High-resolution prediction models for Rhipicephalus microplus and Amblyomma cajennense s.l. ticks affecting cattle and their spatial distribution in continental Ecuador using bioclimatic factors.

In Ecuador, the main tick species affecting cattle are Rhipicephalus microplus and Amblyomma cajennense sensu lato. Understanding their spatial distribution is crucial. To assess their distribution, data from 2895 farms visited between 2012 and 2017 were utilized. Ticks were collected during animal inspections, with each farm's location georeferenced. Bioclimatic variables and vapor pressure deficit data were obtained from Climatologies at High resolution for the Earth´s Land Surface Areas (CHELSA) dataset. They were overlaid to develop predictive maps for each species using Random Forest (RF) models. The cross-validation results for RF prediction models showed high accuracy for both R. microplus and A. cajennense s.l. presence with values of accuracy = 0.97 and 0.98, sensitivity = 0.96 and 0.99, and specificity = 0.96 and 0.93, respectively. A carefully selected subset of bioclimatic variables was used to describe the presence of each tick species. Higher levels of precipitation had positive effect on the presence of R. microplus but a negative effect on A. cajennense s.l. In contrast, isothermality (BIO3) was more important for the presence of A. cajennense s.l. compared to R. microplus. As a result, R. microplus had a broader distribution across the country, while A. cajennense s.l. was mainly found in coastal areas with evident seasonality. The coexistence of both species in some regions could be attributed to transitional zones, whereas high altitudes limited tick presence. This information can aid in developing appropriate tick management plans, particularly considering A. cajennense s.l.'s broad host range species and R. microplus's specificity for cattle. Moreover, the predictive models can identify areas at risk of associated challenging hemoparasite, requiring special attention and mitigation measures.

Indicators sand flies and environment associated to spatial landscaping change in Choco Biosphere Reserve UNESCO.

BACKGROUND OBJECTIVES: Sand flies are insects vector associated with terrestrial forest ecosystems; in the Ecuadorian Andes, they participate in the transmission of human cutaneous leishmaniasis. This geographical area is an opportunity to evaluate the role of sand flies as bioindicators od the degree of intervention of a tropical humid forest ecosystems (THF) associated with changes in the ecology of the local landscape. METHODS: CDC-light traps were used for collecting adults' sand flies in February 2020 in a humid tropical forest within Choco Biosphere Reserve. All species were identified using morphological keys. Analysis data about abundance, richness, species accumulation, diversity index, species composition communities, species sex proportion, spatial sand flies environmental, Renyi's Diversity Profile were performed to compare six spatial habitats in Mashpi locality, Ecuador. RESULTS: Sand flies were collected (n-1435); the main species are represented by Th. reburra Ny. trapidoi, Pa. aclydifera, Py. panamensis and Lu. hartmanni. Only Th. reburra is associated with not intervened forest, while the other 3 species are associated with intervened forest within Mashpi in the Choco Biosphere Reserve. The secondary forest has the major sandflies' richness, while the primary forest exhibits the major abundance. INTERPRETATION CONCLUSION: The results indicated that Th. reburra is a sandfly restricted to the Andean Forest and is a bioindicator of the high environmental health quality of the forest, while Ny. trapidoi and Pa. aclydifera are bioindicators of environmental disturbances in the forest. Additionally, Ps. panamensis, Lu. hartmanni and Ny. trapidoi are bioindicators of human impact and the risk of leishmaniasis.

From roads to biobanks: Roadkill animals as a valuable source of genetic data.

To protect biodiversity we must understand its structure and composition including the bacteria and microparasites associated with wildlife, which may pose risks to human health. However, acquiring this knowledge often presents challenges, particularly in areas of high biodiversity where there are many undescribed and poorly studied species and funding resources can be limited. A solution to fill this knowledge gap is sampling roadkill (animals that die on roads as a result of collisions with circulating vehicles). These specimens can help characterize local wildlife and their associated parasites with fewer ethical and logistical challenges compared to traditional specimen collection. Here we test this approach by analyzing 817 tissue samples obtained from 590 roadkill vertebrate specimens (Amphibia, Reptilia, Aves and Mammalia) collected in roads within the Tropical Andes of Ecuador. First, we tested if the quantity and quality of recovered DNA varied across roadkill specimens collected at different times since death, exploring if decomposition affected the potential to identify vertebrate species and associated microorganisms. Second, we compared DNA stability across taxa and tissues to identify potential limitations and offer recommendations for future work. Finally, we illustrate how these samples can aid in taxonomic identification and parasite detection. Our study shows that sampling roadkill can help study biodiversity. DNA was recovered and amplified (allowing species identification and parasite detection) from roadkill even 120 hours after death, although risk of degradation increased overtime. DNA was extracted from all vertebrate classes but in smaller quantities and with lower quality from amphibians. We recommend sampling liver if possible as it produced the highest amounts of DNA (muscle produced the lowest). Additional testing of this approach in areas with different environmental and traffic conditions is needed, but our results show that sampling roadkill specimens can help detect and potentially monitor biodiversity and could be a valuable approach to create biobanks and preserve genetic data.

