ABSTRACT
Background: Development and evaluation of diagnostics for diseases of epidemic potential are often funded during epidemics, but not afterwards, leaving countries unprepared for the next epidemic. United Nations Children's Emergency Fund (UNICEF) partnered with the United States Agency for International Development (USAID) to address this important gap by investing in an advance purchase commitment (APC) mechanism to accelerate the development and evaluation of Zika rapid diagnostic tests (RDTs) for case detection and surveillance. This paper describes the performance evaluation of five Zika RDTs eligible for procurement. Methods: A network of European Union-funded ZikaPLAN sites in Africa, Asia, Latin America with access to relevant serum specimens were selected to evaluate RDTs developed for the UNICEF APC mechanism. A standardised protocol and evaluation panels were developed and a call for specimens for the evaluation panels issued to different sites. Each site contributed specimens to the evaluation from their biobank. Data were collated, analysed and presented to the UNICEF Procurement Review Group for review. Findings: Three RDTs met the criteria for UNICEF procurement of sensitivity and specificity of 85% against a refence standard. The sensitivity/specificity of the ChemBio anti-Zika Virus (ZIKV) immunoglobulin M (IgM) test was 86.4 %/86.7% and the ChemBio ZCD system for anti-ZIKV IgM was 79.0%/97.1%, anti-dengue virus (DENV) IgM 90.0%/89.2%, anti-Chikungunya virus (CHIKV) IgM 90.6%/97.2%. The sensitivity/specificity of the SD Biosensor anti-ZIKV IgM was 96.8 %/90.8%, anti-DENV IgM 71.8%/83.5%, the DENV nonstructural protein 1 (NS1) glycoprotein 90.0%/90.2%, anti- yellow fever virus (YFV) IgM 84.6%/92.4%, anti-CHIKV IgM 86.3%/97.5%. Interpretation: Three RDTs fulfilled the performance thresholds set by WHO and were eligible for UNICEF procurement. These tests will improve the diagnosis of ZIKV and other arboviral infections as well as providing countries with better tools for surveillance and response to future epidemics. Funding: This work was supported by the USAID grant GHA-G-00-07-00007 and ZikaPLAN (European Union's Horizon 2020 Research and Innovation Programme under Grant Agreement No. 734584).
ABSTRACT
Introducción: En el presente trabajo se muestran los resultados de la validación de los ensayos serológicos in vitro para la detección de anticuerpos IgM, IgG y anticuerpos totales contra el SARS-CoV-2 UMELISA SARS-CoV-2 IgM, UMELISA ANTI-SARS-CoV-2 y UMELISA SARS-CoV-2 IgG desarrollados por el Centro de Inmunoensayo (CIE). Métodos: Se utilizaron paneles de muestras de suero de individuos negativos y de casos confirmados de COVID-19 para determinar el desempeño analítico de cada ensayo. Resultados: La especificidad clínica de los ensayos UMELISA SARS-CoV-2 IgM, UMELISA ANTI-SARS-CoV-2 y UMELISA SARS-CoV-2 IgG fue del 100 por ciento en todos los ensayos y la especificidad analítica fue de 100 por ciento para los dos primeros ensayos y del 93,1 por cientopara el último. La sensibilidad clínica fue de 64,3, 80,8 y 97,5 por ciento, respectivamente. El valor predictivo positivo fue de 100 por ciento en todos los ensayos, en tanto que el negativo osciló entre 83,3 y 95,2 por ciento. La concordancia fluctuó entre 92,4 y 96,9 por ciento y el índice kappa de todos los ensayos fue muy bueno. La sensibilidad de los ensayos se incrementó a 82,76, 96,5 y 100 por ciento, respectivamente, en las muestras de suero colectadas con más de 14 días de iniciado el cuadro clínico. Conclusiones: Los ensayos demostraron una elevada sensibilidad y especificidad, lo que permite contar con herramientas basadas en una tecnología desarrollada en Cuba que posibilita la realización de estudios serológicos, vigilancia epidemiológica y de otro tipo, incluyendo los relacionados con vacunas en una plataforma con amplia distribución nacional(AU)
