comunitária, desenvolvido na perspectiva construcionista-emancipatória, para o controle das DST/Aids. MÉTODOS: Estudo descritivo desenvolvido no município de Manacapuru, Amazonas, de 1997-2004, sobre a utilização de procedimentos desenhados em colaboração com agentes governamentais, profissionais de saúde e comunidade. Foram levantados dados sobre a dinâmica da prostituição e a venda de preservativos na cidade, características comportamentais, avaliação do processo e da assistência às DST/Aids. Sincronicamente, estabeleceram-se ações de prevenção e assistência na rede pública de saúde às DST, centro de testagem, sistema de vigilância epidemiológica, e capacitação de trabalhadoras do sexo. RESULTADOS: Observou-se o fortalecimento das trabalhadoras do sexo como multiplicadoras e sua legitimação como cidadãs e agentes de saúde em projetos com travestis, homossexuais e escolares. Houve incremento da venda de preservativos na cidade, da utilização de preservativos entre trabalhadoras do sexo, redução das DST bacterianas e estabilização da ocorrência de infecção pelo HIV/Aids e sífilis congênita. A sustentabilidade do programa de intervenção estudado, organizado no âmbito do Sistema Único de Saude, foi estimulada pela pactuação política garantindo sede e orçamento regulamentado em lei municipal, e pelo debate permanente dos resultados do processo e programa. CONCLUSÕES: O estudo fortaleceu a noção de que o controle efetivo das DST/Aids depende de uma abordagem sinérgica que combine intervenções no plano individual (biológica-comportamental), sociocultural e programático.(AU)

[Community-based intervention to control STD/AIDS in the Amazon region, Brazil]. / Intervenção de base comunitária para a prevenção das DST/Aids na região amazônica, Brasil.

OBJECTIVE: To describe a case study of community-based intervention, developed in a constructionist-emancipatory framework to control STD/AIDS. METHODS: Descriptive study developed in the town of Manacapuru, in the state of Amazonas, from 1997 to 2004, focusing on procedures designed in collaboration with government agents, health professionals and the community. Data on the dynamics of prostitution and condom sales in this town, preventive practices and STD/AIDS care and process assessment were collected. Actions targeting STD prevention and care in the public healthcare system, a testing center, an epidemiological surveillance system and sex workers' qualification were established concomitantly. RESULTS: It was observed the strengthening of sex workers as peer educators and their legitimization as citizens and health agents in projects involving transvestites, homosexuals and students. There was an increase in condom sales in town, as well as in condom use among sex workers; reduction in bacterial STD; and stabilization of the incidence of HIV/AIDS infections and congenital syphilis. The sustainability of the intervention program studied, organized within the sphere of action of the Sistema Unico de Saúde (National Health System), was promoted by a political pact, which guaranteed headquarters and municipal law-regulated budget, as well as by the constant debate over the process and program results. CONCLUSIONS: The study strengthened the notion that effective control of STD/AIDS depends on a synergic approach that combines interventions on individual (biological-behavioral), sociocultural and programmatic levels.

Rapid tests for diagnosing syphilis: validation in an STD clinic in the Amazon Region, Brazil

Correct, early diagnosis and treatment of syphilis are essential for its control. Traditional diagnostic tests depend on specialized equipment, installations, and human resources. In the search for quick, simple tests, a project was conducted on the validation and reproducibility of four different tests, previously assessed by WHO reference laboratories. The study also verified the operational characteristics and acceptance by patients and health professionals. Samples obtained at an STD clinic were from 541 and 248 patients with 51 and 52 positive results according to FTA-Abs (gold standard) in studies 1 and 2, respectively. The sensitivity varied from 84 to 96 percent, specificity was greater than 98 percent, and PPV was > 90 percent. Reproducibility was > 97 percent and kappa index 0.94, comparing the results obtained by different health workers. The tests took less than 20 minutes to perform, and more than 90 percent of patients agreed to wait up to two hours for the results. The tests presented the necessary requirements for use in diagnosis of syphilis, thus providing an additional option for controlling this disease.

O diagnóstico e o tratamento corretos e precoces da sífilis são essenciais para o seu controle. Os testes diagnósticos tradicionais dependem de equipamentos, instalações e recursos humanos especializados. Na busca de testes de execução simplificada e rápida, realizou-se projeto de validação e da reprodutibilidade de quatro diferentes testes anteriormente avaliados pelos laboratórios de referência da Organização Mundial da Saúde. Verificaram-se também as características operacionais e aceitabilidade dos pacientes e dos profissionais de saúde. As amostras obtidas numa clínica de DST constaram de 541 e 248 pacientes com 51 e 52 positivos no FTA-Abs (padrão ouro) nos estudos 1 e 2, respectivamente. A sensibilidade variou entre 84 e 96 por cento, especificidade superior a 98 por cento e valor preditivo positivo > 90 por cento. A reprodutibilidade foi superior a 97 por cento e 0,94 no índice de kappa, comparando-se os resultados obtidos pelos diferentes profissionais. A execução dos testes foi de menos de vinte minutos, e mais de 90 por cento dos pacientes concordaram em esperar o seu resultado até duas horas. Os testes apresentaram requisitos necessários para serem empregados no diagnóstico da sífilis, dando assim mais uma opção para o controle desta infecção.