Case report: First report on human infection by tick-borne Babesia bigemina in the Amazon region of Ecuador.

Babesiosis is a protozoan disease acquired by the bite of different species of ticks. More than 100 Babesia spp. infect wild and domestic animals worldwide, but only a few have been documented to infect humans. Generally, babesiosis is asymptomatic in immunocompetent persons; however, in immunocompromised can be life-threatening. A 13-year-old boy from the Amazon region presented with a 3-month evolution of fever, chills, general malaise, and arthralgia accompanied by anemia and jaundice. In the last 4 years was diagnosed with chronic kidney failure. By nested-PCR using 18S RNA ribosomal gene as target and DNA sequencing, the phylogenetic analysis showed Babesia bigemina as the causative agent in the blood. Treatment with oral quinine plus clindamycin for six continuous weeks was effective with no relapse occurring during 12 months of follow-up. This is the second human case in Ecuador but the first caused by the zoonotic B. bigemina which confirms the existence of active transmission that should alert public health decision-making authorities on the emergence of this zoonosis and the need for research to determine strategies to reduce tick exposure.

An economic evaluation of cattle tick acaricide-resistances and the financial losses in subtropical dairy farms of Ecuador: A farm system approach.

Estimates of economic losses in cattle due to tick infestations in subtropical areas are limited, such as in Ecuador. Ticks affect animal production and health, but those direct effects are difficult to estimate since financial exercises carried out in farms consider both costs of the inputs and revenues. This study aims to quantify the costs of inputs involved in milk production and to know the role of acaricide treatment in the production costs on dairy farms in subtropical zones using a farming system approach. Regression and classification trees were used to study the relationship between tick control, acaricide resistance and the presence of high level of tick infestation in the farm system. Even though there was no significant direct association between high levels of tick infestation and the presence of acaricide resistance in ticks, a more complex structure for resistances operates in the manifestation of high tick infestation involving levels of farm technology and no acaricide resistance. Farms with higher levels of technology allocate a lower percentage of sanitary expenses to control ticks (13.41%) in comparison to semi-technified (23.97%) and non-technified farms (32.49%). Likewise, more technified and bigger herds have a lower annual expenditure on acaricide treatment (1.30% of the production budget equivalent to 8.46 USD per animal) compared to non-technified farms where it can represent more than 2.74% of the production budget and where the absence of cypermethrin resistance increases the treatment cost to 19.50 USS per animal annually. These results can motivate the development of information campaigns and control programmes targeted to the reality of small and medium farms that are the most affected in terms of the money they invest in controlling ticks.

Intervención educativa basada en metodologías B-learning para mejorar las citologías cervicales: experiencias de enfermeras / Intervenção educacional através do B-learning para melhorar a citologia cervical: experiências de enfermeiras / Educational intervention through B-learning to improve cervical cytology: experiences of nurses

Resumen Objetivo analizar las experiencias de enfermeras en la toma de las citologías cervicales y otros factores organizacionales durante una intervención educativa asistida por metodologías B-learning. Método estudio cualitativo realizado en San Luis Potosí, México. Participaron 15 enfermeras. La recolección de datos se hizo a través de entrevistas semiestructuradas con base en una sistematización de experiencias. Para el análisis de la información se utilizó el programa Taguette y como referente teórico las metodologías B-learning. Resultados se identificaron debilidades en factores relacionados con la accesibilidad de las usuarias al servicio, insumos, infraestructura, bioseguridad, capacitación del personal de salud, entrega de resultados a las pacientes y conocimiento del programa por parte de las usuarias. Conclusiones e implicaciones para la práctica el cáncer cervical es un problema de salud pública. La citología cervical es la prueba de tamizaje más utilizada; sin embargo, existen limitantes en la calidad, por lo que se proponen acciones para mejorar los conocimientos y habilidades del personal de enfermería que tiene como función la toma. La intervención educativa fue efectiva para fomentar el aprendizaje integral sobre la toma de las citologías cervicales y permitió al personal de enfermería compartir sus experiencias.

Resumo Objetivo analisar as experiências das enfermeiras na realização de esfregaços cervicais e outros fatores organizacionais durante uma intervenção educacional assistida por metodologias de b-learning. Método estudo qualitativo realizado em San Luis Potosí, México. Participaram 15 enfermeiras. A coleta de dados foi feita por meio de entrevistas semiestruturadas a partir de uma sistematização de experiências. Para a análise das informações, utilizou-se o programa Taguette e metodologias de b-learning como referencial teórico. Resultados foram identificadas fragilidades em fatores relacionados com a acessibilidade dos usuários ao serviço, insumos, infraestrutura, biossegurança, capacitação da equipe de saúde, entrega de resultados aos pacientes e conhecimento do programa pelos usuários. Conclusões e implicações para a prática o câncer do colo do útero é um problema de saúde pública. A citologia cervical é o teste de triagem mais utilizado; no entanto, existem limitações na qualidade, por isso são propostas ações para aprimorar os conhecimentos e habilidades das enfermeiras que estejam desempenhando essa função. A intervenção educacional foi eficaz para promover o aprendizado integral sobre a realização do esfregaço cervical e permitiu que as enfermeiras compartilhassem suas experiências.

