Susceptibility to Insecticides and Natural Infection in Aedes aegypti: An Initiative to Improve the Mosquito Control Actions in Boyacá, Colombia.

Background: Integrated management strategies for dengue prevention and control have been the main way to decrease the transmission of arboviruses transmitted by A. aegypti in Colombia. However, the increase of chikungunya (CHIKV), Zika, and dengue (DENV) fever cases suggests deficiencies in vector control strategies in some regions from this country. Objective: This work aimed to establish a baseline susceptibility profile of A. aegypti to insecticides, determine the presence of kdr mutations associated with resistance to pyrethroids, and detect natural arbovirus infection in this vector from Moniquirá - Boyacá, one of the most endemic cities in Colombia. Methods: Mosquitos were collected in six neighborhoods, and colonies established in the laboratory. Susceptibility to malathion and lambda-cyhalothrin insecticides was evaluated, and we examined the point mutations present in portions of domains I, II, III, and IV of the sodium channel gene using a simple allele-specific PCR-based assay (AS-PCR). Findings: A. aegypti from Moniquirá showed decreased susceptibility to pyrethroid insecticides, and kdr mutations 419L, 1016I, and 1558C with allelic frequencies of 0.39, 0.40 and 0.95, respectively, were observed. The minimal infection rate (MIR) to DENV-1 was 44.1, while to CHIKV was 14.7. Conclusions: We establish a baseline insecticide resistance, kdr mutations, and arbovirus circulation, which contain the elements necessary for the consolidation of a local surveillance strategy with an early warning system and rational selection and rotation of insecticides.

Eco-epidemiological study reveals the importance of Triatoma dimidiata in the Trypanosoma cruzi transmission, in a municipality certified without transmission by Rhodnius prolixus in Colombia.

Boyaca department is an endemic area for Chagas disease in Colombia, where 24 of its municipalities have been certified by the PAHO with interruption of Trypanosoma cruzi transmission by R. prolixus. However, the presence of secondary vectors, represent a risk of parasite transmission for citizens and a challenge for the health care institutions. The aim of this work was to investigate eco-epidemiological features of Chagas disease in the municipality of Socota (Boyaca), in order to improve control and surveillance strategies. To understand the transmission dynamics of T. cruzi in this area, we designed a comprehensive, multi-faceted study including: (i) entomological survey in five villages (La Vega, Comaita, Chusvita, Guaquira and Pueblo Nuevo), (ii) blood meal source determination, (iii) T. cruzi infection rate in collected triatomines, (iv) identification of circulating T. cruzi genotypes, (v) serological determination of T. cruzi infection in domestic dogs; and (vi) evaluation of infection in synanthropic mammals. A total of 90 T. dimidiata were collected, of which 73.3% (66/90) and 24.4% (22/90) were collected inside dwellings and peridomestic areas, respectively, while the rest (2/90) in Chusvita Elementary School. T. cruzi infection was evidenced in 40% (36/90) of triatomine bugs using PCR analyses, in which only DTU I was found, and TcI Dom was the most distributed. Blood-meal analysis showed that T. dimidiata only fed of humans. Seroprevalence in domestic dogs was 4.6% (3/66), while that two Didelphis marsupialis captured showed no infection. In conclusion, the high dispersion and colonization of T. dimidiata shown in this municipality, along the high rate of T. cruzi (TcI) infection and its anthropophilic behavior constitute a risk situation for Chagas disease transmission in this municipality certified without R. prolixus. The epidemiological implications of these findings are herein discussed.

Colecistectomía laparoscopica en el Hospital Nacional Arzobispo Loayza

Trabajo de investigación de diseño retrospectivo y metodología transversal y descriptiva sobre pacientes con diagnóstico de colecistitis litiásica/alitiásica. El dominio de la técnica y la experiencia del grupo quirúrgico se ven reflejos en una disminución del tiempo operatorio de las complicaciones y de las contraindicaciones. Los resultados obtenidos en el HNAL son similares a lo obtenido por otros grupos de trabajo nacionales e internacionales. Es de fundamental importancias la evaluación y diagnóstico preoperatorio acertado, a fin de disminuir tanto el número de pacientes en el que debe convertirse a colecistectomía tradicionalmente como también la incidencia de complicaciones. Debemos de considerar que la eficacia del tratamiento en la patología vesicular con la técnica laparoscopica en el HNAL de estudio, hamotivado una baja morbimortalidad. Por todo lo expuesto consideramos que la colecistectomía laparoscópica es un meoderno procedimiento quirúrgico para le tratamiento de la enfermedad vesicular sintomatica; posee una morbilidad y mortalidad comprables a la colecistectomía "convecnional" o abierta, con la ventaja de un menor tiempo de hospitalización, menores molestias postoperatorias, alimentación precoz reintegración más rapida a us actividades cotidianas y mejores resultados cosméticos.