Dog Population Rabies Immunity before a Mass Vaccination Campaign in Lima, Peru: Vulnerabilities for Virus Reestablishment.

Lima, Peru, has not had a case of canine rabies since 1999. However, Lima remains at risk of rabies reintroduction due to the free movement of dogs from nearby rabies-endemic areas. In Latin America, rabies vaccination campaigns must reach 80% of dogs to halt transmission, but estimates of vaccine coverage are often unavailable, unreliable, or inaccurate. Quantifying virus neutralizing antibodies (VNA) allows monitoring of the immunological status of the canine population, evaluation of the degree of humoral protection to the virus, and assessing, partially, the population response to vaccination. We evaluated the dog population's immunity level against the rabies virus before a mass vaccination campaign in Lima. We collected 141 canine blood samples in the district of Surquillo and quantified rabies virus neutralizing antibody titers using the fluorescent antibody virus neutralization test). We surveyed dogs owners to reconstruct canine vaccination histories. Among dogs previously vaccinated, 73.9% exceeded the seroconversion threshold of > 0.5 IU/mL. Among all dogs, only 58.2% reached the titer limit for seroconversion. Dogs ≤ 1 year old constituted 26.2% of the total canine population and had lower levels of VNA than dogs > 1 year old (χ2 = 9.071; P = 0.028). Importantly, dogs vaccinated with single-pathogen vaccines had higher levels of VNA than those who received combined-pathogen vaccines (χ2 = 7.721; P = 0.005). We provide an important and timely glimpse to the immunity status of the dog population in urban areas of Lima, a metropolis near a dog rabies-endemic region.

Ecological determinants of rabies virus dynamics in vampire bats and spillover to livestock.

The pathogen transmission dynamics in bat reservoirs underpin efforts to reduce risks to human health and enhance bat conservation, but are notoriously challenging to resolve. For vampire bat rabies, the geographical scale of enzootic cycles, whether environmental factors modulate baseline risk, and how within-host processes affect population-level dynamics remain unresolved. We studied patterns of rabies exposure using an 11-year, spatially replicated sero-survey of 3709 Peruvian vampire bats and co-occurring outbreaks in livestock. Seroprevalence was correlated among nearby sites but fluctuated asynchronously at larger distances. A generalized additive mixed model confirmed spatially compartmentalized transmission cycles, but no effects of bat demography or environmental context on seroprevalence. Among 427 recaptured bats, we observed long-term survival following rabies exposure and antibody waning, supporting hypotheses that immunological mechanisms influence viral maintenance. Finally, seroprevalence in bats was only weakly correlated with outbreaks in livestock, reinforcing the challenge of spillover prediction even with extensive data. Together our results suggest that rabies maintenance requires transmission among multiple, nearby bat colonies which may be facilitated by waning of protective immunity. However, the likelihood of incursions and dynamics of transmission within bat colonies appear largely independent of bat ecology. The implications of these results for spillover anticipation and controlling transmission at the source are discussed.

Lesiones de causa externa y su relación con el alcohol en pacientes atendidos en un hospital de emergencia de Lima, Perú / External lesions and their relationship with alcohol consumption in patients attending in an emergency hospital in Lima, Peru