Abstract Objective to analyze the nursing staff's experiences in taking cervical smears and other organizational factors during an educational intervention assisted by B-learning methodologies. Method a qualitative study was carried out in San Luis Potosí, Mexico, with 15 nurses. Data collection was done through semi-structured interviews based on a systematization of experiences. The Taguette program and B-learning methodologies as theoretical references were used to analyze the information. Results weaknesses were identified in factors related to the accessibility of users to the service, supplies, infrastructure, biosafety, training of health personnel, delivery of results to patients, and knowledge of the program by the users. Conclusions and implications for practice cervical cancer is a public health problem. Cervical cytology is the most widely used screening test; however, there are limitations in quality, so actions are proposed to improve the knowledge and skills of the nursing staff in their functions. The educational intervention effectively promoted comprehensive learning about taking cervical smears and allowed the nursing staff to share their experiences.

Computer System for the Capture and Preparation of Cytopathological Reports for Cervical Cancer Detection and His Utility in Training for Health Personnel.

Health information systems and training are tools that support process management. The current study describes the results of the implementation of technological innovation in the process of the capture and preparation of cytopathological reports. The electronic system was structured based on national standards regarding cervical cancer control. PHP was used to design the software and MYSQL was used for the structure of the database. The total number of health personnel assigned to the cytology department participated, along with a pathologist, who made the records of the patients who came for cervical cytology to a university health center in San Luis Potosi, Mexico. The system was evaluated based on the indicators of structure, process, and results. Structure: comply with the official Mexican regulations for the registration of cervical cancer and electronic health information systems. Process: all records were legible and accurate, with varying percentages of completeness in the patient identification sections (46%) and alternate contact data (80%). Result: percentages above 80% were obtained in the satisfaction of the professionals who used the system. The system was effective as it yielded readable and accurate data that made the process of information capture and delivery of cervical screening results more efficient and faster.

The Associated Decision and Management Factors on Cattle Tick Level of Infestation in Two Tropical Areas of Ecuador.

Decision-making on tick control practices is linked to the level of knowledge about livestock farming and to the social context in which individuals practice them. Tick infestation is one of the main problems in tropical livestock production. The objective of this study was to characterize tick-control related practices in two tropical livestock areas and their potential association with the level of tick infestation. A total of 139 farms were included in this survey. To determine this association, a multivariate logistic regression model was used. A stepwise model selection procedure was used and model validation was tested. Cattle husbandry as a main activity, the use of external paddocks, the use of amitraz, and the lack of mechanization on the farm were related with high tick infestation. On the other hand, owner involvement in the preparation of acaricide solution was identified as a protective factor against high tick infestation. At animal level, age (old), body condition status (thin), and lactation were also associated with high tick infestations, while Bos primigenius indicus cattle and their crosses reduced the probability of high tick infestations. The factors studied, such as herd size, education level of the owners, and veterinary guidance, varied from farm to farm. Nonetheless, these differences did not generate changes in the level of tick infestation. According to the area under the receiver operating characteristic curve (AUC-ROC), the model at farm level predicts a high level of infestation, with an accuracy of 72.00% and high sensitivity. In addition, at animal level, crossbreeding with indicus cattle and breeding selection for host resistance will be useful against high tick infestation. Likewise, the implementation of programs of capacitation and research on tick control for farmers, cowboys, and vets in these areas is necessary.

Histopathological Diagnosis of Cervical Biopsies: Reduction of Sampling Errors with the Evaluation of a Third Histologic Level.

AIM: Cervical cancer (CC) is considered as a major public health problem; this disease affects mainly vulnerable women in poverty, causing a negative effect on a country's workforce. OBJECTIVE: To determine the histopathological diagnosis variation after examining three more levels of cervical biopsy paraffin blocks from patients with HPVI, CIN and CC. MATERIALS AND METHODS: A quantitative, retrospective correlational study was performed in a hospital with a second level of health care. We worked with 152 paraffin blocks of CIN (CIN, I, II and III) and cervical cancer samples. Currently, CIN I is considered as a set of low-grade injuries (low-grade squamous intraepithelial lesions, LSIL), while CIN II, CIN III and cancer in situ are considered as high-grade lesions (high-grade squamous intraepithelial lesions, HSIL). A slab was prepared with the 50micron block, which was subsequently cut into 5 microns; later, the same thing was done at two more levels to reevaluate the histopathological diagnosis and correlate it with the initial diagnosis issued by the institution. RESULTS: During the examination of the additional block levels, a difference was observed from the initial diagnosis: of 32 cases of HPV diagnosis, there were 17 changes to CIN I; of 31 cases of CIN I, there were 4 changes to CIN II; of 30 cases of CIN II, there were 8 changes to CIN III and 1 change to invasive cancer; of 29 cases of CIN III, there were 9 changes to cancer in situ; and finally, of 14 cases of cancer in situ, there was 1 change to invasive cancer. After the statistical analysis, a value of p <0.05 was obtained, which indicated that the differences were statistically significant. CONCLUSION: By modifying the histopathological study technique, guidelines can be given to generate a more accurate diagnosis with a more solid base, and thus, a more appropriate and timely treatment can be offered to avoid the development of cervical cancer.