Introduction: This paper shows the results obtained in the validation of in vitro serological assays to detect IgM, IgG antibodies, and total antibodies against SARS-CoV-2 UMELISA SARS-CoV-2 IgM, UMELISA ANTI-SARS-CoV-2 and UMELISA SARS-CoV-2 IgG developed by the Immunoassay Center. Methods: Panels of serum samples from negative and COVID-19 confirmed patients were used to determine the analytical performance of each assay. Results: UMELISA SARS-CoV-2 IgM, UMELISA ANTI-SARS-CoV-2 and UMELISA SARS-CoV-2 IgG assays demonstrated 100 percent clinical specificity for all assays; and 100 percent analytical specificity for the first two assays, and 93.1 percent for the last one. Clinical sensitivity was 64.3 percent, 80.8 percent and 97.5 percent, respectively. The positive predictive value was 100 percent in all assays, while the negative predictive value ranged from 83.3 percent to 95.2 percent. Concordance varied from 92.4 percent to 96.9 percent, and kappa index in every assay was very good. Assays sensitivity increased to 82.7 percent, 96.5 percent and 100 percent, respectively for serum samples collected more than 14 days after onset of the symptoms. Conclusions: The assays demonstrated high sensitivity and specificity, which allows us to have Cuban technology-based tools for serological, epidemiological surveillance, and other types of studies, including those related to vaccines on a platform with wide national distribution(AU)
Subject(s)
HumansABSTRACT
Los arbovirus constituyen una de las principales causas de emergencia en salud por la morbilidad y mortalidad que producen y el estrés sanitario que conllevan. Cuba no ha estado excenta de riesgo, y el enfrentamiento del dengue inicialmente y de otros arbovirus después, ha sido, y es, una prioridad de las máximas autoridades del país. La vigilancia de laboratorio de dengue se estableció desde inicios de la década del 70 aunque sus objetivos y estrategias han cambiado según la situación epidemiológica nacional y regional y la tecnología de diagnóstico disponible. Se destacan cuatro etapas en su desarrollo. En este trabajo se resumen las estrategias desarrolladas para la vigilancia de laboratorio de dengue y de otros arbovirus en el periodo de 1970 a 2017. Se describe además el papel desempeñado por el Instituto de Medicina Tropical, ¨Pedro Kouri¨ (IPK) como Laboratorio Nacional de Referencia(AU)
Arboviruses are one of the leading causes of health emergencies due to their morbidity and mortality and the sanitary stress they bring about. Cuba has not been free from risk, and the response first to dengue fever and then to other arboviruses has been and still is a priority for the country's top authorities. Laboratory surveillance of dengue fever was implemented in the 1970s, though its aims and strategies have evolved in keeping with the national and regional epidemiological situation, and the available diagnostic technology. Four stages stand out in the development of dengue laboratory surveillance. The present paper summarizes the strategies developed for laboratory surveillance of dengue fever and other arboviruses in the period 1970-2017. A description is also provided of the role played by Pedro Kourí Tropical Medicine Institute (IPK) as a national reference laboratory(AU)
Subject(s)
Humans , Arbovirus Infections/prevention & control , Surveillance in Disasters , Dengue/epidemiology , Dengue Virus/immunology , Public Health Laboratory ServicesABSTRACT