Eficacia y tolerancia de ribavirina más interferon enpacientes con hepatitis crónica C / Efficacy and permissiveness of ribavirin more interferon in patient with chronic hepatitis C

Evaluar la eficacia y seguridad de un regimen de 1200 mg/día de Ribavirina más 3 MU de Interferon alfa 2b, 3 veces por semana durante 6 meses, en el tratamiento de la hepatitis crónica C. Se realizó estudio doble ciego y aleatorizado que incluyó 47 pacientes con hepatitis crónica tipo C. Veintiseis recibieron Ribavirina oral a la dosis de 1200 mg/día e Interferon subcutáneo 3MU tres veces por semana, durante 24 semanas y los 21 restantes recibieron placebo más Interferon subcutanéo 3MU tres veces por semana durante 24 semanas. Todos los pacientes enrolados en la investigación tenían diagnóstico histológico reciente y Anti VHC y RNA VHC positivos y eran HBsAg y AntiVIH negativos con ALT 1.5 veces o mayor sobre los valores normales (valor normal=12 UI). No se enconttraron diferencias significactivas entre los grupos asignados

Cuba: un quinquenio de lucha contra la infección por el VIH y el SIDA

Se presentan los datos de la vigilancia seroepidemiológica de la infección-enfermedad por el VIH en Cuba en el quinquenio de 1986 a 1990. Se han realizado más de 9 000 000 determinaciones para la detección de anticuerpos contra el VIH y se han diagnosticado 528 personas seropositivas, entre las cuales se cuentan 70 enfermos de SIDA de los que ya han fallecido 40. Las tasas de infección muestran una suave tendencia al ascenso con cifras cercanas a 10 por millón de habitantes. Se constata que la trasmisión perinatal se encuentra bajo estrcho control al igual que la trasmisión mediante sangre y hemoderivados. Se observan en el período modificaciones en el patrón de conducta sexual predominante entre los seropositivos en el sentido heterosexual-homosexual. La penetración del VIH en la población general se mantiene durante todo el período en niveles bajos y estables. El período de sobrevida de los que han enfermado es de 18,6 meses y las entidades clínicas mayores más frecuentes entre ellos son la neumonia a Pneumocistis carinii, Cryptosporidiosis, toxoplasmosis, citomegalovirosis e histoplasmosis por ese orden. Sólo 2 pacientes han hecho sarcoma de Kaposi. Se utilizaron para el análisis estadístico, las técnicas de Mantel-Haenzel y la prueba de la t de Student

Prevalencia del virus de la Hepatitis C en donantes de sangre de Ciudad de La Habana

Cuatrocientos sesenta y una muestras seleccionadas aleatoriamente entre los donantes voluntarios de 3 bancos de sangre de Ciudad de La Habana fuerom investigadas para determinar la presencia de anticuerpos contra el virus de la hepatitis C. Se consideraron positivas aquéllas que resultaron repetidamente reactivas al test inmunoenzimático de la firma Organon Tecknica. Se aplicó a todos los donantes incluidos en la muestra una encuesta epidemiológica para evaluar factores de riesgo con relación a la infección por este agente. Siete personas (1,5 %) resultaron repetidamente reactivas, cifra ligeramente superior a los niveles de seroprevalencia reportados en países desarrollados. La mediana de la edades de los positivos fue 7 años mayor que la de los negativos (39 vs 31,5), pero la prueba de la t de Student no mostró diferencias significativas. El índice de seropositividad fue más elevado en el sexo masculino (1,7 vs 0,9) y muy similares según el color de la piel (1,9 mestizos; 1,5 blancos y 1,0 negros); pero no hubo diferencias estadísticamente significativas (p>0,05). Los factores de riesgo con razón de disparidad más elevados fueron el tener más de 5 parejas en los últimos 5 años (3,2) y haber trabajado en unidades de salud (2,8), pero no fueron estadísticamente significativas (p>0,05). Se estimó la probabilidad de recibir una unidad de sangre infestada con el virus C en un 1,5 % aproximadamente, la cual asciende hasta casi un 45 % cuando se reciben 40 unidades. Se enfatiza la importancia que tiene este agente y la necesidad de establecer en el menor plazo posible, medidas específicas de control de calidad de la sangre para el mismo