Spatial-Temporal Analysis of Lutzomyia trapidoi and Lutzomyia reburra (Diptera: Phlebotominae), in Rural Tourist Locations, Biosphere Reserve and Leishmaniasis Endemic Area, Ecuador.

This research represents the first attempt to assess the spatial and temporal distribution based on micro-meso scales on two species with different host preference habits (anthropophilic vs zoophilic), in the major Leishmaniasis endemic area in Ecuador, tourist locations, and Biosphere reserve. Phlebotomine species, Lutzomyia trapidoi (Fairchild) and Lutzomyia reburra (Fairchild and Hertig), were analyzed by trap/habitat/month/locality/altitude, through the Poisson generalized regression model. Our data reveal a bimodal pattern for both species related with low precipitations and preference for forest habitat. Altitude, proximity to the forest, and the river were the variables that determine the hypervolume of the spatial distribution of relative abundance, where the overlap of these two species increases the risk of translocation and circulation of the etiological agent of leishmaniasis in sylvatic environments to rural-tourist-biosphere reserve areas and vice versa. The ecological characteristics of these two phlebotomines could explain the permanence of the major active and endemic focus of cutaneous leishmaniasis in the North-Western Ecuador a key aspect in tourism health-security in alternative tourism.

Necesidad de educación sexual y reproductiva en adolescentes de escuela secundaria / Need for sexual and reproductive education in high school teens

Introducción: los adolescentes enfrentan problemáticas que atentan su salud, entre los que destacan el embrazo y las infecciones de transmisión sexual, ambas prevenibles con educación. Objetivo: identificar el nivel de necesidad de educación sexual y reproductiva en adolescentes de secundaria. Material y métodos: estudio transversal, realizado de agosto 2018 a marzo 2019. Muestra de 227 estudiantes de una secundaria pública del estado de San Luis Potosí, inscritos en el ciclo escolar 2018-2019. Se aplicó una encuesta autoadministrada para medir la necesidad y se diseñó una escala ordinal con base al puntaje obtenido: alta= 73-93, media= 52-72 y baja= 31-51. Se aplicó la prueba X2 para determinar asociación entre variables. Resultados: la mayoría de los alumnos tienen un nivel de necesidad de educación sexual y reproductiva medio. Los estudiantes de segundo grado tienen mayor necesidad de educación (35.2%) que los de primero (16.7%) y tercero (6%) con una diferencia significativa (p<0.001). Quienes tienen menor necesidad de educación sexual son aquellos que platican frecuentemente con sus padres. Conclusión: es necesario que la educación sexual sea integral e impartida desde niveles de educación básica de manera continua; asimismo, capacitar a los padres de familia para que puedan brin-dar más información. De igual forma, fomentar la comunicación entre padres e hijos.

Factibilidad para implementar un sistema electrónico de registros de citología cervical / Feasibility to implement an electronic cervical cytology record system

Introducción: para garantizar la información y la atención de calidad, la Organización Mundial de la Salud, la Organización Panamericana de la Salud y las normas oficiales del cáncer cervicouterino y los sistemas de salud en México sugieren fortalecer los sistemas de información en salud con el uso de herramientas tecnológicas. Objetivo: el propósito de este estudio es conocer la factibilidad de un proyecto para la innovación de procesos, a través de un sistema electrónico para los registros de las citologías cervicales. Metodología: estudio observacional, transversal, prospectivo, realizado del 4 al 25 de junio de 2018 en la Unidad de Cuidados Integrales e Investigación en Salud de la Universidad Autónoma de San Luis Potosí, México. Se estudió al universo del personal sanitario que implementa el Programa de Detección Oportuna de Cáncer Cervico Uterino, con 7 participantes: personal directivo (2) y operativo (5). Resultados: las políticas y recursos institucionales permiten la implementación del proyecto, pues consideran tendría impacto positivo en la atención. Conclusiones: actualmente, la totalidad del personal cuenta con las competencias básicas para el manejo de sistemas electrónicos.

Introduction: To guarantee quality information and care, World Health Organization, Pan American Health Organization and the Official Standards of Cervical Cancer and Health Systems in Mexico suggest strengthening health information systems with the use of technological tools. Objective: The purpose of the study is to know the feasibility of a project for process innovation, through an electronic system for records of cervical cytologies. Methods: An observational, cross-sectional, prospective study conducted from June 4 to 25, 2018 in the Unit of Integral Care and Health Research of the Autonomous University of San Luis Potosí, Mexico. The universe of health personnel that implements the Timely Detection of Cervical Cancer Program was studied, 7 participants: managerial staff (2) and operative staff (5). Results: Institutional policies and resources allow for the implementation of the project, as they consider it would have a positive impact on care. Conclusions: Currently, all the staff has the basic skills for the management of electronic systems.