Commercially available diagnostic test kits for detection of dengue virus (DENV) non-structural protein 1 (NS1) and anti-DENV IgM were evaluated for their sensitivity and specificity and other performance characteristics by a diagnostic laboratory network developed by World Health Organization (WHO), the UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR) and the Pediatric Dengue Vaccine Initiative (PDVI). Each network laboratory contributed characterized serum specimens for the panels used in the evaluation. Microplate enzyme-linked immunosorbent assay (ELISA) and rapid diagnostic test (RDT formats) were represented by the kits. Each ELISA was evaluated by 2 laboratories and RDTs were evaluated by at least 3 laboratories. The reference tests for IgM anti-DENV were laboratory developed assays produced by the Armed Forces Research Institute for Medical Science (AFRIMS) and the Centers for Disease Control and Prevention (CDC), and the NS1 reference test was reverse transcriptase polymerase chain reaction (RT-PCR). Results were analyzed to determine sensitivity, specificity, inter-laboratory and inter-reader agreement, lot-to-lot variation and ease-of-use. NS1 ELISA sensitivity was 60-75% and specificity 71-80%; NS1 RDT sensitivity was 38-71% and specificity 76-80%; the IgM anti-DENV RDTs sensitivity was 30-96%, with a specificity of 86-92%, and IgM anti-DENV ELISA sensitivity was 96-98% and specificity 78-91%. NS1 tests were generally more sensitive in specimens from the acute phase of dengue and in primary DENV infection, whereas IgM anti-DENV tests were less sensitive in secondary DENV infections. The reproducibility of the NS1 RDTs ranged from 92-99% and the IgM anti-DENV RDTs from 88-94%.
Subject(s)
Antibodies, Viral/blood , Antigens, Viral/blood , Dengue Virus/immunology , Immunoglobulin M/blood , Reagent Kits, Diagnostic , Viral Nonstructural Proteins/immunology , Enzyme-Linked Immunosorbent Assay/methods , Humans , Sensitivity and SpecificityABSTRACT
Anti-dengue virus immunoglobulin M kits were evaluated. Test sensitivities were 21%-99% and specificities were 77%-98% compared with reference ELISAs. False-positive results were found for patients with malaria or past dengue infections. Three ELISAs showing strong agreement with reference ELISAs will be included in the World Health Organization Bulk Procurement Scheme.
Subject(s)
Antibodies, Viral/blood , Dengue Virus/immunology , Dengue/diagnosis , Immunoglobulin M/blood , Reagent Kits, Diagnostic , Dengue/virology , Enzyme-Linked Immunosorbent Assay , False Positive Reactions , Humans , Reproducibility of Results , Sensitivity and SpecificityABSTRACT
Se analizó la situación en la región de las Américas acerca de la reemergencia del dengue y la emergencia de su forma severa, el dengue hemorrágico, que continúa siendo un problema con una tendencia al incremento a partir de la década de los 90, con el mayor número de casos en 2002 (más de 1 000 000 de enfermos). Se discutieron los factores que determinaron la emergencia de la enfermedad, haciendo énfasis en los factores socioeconómicos, entre los que se encuentran la pobreza y las iniquidades, las migraciones y el acceso a los servicios básicos de la población, como los de mayor preponderancia en el mantenimiento de la enfermedad en la mayoría de los países. Se analizaron también los principios básicos para el control del vector como única solución viable hoy día para controlar la enfermedad y la necesidad de la voluntad política, la intersectorialidad, la participación de toda la comunidad y el fortalecimiento de la legislación sanitaria en el control, al no disponer aún de una vacuna segura y accesible.
Dengue and dengue hemorrhagic fever in the Americas have been on the rise throughout the 1990s, with the highest number over one million cases reported in 2002. This paper analyzed the situation of dengue in the region and discussed the determining factors that account for the rise of the disease, making emphasis on socioeconomic factors, such as poverty, inequality, migrations and the lack of access to basic services, which are the most influential in perpetuating this disease in most countries. Considering that a safe and accessible vaccine is now unavailable, basic principles of vector control combined with political willingness, inter-sectoral involvement, active community participation and the tightening of health legislation were also examined as the only viable solution at present.