RESUMEN Objetivo: Describir las características demográficas, temporales y espaciales de las personas con lesiones de causa externa (LCE) y la relación con el consumo y la disponibilidad de alcohol, ocurridos en el distrito y atendidos en un hospital de emergencias. Material y métodos: Estudio descriptivo retrospectivo de personas atendidas por LCE en el Hospital de Emergencias José Casimiro Ulloa en el periodo 2014-2016 y la información de la denuncia policial por los afectados, en la comisaría del distrito. Se determinó la asociación entre las variables demográficas, temporales y espaciales con el tipo de LCE y la presencia de alcohol mediante pruebas de regresión logística. Resultados : Se encontró que era más probable la presencia de alcohol en un accidentado con LCE, cuando este era del sexo masculino en los días jueves a domingo. La contusión en una LCE en vez de una herida cortante, fue más probable cuando el accidentado era de sexo masculino, edades entre 15 a 38 años, la causa era una agresión, la ocurrencia del evento se producía entre las 00:00 a 18:00 horas, los días jueves a domingo y en los años 2014 y 2016. Geográficamente, la ocurrencia fue mayor en avenidas principales a no más de 500 metros de lugares donde se vendía y consumía licor. Conclusiones : La persona que va atenderse por lesiones de causa externa causadas como consecuencia de la violencia tiene una alta probabilidad de ser varón, además ocurren con mayor frecuencia los fines de semana y en avenidas principales en donde se puede usar un transporte público y no a más de 500 metros de lugares en donde se puede vender y consumir alcohol sin necesidad de ser residentes del distrito de ocurrencia, sin descartar que el consumo de alcohol pueda considerarse un factor de riesgo.

SUMMARY Objective: To describe demographic, temporal and spatial relationships of external lesions (EL) with alcohol consumption in patients attending an emergency hospital in Lima. Methods: Retrospective study of patients with EL attended at Hospital de Emergencias Casimiro Ulloa from 2014-2016 including information on police investigation. Logistic regression analysis was carried-out to evaluate association between type of EL and alcohol consumption. Results: The relationship of alcohol consumption and EL was stronger in males and from Thursday to Sunday. Contusions instead of stab wounds were more likely when the victim was male from 15-38 years of age and when had occurred from 00:00 to 18:00 from Thursdays to Sundays. EL occurred more frequently near main avenues at no more than 500 meters from alcoholic beverages were sold. Conclusions: Victims of EL are more likely to be males not necessarily living in the district where the aggression occurred, which tended to happen near main avenues close to where alcoholic beverages are offered. Alcohol consumption could not be ruled-out as a risk factors for EL.

Long-term maintenance of multidrug-resistant Escherichia coli carried by vampire bats and shared with livestock in Peru.

Extended-spectrum beta-lactamase-producing Escherichia coli (ESBL-E. coli) have been reported in wildlife worldwide. Whether wildlife is a transient host of ESBL-E. coli or comprises an independently maintained reservoir is unknown. We investigated this question by longitudinally monitoring ESBL-E. coli in common vampire bats and nearby livestock in Peru. Among 388 bats from five vampire bat colonies collected over three years, ESBL-E. coli were detected at a low prevalence (10% in 2015, 4% in 2017 and 2018) compared to a high prevalence (48%) from 134 livestock sampled in 2017. All ESBL-E. coli were multidrug-resistant, and whole genome sequencing of 33 randomly selected ESBL-E. coli isolates (18 recovered from bats) detected 46 genes conferring resistance to antibiotics including third-generation cephalosporins (e.g., blaCTX-M-55, blaCTX-M-15, blaCTX-M-65, blaCTX-M-3, blaCTX-M-14), aminoglycosides, fluoroquinolones, and colistin (mcr-1). The mcr-1 gene is reported for the first time on a wild bat in Latin America. ESBL-E. coli also carried 31 plasmid replicon types and 16 virulence genes. Twenty-three E. coli sequence types (STs) were detected, including STs involved in clinical infections worldwide (e.g., ST 167, ST 117, ST 10, ST 156 and ST 648). ESBL-E. coli with identical cgMLST (ST 167) were detected in the same bat roost in 2015 and 2017, and several ESBL-E. coli from different bat roosts clustered together in the cgMLST reconstruction, suggesting long-term maintenance of ESBL-E. coli within bats. Most antibiotic resistance and virulence genes were detected in E. coli from both host populations, while ESBL-E. coli ST 744 was found in a bat and a pig from the same locality, suggesting possible cross-species exchanges of genetic material and/or bacteria between bats and livestock. This study suggests that wild mammals can maintain multidrug-resistant bacteria and share them with livestock.

Abortive vampire bat rabies infections in Peruvian peridomestic livestock.