New Records of Ticks of Genus Amblyomma Koch, 1844 (Acari: Ixodidae) for Ecuador.

PURPOSE: In Ecuador, knowledge of the diversity and geographic distribution of ticks, as well as their importance as vectors, is scarce. Within the family Ixodidae, the genus Amblyomma is the most diverse and parasitizes wild and domestic animals. This genus is represented by 19 species in Ecuador, 12 of which occur in the continental territory and 7 in the Galapagos Islands. In this way, the objective of this work was to update the diversity of ticks reported for Ecuador on wild and domestic animals. METHODS: The specimens were collected manually on mammals and birds, in four localities belonging to the Sierra and Amazon of Ecuador and were kept in tubes with 96% ethyl alcohol. After that, all specimens were separated into immatures, males and females and were identified using their morphological characters. RESULTS: This study records Amblyomma coelebs Neumann, 1899, Amblyomma longirostre (Koch, 1844) Neumann, 1905 and Amblyomma varium Koch, 1844 for the first time in Ecuador. Thus, the genus Amblyomma is currently represented by 22 species. In addition, their hosts, distribution, and importance are also discussed. CONCLUSIONS: Knowing the diversity of ticks that wildlife possesses, its interrelation with the domestic fauna, and the possible pathogens that could be transmitting could significantly contribute to wildlife's conservation.

Coleta de amostra para identificação de DNA do papilomavírus: conhecimento e habilidades / Toma de muestra para identificación de ADN del papilomavirus: conocimiento y habilidades / Sample taking for identification of papilomavirus DNA: skills and knowledge

Resumo Objetivo Estabelecer a relação entre o conhecimento e as habilidades dos profissionais da saúde em coletar amostras para a identificação do DNA do papilomavírus. Métodos Estudo transversal, realizado entre março e junho de 2017, com uma população de 313 pessoas. A amostra probabilística foi calculada considerando um r=0,306, 95% de confiança e poder de 90%, equivalente a 90 trabalhadores de 23 centros de saúde. Um teste de conhecimento e um checklist foram administrados para avaliar as habilidades na coleta de amostra utilizando o teste de Captura Híbrida 2 (teste HPV-CH2). Para análise dos dados, foi utilizada a correlação de Pearson e ANOVA. Resultados Foi encontrada uma correlação entre conhecimento e habilidades (r=0,438) (p<0,001). Quanto ao conhecimento, não houve diferença significativa nas médias obtidas nos três grupos de participantes (enfermeiros versus estagiários 3,27 p=0,557, médicos vs. enfermeiros 2,17 p=0,852, e médicos vs. estagiários 5,45 p=0,441). Quanto às habilidades, não houve diferença entre as médias obtidas entre médicos e enfermeiros (4,27 p=0,388), nem entre enfermeiros e estagiários (4,54 p=0,179), mas houve diferença entre médicos e estagiários (8,81 p=0,041). Conclusão Houve correlação entre o conhecimento e as habilidades em coletar amostras para a identificação do DNA do papilomavírus. Não houve diferenças significativas no conhecimento entre os grupos estudados, mas uma diferença em relação às habilidades foi encontrada entre médicos e estagiários.

Resumen Objetivo establecer la relación entre el conocimiento y las habilidades de los profesionales de la salud para tomar muestras para identificación del ADN del papilomavirus. Métodos estudio transversal realizado entre marzo y junio de 2017, con una población de 313 personas. El muestreo probabilístico fue calculado considerando un r=0,306, 95% de confianza y poder de 90%, equivalente a 90 trabajadores de 23 centros de salud. Se aplicó una prueba de conocimiento y una checklist para evaluar las habilidades de toma de muestra utilizando la prueba de captura de híbridos 2 (prueba HPV-CH2). Para el análisis de datos se utilizó la correlación de Pearson y ANOVA. Resultados se encontró una correlación entre conocimiento y habilidades (r=0,438) (p<0,001). Con relación al conocimiento, no hubo diferencia significativa en los promedios obtenidos en los tres grupos de participantes (enfermeros vs. practicantes 3,27 p=0,557, médicos vs. enfermeros 2,17 p=0,852 y médicos vs. practicantes 5,45 p=0,441). Respecto a las habilidades, no hubo diferencia en los promedios obtenidos entre médicos y enfermeros (4,27 p=0,388), ni entre enfermeros y practicantes (4,54 p=0,179), pero hubo diferencia entre médicos y practicantes (8,81 p=0,041). Conclusión hubo correlación entre el conocimiento y las habilidades para tomar muestras para identificar el ADN del papilomavirus. No hubo diferencias significativas en el conocimiento entre los grupos estudiados, pero se encontró una diferencia con relación a las habilidades entre médicos y practicantes.