Subject(s)
Humans , Dengue , Poverty , Socioeconomic FactorsABSTRACT
Se analizó la situación en la región de las Américas acerca de la reemergencia del dengue y la emergencia de su forma severa, el dengue hemorrágico, que continúa siendo un problema con una tendencia al incremento a partir de la década de los 90, con el mayor número de casos en 2002 (más de 1 000 000 de enfermos). Se discutieron los factores que determinaron la emergencia de la enfermedad, haciendo énfasis en los factores socioeconómicos, entre los que se encuentran la pobreza y las iniquidades, las migraciones y el acceso a los servicios básicos de la población, como los de mayor preponderancia en el mantenimiento de la enfermedad en la mayoría de los países. Se analizaron también los principios básicos para el control del vector como única solución viable hoy día para controlar la enfermedad y la necesidad de la voluntad política, la intersectorialidad, la participación de toda la comunidad y el fortalecimiento de la legislación sanitaria en el control, al no disponer aún de una vacuna segura y accesible(AU)
Dengue and dengue hemorrhagic fever in the Americas have been on the rise throughout the 1990s, with the highest number over one million cases reported in 2002. This paper analyzed the situation of dengue in the region and discussed the determining factors that account for the rise of the disease, making emphasis on socioeconomic factors, such as poverty, inequality, migrations and the lack of access to basic services, which are the most influential in perpetuating this disease in most countries. Considering that a safe and accessible vaccine is now unavailable, basic principles of vector control combined with political willingness, inter-sectoral involvement, active community participation and the tightening of health legislation were also examined as the only viable solution at present(AU)
Subject(s)
Humans , Dengue , Americas/epidemiology , Poverty , Socioeconomic FactorsABSTRACT
Dengue and dengue hemorrhagic fever in the Americas have been on the rise throughout the 1990s, with the highest number -over one million cases- reported in 2002. This paper analyzed the situation of dengue in the region and discussed the determining factors that account for the rise of the disease, making emphasis on socioeconomic factors, such as poverty, inequality, migrations and the lack of access to basic services, which are the most influential in perpetuating this disease in most countries. Considering that a safe and accessible vaccine is now unavailable, basic principles of vector control combined with political willingness, inter-sectoral involvement, active community participation and the tightening of health legislation were also examined as the only viable solution at present.
Subject(s)
Dengue/epidemiology , Socioeconomic Factors , Aedes , Animals , Communicable Diseases, Emerging/economics , Communicable Diseases, Emerging/epidemiology , Dengue/economics , Dengue/prevention & control , Emigration and Immigration , Global Health , Health Policy , Health Services Accessibility , Humans , Incidence , Insect Vectors , Latin America/epidemiology , Mosquito Control , Poverty , Privatization , Social Justice , United States/epidemiology , Water SupplyABSTRACT
In June 2001, dengue transmission was detected in Havana, Cuba; 12,889 cases were reported. Dengue 3, the etiologic agent of the epidemic, caused the dengue hemorrhagic fever only in adults, with 78 cases and 3 deaths. After intensive vector control efforts, no new cases have been detected.