Rabies virus infections normally cause universally lethal encephalitis across mammals. However, 'abortive infections' which are resolved prior to the onset of lethal disease have been described in bats and a variety of non-reservoir species. Here, we surveyed rabies virus neutralizing antibody titers in 332 unvaccinated livestock of 5 species from a vampire bat rabies endemic region of southern Peru where livestock are the main food source for bats. We detected rabies virus neutralizing antibody titers in 11, 5 and 3.6% of cows, goats and sheep respectively and seropositive animals did not die from rabies within two years after sampling. Seroprevalence was correlated with the number of local livestock rabies mortalities reported one year prior but also one year after sample collection. This suggests that serological status of livestock can indicate the past and future levels of rabies risk to non-reservoir hosts. To our knowledge, this is the first report of anti-rabies antibodies among goats and sheep, suggesting widespread abortive infections among livestock in vampire bat rabies endemic areas. Future research should resolve the within-host biology underlying clearance of rabies infections. Cost-effectiveness analyses are also needed to evaluate whether serological monitoring of livestock can be a viable complement to current monitoring of vampire bat rabies risk based on animal mortalities alone.

Fluorescent biomarkers demonstrate prospects for spreadable vaccines to control disease transmission in wild bats.

Vaccines that autonomously transfer among individuals have been proposed as a strategy to control infectious diseases within inaccessible wildlife populations. However, rates of vaccine spread and epidemiological efficacy in real-world systems remain elusive. Here, we investigate whether topical vaccines that transfer among individuals through social contacts can control vampire bat rabies-a medically and economically important zoonosis in Latin America. Field experiments in three Peruvian bat colonies, which used fluorescent biomarkers as a proxy for the bat-to-bat transfer and ingestion of an oral vaccine, revealed that vaccine transfer would increase population-level immunity up to 2.6 times beyond the same effort using conventional, non-spreadable vaccines. Mathematical models showed that observed levels of vaccine transfer would reduce the probability, size and duration of rabies outbreaks, even at low but realistically achievable levels of vaccine application. Models further predicted that existing vaccines provide substantial advantages over culling bats-the policy currently implemented in North, Central and South America. Linking field studies with biomarkers to mathematical models can inform how spreadable vaccines may combat pathogens of health and conservation concern before costly investments in vaccine design and testing.

[Detection of stool antigens of Echinococcus granulosus in dogs belonging to slaughterhouse workers and offal merchants in Metropolitan Lima]. / Detección de coproantígenos de Echinococcus granulosus en canes de trabajadores de camales y comercializadores de vísceras en Lima metropolitana.

OBJECTIVE: To demonstrate the presence of Echinoccocus granulosus in the definitive host in the city of Lima, Perú, by detecting parasite antigens in the stool of dogs belonging to offal handlers and merchants in authorized slaughterhouses in Metropolitan Lima. METHODS: Stool samples were collected from 58 dogs and examined using the coproELISA technique for the detection of secretory/excretory antigens of E. granulosus. A survey was conducted to obtain information on pet feeding and handling practices. RESULTS: Positivity to E. granulosus was detected in 13.8% (8/58) of the dogs. In 27.8% (5/18) of the homes, at least one animal showed positivity, and in families that had more than four dogs the chances of finding positivity in at least one dog were higher (P < 0.05). In all homes where at least one dog tested positive the pets were fed on offal. Of study participants, 94.4% (17) knew nothing about the routes of transmission of hydatid disease. CONCLUSIONS: Results show the presence of definitive hosts in the urban area of Lima and underscore the need to more widely disseminate practices for the prevention of parasite transmission.