Abstract Objective To establish the relationship between the knowledge and skills of health personnel in taking samples for the identification of papillomavirus DNA. Methods Cross-sectional study, conducted between March and June of 2017. Population of 313 people, the probabilistic sample was calculated considering a r = 0.306 expected, 95% confidence, and power of 90%, which equated to 90 workers from 23 health centers. A knowledge test and checklist were administered to evaluate sampling skills, with the hybrid capture method (HPV-CH2 test). For data analysis, Pearson's and the ANOVA correlation were used. Results A correlation between knowledge and skills was found (r=0.438) (p<0.001). Regarding knowledge, there was no significant difference in the means obtained from the three groups of participants (nurses vs. interns 3.27 p=0.557, physicians vs. nurses 2.17 p=0.852, physicians vs. interns 5.45 p=0.441). Regarding skills, there was no difference between the means obtained between physicians and nurses (4.27 p=0.388), nor between nurses and interns (4.54 p=0.179), but there was a difference between physicians and interns (8.81 p=0.041). Conclusion There was a correlation between the knowledge and skills in taking samples for the identification of papillomavirus DNA. There were no significant differences in knowledge between the groups studied; but a difference in means for skills was found between physicians and interns.

Intervención educativa sobre nivel de conocimientos en salud bucal en adolescentes de "Rafael Freyre" / Educational intervention on level of knowledge in oral health in adolescents from "Rafael Freyre"

RESUMEN Introducción: la necesidad de promover temas de salud sobre la prevención de enfermedades bucales es universal. Es tarea de los trabajadores de la salud contribuir a la educación sanitaria de los adolescentes y jóvenes, para lograr que ellos se preocupen por su propia salud y la de la comunidad donde viven. Objetivo: evaluar la efectividad de un programa educativo en la modificación del nivel de conocimientos sobre salud bucal en adolescentes de una secundaria básica. Métodos: se realizó una investigación cuasiexperimental sin grupo control de intervención comunitaria, donde el universo fueron 158 estudiantes. La muestra fue de 50 individuos y de obtuvo a través de un muestreo aleatorio simple. Se realizó una encuesta y un control de placa dentobacteriana antes y después de la intervención. Se confeccionó e implementó el Programa Educativo "Nuestra Meta: una boca sana". El trabajo se realizó en Holguín, en la Escuela Secundaria Básica (ESB) Rafael Freyre Torres, desde septiembre del 2014 hasta febrero del 2015. Resultados: antes de la instrucción, el 50% de los adolescentes presentaba un nivel de conocimiento regular sobre salud bucal, y posteriormente el 86% se apropió de un conocimiento adecuado. Antes de la intervención, la mayoría poseía una higiene bucal deficiente (64%) y al final de esta una higiene bucal eficiente (72%). El nivel de conocimiento sobre prevención de caries dental, periodontopatías y traumatismos dentarios fue en su mayoría regular; el de cáncer bucal malo antes de la intervención y adecuado después de esta. Conclusiones: se demostró que la aplicación de este programa educativo ser eficaz, según los resultados obtenidos en cuanto a la modificación de los conocimientos sobre salud bucal, evaluados de satisfactorios.

ABSTRACT Introduction: buccal diseases prevention within health promotion is a universal need. It is health professionals' responsibility to contribute to teenagers and young people sanitary education, in order they achieve not only oral health theoretical knowledge but also practice and cooperation, in favor of their own health and community wellbeing. Objective: to assess an effective educational program about the modification of buccal health knowledge level in teenagers from "Rafael Freyre Torres" High School in Rafael Freyre municipality, Holguín, since September 2014 to February 2015. Methods: a non-observational study of the kind community intervention was carried out. The universe was 158 students of 9th grade and the sample was 50 students. A survey and a dental-bacterial plaque control were also applied. The Educative Program "Our goal is to have a healthy mouth" was put into practice. Results: this research showed a 50% of the teenagers with a regular knowledge level about buccal health before program intervention; after the 86% presented a good level of knowledge. Before program intervention, the majority of individuals had a deficient oral hygiene; after, they presented an efficient oral hygiene. After program intervention, the level of knowledge about dental cavities, periodontal diseases, dental traumatisms and buccal cancer was good. Conclusions: the Educational Program "Our goal is to have a healthy mouth" confirmed to be effective since satisfactory results were obtained according to the positive modification of knowledge about buccal health.

Atención estomatológica al adulto mayor en Holguín, del 2011 al 2015 / Odontology elders’ attention in Holguín, Cuba, from 2011 to 2015

Introducción: desde 1948, la Organización de Naciones Unidas (ONU), ha manifestado una especial preocupación por el envejecimiento de la población a escala mundial; por lo que ha planteado la necesidad de proteger los derechos de los ancianos como principal garantía para su bienestar, debido a su vulnerabilidad ante enfermedades bucodentales. Objetivo: caracterizar la atención estomatológica del adulto mayor en la provincia de Holguín, en el quinquenio 2011-2015. Métodos: se realizó un estudio transversal retrospectivo, con un universo de pacientes de 60 años y mayores, atendidos en el período de enero de 2011 a diciembre de 2015, en la provincia de Holguín. Los datos fueron obtenidos en el Registro Estadístico Provincial de Holguín. Resultados: se examinaron en este quinquenio 477 907 pacientes en Atención Primaria de Estomatología, y de ellos, 377 276 no requerían tratamiento. Se dieron 588 001 altas. Los municipios de Holguín y Rafael Freyre aportaron las cifras más elevadas. En lo referente a la rehabilitación protésica, 25 032 adultos mayores fueron dados de alta de este servicio. Conclusiones: existió tendencia al aumento paulatino en las cifras de adultos mayores atendidos y, en el transcurso del año 2015, una mayor cantidad de pacientes fueron examinados. Las altas de Atención Primaria aportaron cifras más elevadas en los municipios de Holguín y Rafael Freyre. Se apreció, en cada año, un incremento lineal de pacientes con atención concluida de rehabilitación protésica.