Subject(s)
Dengue/epidemiology , Adolescent , Adult , Cuba/epidemiology , Dengue/prevention & control , Dengue/transmission , Female , Humans , Male , Middle Aged , Time FactorsSubject(s)
Serologic Tests , Dengue/diagnosis , Enzyme-Linked Immunosorbent Assay , Latin America , Quality ControlABSTRACT
Objective. To report the results from participating laboratories for four external quality control proficiency tests of dengue serological diagnosis that were carried out in the Region of the Americas in the period of 1996-2001. Methods. External quality control proficiency tests of dengue serological diagnosis were carried out in 1996-1997, 1998-1999, 2000-2001. Panels made up of 20 serum samples (12 of them positive for dengue IgM antibodies) were sent to participating laboratories in the Region. The sera were negative for HIV antibodies, hepatitis C virus antibodies, and hepatitis B surface antigen. The sera were stored at -20 degrees C until they were sent in refrigerated shipments to the participating laboratories. THe presence of IgM antibodies was determined through IgM-capture enzyme-linked immunosorbent assay (ELISA), while the IgG antibody titer was determined by hemagglutination inhibition or by IgG ELISA. The results of the IgM antibody testing that differed from those of the reference center were considered discordant. The IgG antibody titer was considered discordant when the results differed by two dilutions or more with respect to the reference center's results. Results. A total of 27 laboratories received a total of 59 serum panels over the 1996-2001 period, and the results from testing 54 of those panels (91.5 percent) were sent back in. Of the total of 1, 080 sera samples from those 54 panels, the results from 95.6 percent of the IgM antibody tests were concordant with the results from the reference center. With 47 of the 54 panels (87.0 percent) the participating laboratories' agreement with the reference center's results for the IgM antibody testing was 90.0 percent or higher. The laboratories sent back results from a total of 27 IgG antibody titer tests, and 22 of them (81.5 percent) coincided with those from the reference center. Considering the IgM antibody testing results from the four periods, the findings from 22 of the participating laboratories coincided with those from the reference center for at least 90 percent of the samples, and 13 of the laboratories were in complete concordance with the reference center. Conclusions. The majority of the participating laboratories showed an excellent level of performance in detecting dengue IgG and IgM antibodies. However, the deficiencies found in some instances confirm the need for continuing to improve laboratory diagnosis of dengue in the Region of the Americas (AU)
Subject(s)
Dengue/diagnosis , Americas , Serologic Tests/statistics & numerical data , Caribbean Region , Serologic Tests , Quality ControlABSTRACT
Dar a conocer los resultados de cuatro controles externos de la calidad del diagnóstico serológico del dengue realizados en la Región de las Américas en el período de 1996- 2001 y presentar los resultados obtenidos por los laboratorios participantes. MÉTODOS: Se realizaron controles externos de la calidad del diagnóstico serológico del dengue en 1996-1997, 1998-1999, 1999-2000 y 2000-2001. Paneles compuestos por 20 sueros (12 de estos positivos a anticuerpos IgM contra el dengue) fueron enviados a laboratorios de la Región para que participaran en los controles realizados. Los sueros de los paneles eran negativos a anticuerpos contra el virus de la inmunodeficiencia humana y el virus de la hepatitis C, así como al antígeno de superficie de la hepatitis B, y fueron almacenados a -20 °C hasta su envío en refrigeración a los laboratorios participantes. La presencia de anticuerpos IgM se determinó mediante un ensayo inmunoenzimático (ELISA) de captura, mientras que el título de anticuerpos IgG se determinó por inhibición de la hemoaglutinación o ELISA de IgG. Los resultados de la determinación de anticuerpos IgM contra el dengue que no coincidían con los del centro de referencia se consideraron discordantes. El título de anticuerpos IgG se consideró discordante cuando los resultados difirieron en dos diluciones o más con respecto al resultado del centro de referencia. RESULTADOS: Un total de 27 laboratorios recibió 59 paneles de sueros de 1996 a 2001, y se recibieron los resultados del análisis de 54 de esos paneles (91,5 por ciento). De 1 080 sueros (20 X 54), 95,6 por ciento coincidieron con el laboratorio de referencia en cuanto a los resultados de la detección de anticuerpos IgM contra el dengue. Además, en 47 paneles (87 por ciento) la coincidencia con el laboratorio de referencia se observó en 90 por ciento de las muestras del panel o más. De los 27 paneles para los cuales se recibieron los resultados de los títulos de anticuerpos IgG contra el dengue, 22 (81,5 por ciento) coincidieron con el centro de referencia. Tomando en conjunto los cuatro controles realizados, 22 laboratorios coincidieron con el centro de referencia en 90 por ciento de las muestras o más y 13 en 100 por ciento de las muestras en cuanto a la presencia de IgM. CONCLUSIONES: Los resultados indican que la mayoría de los laboratorios participantes mostraron un excelente desempeño en la detección de anticuerpos IgG e IgM contra el dengue. No obstante, las deficiencias encontradas ...