Detección de coproantígenos de Echinococcus granulosus en canes de trabajadores de camales y comercializadores de vísceras en Lima metropolitana / Detection of stool antigens of Echinococcus granulosus in dogs belonging to slaughterhouse workers and offal merchants in Metropolitan Lima

Objetivo. Demostrar la presencia de Echinoccocus granulosus en el hospedero definitivo en la ciudad de Lima, Perú, mediante la detección de antígenos del parásito en heces de canes pertenecientes a trabajadores y comercializadores de vísceras de centros de beneficio autorizados en Lima metropolitana. Métodos. Se recolectaron muestras de heces de 58 canes, que fueron evaluadas utilizando la técnica coproELISA para detectar antígenos secretorio/excretorio de E. granulosus. Mediante una encuesta se obtuvo información sobre las prácticas de alimentación y el manejo de las mascotas. Resultados. El 13,8% (8/58) de canes fue positivo a E. granulosus. En 27,8% (5/18) de los hogares se encontró al menos un animal positivo y se estimó que en las familias que tenían más de cuatro canes las posibilidades de encontrar al menos uno positivo eran mayores. En todos los hogares con al menos un can positivo sus mascotas se alimentaban con vísceras. El 94,4% (17) de los participantes no tenía conocimiento de las formas de contagio de la equinococosis. Conclusiones. Los resultados muestran la presencia de hospederos definitivos en la zona urbana de Lima y subrayan la necesidad de aumentar la difusión de las prácticas para evitar la transmisión del parasito.

Objective. To demonstrate the presence of Echinoccocus granulosus in the definitive host in the city of Lima, Perú, by detecting parasite antigens in the stool of dogs belonging to offal handlers and merchants in authorized slaughterhouses in Metropolitan Lima. Methods. Stool samples were collected from 58 dogs and examined using the coproELISA technique for the detection of secretory/excretory antigens of E. granulosus. A survey was conducted to obtain information on pet feeding and handling practices. Results. Positivity to E. granulosus was detected in 13.8% (8/58) of the dogs. In 27.8% (5/18) of the homes, at least one animal showed positivity, and in families that had more than four dogs the chances of finding positivity in at least one dog were higher (P < 0.05). In all homes where at least one dog tested positive the pets were fed on offal. Of study participants, 94.4% (17) knew nothing about the routes of transmission of hydatid disease. Conclusions. Results show the presence of definitive hosts in the urban area of Lima and underscore the need to more widely disseminate practices for the prevention of parasite transmission.

Detección de coproantígenos de Echinococcus granulosus en canes de trabajadores de camales y comercializadores de vísceras en Lima metropolitana / Detection of stool antigens of Echinococcus granulosus in dogs belonging to slaughterhouse workers and offal merchants in Metropolitan Lima

RESUMEN Objetivo Demostrar la presencia de Echinoccocus granulosus en el hospedero definitivo en la ciudad de Lima, Perú, mediante la detección de antígenos del parásito en heces de canes pertenecientes a trabajadores y comercializadores de vísceras de centros de beneficio autorizados en Lima metropolitana. Métodos Se recolectaron muestras de heces de 58 canes, que fueron evaluadas utilizando la técnica coproELISA para detectar antígenos secretorio/excretorio de E. granulosus. Mediante una encuesta se obtuvo información sobre las prácticas de alimentación y el manejo de las mascotas. Resultados El 13,8% (8/58) de canes fue positivo a E. granulosus. En 27,8% (5/18) de los hogares se encontró al menos un animal positivo y se estimó que en las familias que tenían más de cuatro canes las posibilidades de encontrar al menos uno positivo eran mayores. En todos los hogares con al menos un can positivo sus mascotas se alimentaban con vísceras. El 94,4% (17) de los participantes no tenía conocimiento de las formas de contagio de la equinococosis. Conclusiones Los resultados muestran la presencia de hospederos definitivos en la zona urbana de Lima y subrayan la necesidad de aumentar la difusión de las prácticas para evitar la transmisión del parasito.

ABSTRACT Objective To demonstrate the presence of Echinoccocus granulosus in the definitive host in the city of Lima, Perú, by detecting parasite antigens in the stool of dogs belonging to offal handlers and merchants in authorized slaughterhouses in Metropolitan Lima. Methods Stool samples were collected from 58 dogs and examined using the coproELISA technique for the detection of secretory/excretory antigens of E. granulosus. A survey was conducted to obtain information on pet feeding and handling practices. Results Positivity to E. granulosus was detected in 13.8% (8/58) of the dogs. In 27.8% (5/18) of the homes, at least one animal showed positivity, and in families that had more than four dogs the chances of finding positivity in at least one dog were higher (P < 0.05). In all homes where at least one dog tested positive the pets were fed on offal. Of study participants, 94.4% (17) knew nothing about the routes of transmission of hydatid disease. Conclusions Results show the presence of definitive hosts in the urban area of Lima and underscore the need to more widely disseminate practices for the prevention of parasite transmission.