Introduction: since 1948, the United Nations Organization (UNO) has been especially concerned on humankind aging. That´s how the need for protecting elderly people´s wellbeing, regarding high risk of buccal-dental diseases, emerged. Objective: characterize elders' dentistry attention within the five-year period, from 2011 to 2015, in Holguín province. Methods: a retrospective, descriptive and observational study was carried out on 60 years old and older patients' universe, which was assisted from January 2011 to December 2015, in Holguín province. Data was obtained at the Provincial Statistical Registration. Results: during this period, 477 907 Primary Dentistry Attention patients were examined, and 377 276 didn't require treatment. Holguín and Rafael Freyre showed higher numbers, with 25 032 discharges after attention, and 58 801 after prosthetic rehabilitation. Conclusions: a gradually increased amount of elderly patients discharged from Primary Attention, examined at 2015 in Holguín and Rafael Freyre municipalities. There is still a growing number of concluded patient's prosthetic rehabilitation every year.

[Future type 2 diabetes mellitus scenario estimated with a predictive dynamic simulation model]. / Escenario futuro de la diabetes mellitus tipo 2 estimado con un modelo de simulación dinámico predictivo.

OBJECTIVE: Develop a predictive dynamic model to estimate future scenarios for the incidence rate of type 2 diabetes mellitus (T2DM). METHODS: A retrospective ecological study was conducted in 2013-2015 in the city of San Luis Potosí, Mexico. Secondary official data from the 58 municipalities making up the state of San Luis Potosí were analyzed. Linear correlation, multiple linear regression, and structural equations were carried out, and four predictive dynamic submodels were developed: T2DM, urban population, inhabited private dwellings that have television, and population aged 45-49 years. A holistic model was also developed. RESULTS: The structural model explains 27.2% of total variance in type 2 diabetes mellitus. Percentage of inhabited dwellings that have television weighs 4.46 non-standard units on diabetes; that of urban population, 2.84; and that of population aged 45-49 years, 156.69. Estimated scenarios for T2DM per 100 000 population for the years 2015, 2020, 2025, and 2030 were 1,052.4, 1,413.7, 1,850.1, and 2,351.1 respectively. CONCLUSION: The T2DM scenario shows exponential growth from 2000 to 2030. Risk factors according to the weight they represent in occurrence of the disease were: population aged 45-49 years, inhabited private dwellings that have television, and urban population.

Atención estomatológica al adulto mayor en Holguín, del 2011 al 2015 / Odontology elders attention in Holguín, Cuba, from 2011 to 2015

Introducción: desde 1948, la Organización de Naciones Unidas (ONU), ha manifestado una especial preocupación por el envejecimiento de la población a escala mundial; por lo que ha planteado la necesidad de proteger los derechos de los ancianos como principal garantía para su bienestar, debido a su vulnerabilidad ante enfermedades bucodentales.Objetivo: caracterizar la atención estomatológica del adulto mayor en la provincia de Holguín, en el quinquenio 2011-2015. Métodos: se realizó un estudio transversal retrospectivo, con un universo de pacientes de 60 años y mayores, atendidos en el período de enero de 2011 a diciembre de 2015, en la provincia de Holguín. Los datos fueron obtenidos en el Registro Estadístico Provincial de Holguín.Resultados: se examinaron en este quinquenio 477 907 pacientes en Atención Primaria de Estomatología, y de ellos, 377 276 no requerían tratamiento. Se dieron 588 001 altas. Los municipios de Holguín y Rafael Freyre aportaron las cifras más elevadas. En lo referente a la rehabilitación protésica, 25 032 adultos mayores fueron dados de alta de este servicio. Conclusiones: existió tendencia al aumento paulatino en las cifras de adultos mayores atendidos y, en el transcurso del año 2015, una mayor cantidad de pacientes fueron examinados.Las altas de Atención Primaria aportaron cifras más elevadas en los municipios de Holguín y Rafael Freyre. Se apreció, en cada año, un incremento lineal de pacientes con atención concluida de rehabilitación protésica.(AU)

Introduction: since 1948, the United Nations Organization (UNO) has been especially concerned on humankind aging. That´s how the need for protecting elderly people´s wellbeing, regarding high risk of buccal-dental diseases, emerged. Objective: characterize elders dentistry attention within the five-year period, from 2011 to 2015, in Holguín province. Methods: a retrospective, descriptive and observational study was carried out on 60 years old and older patients universe, which was assisted from January 2011 to December 2015, in Holguín province. Data was obtained at the Provincial Statistical Registration. Results: during this period, 477 907 Primary Dentistry Attention patients were examined, and 377 276 didn't require treatment. Holguín and Rafael Freyre showed higher numbers, with 25 032 discharges after attention, and 58 801 after prosthetic rehabilitation. Conclusions: a gradually increased amount of elderly patients discharged from Primary Attention, examined at 2015 in Holguín and Rafael Freyre municipalities. There is still a growing number of concluded patients prosthetic rehabilitation every year.(AU)