Objective. To report the results from participating laboratories for four external quality control proficiency tests of dengue serological diagnosis that were carried out in the Region of the Americas in the period of 19962001. Methods. External quality control proficiency tests of dengue serological diagnosis were carried out in 19961997, 19981999, 19992000, and 20002001. Panels made up of 20 serum samples (12 of them positive for dengue IgM antibodies) were sent to participating laboratories in the Region. The sera were negative for HIV antibodies, hepatitis C virus antibodies, and hepatitis B surface antigen. The sera were stored at 20 °C until they were sent in refrigerated shipments to the participating laboratories. The presence of IgM antibodies was determined through IgM-capture enzyme-linked immunosorbent assay (ELISA), while the IgG antibody titer was determined by hemagglutination inhibition or by IgG ELISA. The results of the IgM antibody testing that differed from those of the reference center were considered discordant. The IgG antibody titer was considered discordant when the results differed by two dilutions or more with respect to the reference center's results. Results. A total of 27 laboratories received a total of 59 serum panels over the 1996 2001 period, and the results from testing 54 of those panels (91.5%) were sent back in. Of the total of 1 080 sera samples from those 54 panels, the results from 95.6% of the IgM antibody tests were concordant with the results from the reference center. With 47 of the 54 panels (87.0%) the participating laboratories' agreement with the reference center's results for the IgM antibody testing was 90.0% or higher. The laboratories sent back results from a total of 27 IgG antibody titer tests, and 22 of them (81.5%) coincided with those from the reference center. Considering the IgM antibody testing results from the four periods, the findings from 22 of the participating laboratories coincided with those from the reference center for at least 90% of the samples, and 13 of the laboratories were in complete concordance with the reference center. Conclusions. The majority of the participating laboratories showed an excellent level of performance in detecting dengue IgG and IgM antibodies. However, the deficiencies found in some instances confirm the need for continuing to improve laboratory diagnosis of dengue in the Region of the Americas
Subject(s)
Humans , Dengue/diagnosis , Laboratories/standards , Serologic Tests/standards , Americas , Antibodies, Viral/blood , Dengue Virus/immunology , Dengue/blood , Immunoglobulin G/blood , Immunoglobulin M/blood , Quality ControlABSTRACT
OBJECTIVE: To report the results from participating laboratories for four external quality control proficiency tests of dengue serological diagnosis that were carried out in the Region of the Americas in the period of 1996-2001. METHODS: External quality control proficiency tests of dengue serological diagnosis were carried out in 1996-1997, 1998-1999, 1999-2000, and 2000-2001. Panels made up of 20 serum samples (12 of them positive for dengue IgM antibodies) were sent to participating laboratories in the Region. The sera were negative for HIV antibodies, hepatitis C virus antibodies, and hepatitis B surface antigen. The sera were stored at -20 degrees C until they were sent in refrigerated shipments to the participating laboratories. The presence of IgM antibodies was determined through IgM-capture enzyme-linked immunosorbent assay (ELISA), while the IgG antibody titer was determined by hemagglutination inhibition or by IgG ELISA. The results of the IgM antibody testing that differed from those of the reference center were considered discordant. The IgG antibody titer was considered discordant when the results differed by two dilutions or more with respect to the reference center's results. RESULTS: A total of 27 laboratories received a total of 59 serum panels over the 1996-2001 period, and the results from testing 54 of those panels (91.5%) were sent back in. Of the total of 1 080 sera samples from those 54 panels, the results from 95.6% of the IgM antibody tests were concordant with the results from the reference center. With 47 of the 54 panels (87.0%) the participating laboratories' agreement with the reference center's results for the IgM antibody testing was 90.0% or higher. The laboratories sent back results from a total of 27 IgG antibody titer tests, and 22 of them (81.5%) coincided with those from the reference center. Considering the IgM antibody testing results from the four periods, the findings from 22 of the participating laboratories coincided with those from the reference center for at least 90% of the samples, and 13 of the laboratories were in complete concordance with the reference center. CONCLUSIONS: The majority of the participating laboratories showed an excellent level of performance in detecting dengue IgG and IgM antibodies. However, the deficiencies found in some instances confirm the need for continuing to improve laboratory diagnosis of dengue in the Region of the Americas.
Subject(s)
Dengue/diagnosis , Laboratories/standards , Serologic Tests/standards , Americas , Antibodies, Viral/blood , Dengue/blood , Dengue Virus/immunology , Humans , Immunoglobulin G/blood , Immunoglobulin M/blood , Quality ControlSubject(s)
Dengue , Serologic Tests , Americas , Antibodies, Viral , Immunoglobulin G , Immunoglobulin M , Quality Control , Laboratories , Dengue VirusABSTRACT
En los últimos años se ha observado un incremento cada vez más creciente de nuevas enfermedades infecciosas o de otras que ya se consideraban controladas. Las llamadas enfermedades emergentes y reemergentes son aquellas infecciones nuevas que han aparecido en una población o que han existido pero están aumentando rápidamente en incidencia o rango geográfico. Factores sociales y económicos, de la atención médica, producción de alimentos, cambios en el comportamiento del hombre, cambios ambientales, deterioro de los sistemas de salud y adaptación y cambio de los microorganismos se relacionan con el surgimiento o resurgimiento de diferentes entidades. En este trabajo se presentó un análisis de la emergencia y reemergencia de las enfermedades virales y de los factores que han influido en esta situación
Subject(s)
Communicable Diseases , Disease Outbreaks , IncidenceABSTRACT
En los últimos años se ha observado un incremento cada vez más creciente de nuevas enfermedades infecciosas o de otras que ya se consideraban controladas. Las llamadas enfermedades emergentes y reemergentes son aquellas infecciones nuevas que han aparecido en una población o que han existido pero están aumentando rápidamente en incidencia o rango geográfico. Factores sociales y económicos, de la atención médica, producción de alimentos, cambios en el comportamiento del hombre, cambios ambientales, deterioro de los sistemas de salud y adaptación y cambio de los microorganismos se relacionan con el surgimiento o resurgimiento de diferentes entidades. En este trabajo se presentó un análisis de la emergencia y reemergencia de las enfermedades virales y de los factores que han influido en esta situación(AU)
Subject(s)
Humans , Male , Female , Communicable Diseases/epidemiology , Disease Outbreaks , IncidenceABSTRACT
Se realizaron estudios serologicos utilizando las tecnicas de inhibicion de la hemaglutinacion y neutralizacion con el objetivo de conocer la dinamica de circulacion de algunos Arbovirus, con el empleo de los antigenos de encefalitis equina del este, equina del oeste y San Luis en sueros humanos de personas sanas y sintomaticas, asi como de aves centinelas, en el periodo de 1987 a 1991 y durante el ano 1994. El 1,7 por ciento de las personas asintomaticas testadas presentaron anticuerpos neutralizantes a equina del este y un 4,8 por ciento a encefalitis de San Luis. Se detectaron 16 pacientes con seroconversion por inhibicion de la hemaglutinacion al virus de San Luis. La vigilancia con aves centinelas demostro que durante los anos 1988, 1989 y 1994 circulo San Luis en los municipios de Moron, Bolivia y Chambas, mientra que en este ultimo municipio en los anos 1988 y 1989 circulo la encefalitis equina del este. Se detectaron en personas sanas anticuerpos heterologos, ya que no hubo presencia de anticuerpos neutralizantes contra este virus