Calidad de los registros en programa de detección oportuna de cáncer cervicouterino / Quality of records in a timely screening program for cervical cancer

Resumen Introducción: El cáncer cervicouterino es un problema de salud pública en México, en 2012 se estimaron 528 000 nuevos casos. Una línea de investigación con relación al programa de cáncer cervicouterino, es la calidad de los registros en cuanto a su legibilidad, completitud y precisión. Objetivo: Evaluar la calidad de los registros realizados por el personal de salud en el servicio de Detección de Cáncer Cervicouterino. Materiales y Métodos: Estudio transversal, realizado en el Instituto Mexicano del Seguro Social de San Luis Potosí, México, entre agosto de 2012 a septiembre de 2013. Ante un universo de 4139 registros, hoja de solicitud y resultados de la citología cervical, realizados durante enero a noviembre de 2012, se aplicó un muestreo probabilístico estratificado (1115 registros). Se utilizó una lista de verificación con 32 ítems divididos en siete apartados. Para analizar los datos se utilizaron tres indicadores: precisión, legibilidad y completitud. Se estableció una escala ordinal con el puntaje obtenido: bajo (0-64), medio (65-128) y alto (129-192). Se aplicó la prueba t de student para comparar los puntajes en la calidad de los registros. Resultados: En legibilidad se obtuvo un nivel medio en la calidad de los registros (80,6%), en la completitud un 59,6% en el nivel alto y en la precisión un 40,4% en el nivel medio. El personal de enfermería obtuvo mejor calificación en la calidad de los registros que los cito-tecnólogos (p= 0,05). Conclusión: La calidad de los registros realizados por el personal de salud es media. MÉD.UIS. 2017;30(3):59-65.

ABSTRACT Introduction: Cervical cancer is a public health problem in Mexico, in 2012 528 000 new cases. One line of research related to the cervical cancer program is the quality of records in terms of readability, completeness, and accuracy. Objective: To evaluate the quality of the records made by the health personnel in the Cervical Cancer Detection Service. Materials and Methods: A cross-sectional study carried out at the Mexican Social Security Institute of San Luis Potosí, Mexico, from august 2012 to september 2013. The universe of records, application forms and results of cervical cytology performed during january to november of 2012 was 4139. A stratified probabilistic sampling (1 115 records) was applied. We used a checklist with 32 items divided into 7 sections. Three indicators were used to analyze the data: accuracy, readability and completeness. An ordinal scale was established with the score obtained: low (0-64), medium (65-128) and high (129-192). Student's t-test was used to compare scores on the quality of the records. Results: Readability reached a median level in the quality of the records (80.6%), in the completeness 59.6% in the high level and in the precision 40.4% in the average level. Nurses received better quality of records than cytotechnologists (p = 0.05). Conclusion: The quality of the records made by the health personnel is medium. MÉD.UIS. 2017;30(3):59-65.

[Eco-epidemiological aspects, natural detection and molecular identification of Leishmania spp. in Lutzomyia reburra, Lutzomyia barrettoi majuscula and Lutzomyia trapidoi].

INTRODUCTION: The province of Pichincha in Ecuador is an endemic area of cutaneous leishmaniasis, where anthropophilic sand flies with natural infection by Leishmania, have been reported as vectors. However, the role in transmission of zoophilic species has not been evaluated. OBJECTIVE: To evaluate natural infection by Leishmania in two zoophilic phlebotomine sand fly species, Lutzomyia reburra and Lu. barrettoi majuscula, and one anthropophilic species, Lu. trapidoi, as well as the endophagy and synanthropism of these species in the northwest of Pichincha. MATERIALS AND METHODS: Phlebotomines were collected using CDC light traps in different habitats and altitudes with presence of cutaneous leishmaniasis. Leishmania infection was detected using genomic DNA from females of the collected sand flies. We amplified the internal transcribed spacer gene of ribosomal RNA I (ITS1), the mitochondrial topoisomerase II gene (mtTOPOII), and the nuclear topoisomerase II gene (TopoII). Percentages of positivity for Leishmania, at spatio-temporal scale, proportion of endophagy and synanthropism index were calculated. RESULTS: Natural infection was determined for Le. amazonensis in Lu. reburra (9.5%) and Lu. b. majuscula (23.8%), while in Lu. trapidoi we detected Le. amazonensis, Le. brazilienis and Le. naiffi-lainsoni. Phlebotomines were asynanthropic and with low endophagy. CONCLUSION: Natural infection with Le. amazonensis was recorded for the first time in Lu. reburra and Lu. b. majuscula, demonstrating the importance of zoophilic phlebotomines in the maintenance of the Leishmania transmission cycle in endemic foci.