Characterization of paneth cells in alpacas (Vicugna pacos, Mammalia, Camelidae).

Paneth cells are secretory epithelial cells of the innate immune system of the intestine of several mammals, including alpacas. Little is known about the latter; thus, in the present study we described the morphology and histochemical characteristics of Paneth cells in healthy fetuses, and young and adult alpacas. For this purpose, samples of duodenum, jejunum and ileum were taken from 6 fetuses at different days of pregnancy (between days 221-330), 66 offsprings (between 0 and 45-days-old) and 5 adult alpacas (>2-years-old). Samples were fixed in 10% buffered formalin and processed for histological and morphometrical analysis using HE and Masson Trichomics technique. Immunohistochemistry was used to identify Paneth cells using anti-lysozyme antibody. In addition, the lectinhistochemichal binding-pattern of Paneth cells granules was evaluated. Lyzozyme was immunohistochemically detected in the granules of Paneth cells from day 283 of pregnancy in all the small intestinal sections of the studied fetuses. In newborn alpacas Paneth cells were initially found in the duodenum, but the following days (days 18-21 after birth) they were also found in the ileum. Their size gradually increased after birth, but then no significant differences were found. In adult alpacas the number was lower than offsprings. We suggest that Paneth cells early differentiate in the small intestine of alpacas, and the increase in their number during the first two weeks of life strongly support their possible involvement in the intestinal defensive functions against the enteric diseases that occur during the lactancy stage.

Contaminación de suelos con huevos de Toxocara sp. en ambientes internos de Instituciones Educativas Estatales de los distritos del cono Norte de Lima / Soil contamination with Toxocara eggs in indoor environments of Educational Instutions from North Lima

Determinar la presencia de huevos de T. canis en el suelo de Instituciones Educativas del Norte de Lima. Metodología: Se recolectó una muestra de suelo en 30 instituciones estatales educativas (IEE) de los siguientes distritos de Lima norte: Comas (n=17), Puente Piedra (n=8), Ancón (n=3) y Carabayllo (n=2). Todas las muestras se procesaron mediante la técnica de concentración por flotación. Resultados y Conclusiones: Se obtuvieron dos muestras positivas lo que representa una frecuencia 6.7%. Las IEE que resultaron positivas correspondían al distrito de Comas y Puente Piedra...

To determine the presence of Toxocara canis eggs on the ground of some Public Schools in North Lima. Methods: Thirty ground samples were collected from Public Schools in the following North Lima districts: Comas (n=17), Puente Piedra (n=8), Ancón (n= 3) and Carabayllo (n=2). Samples were processed using the Concentration by Flotation Technique. Results: Two samples positive, which represents a frequency of 6.7%. The positive samples belong to to the districts of Comas and Puente Piedra...

Indicadores demográficos y estimación de la población de canes con dueños en el distrito de San Martin de Porres, Lima-Perú / Demographic Indicators and Estimated Population of owned dogs in the district of San Martin de Porres, Lima-Peru

Determinar los indicadores demográficos y estimar la población de canes con dueño en el distrito de San Martin de Porres. Metodología: Se desarrolló encuestas, que se entregaron a los hogares a través de los estudiantes de nivel primario o fueron resueltas en el aula por estudiantes de nivel secundario de Instituciones Educativas cuyas autoridades respaldaron la investigación. El instrumento utilizado fue aprobado por las autoridades de la Municipalidad, las mismas que apoyaron la coordinación y distribución correspondiente. Para la estimación de la población de canes se utilizó los resultados del Censo de población del INEI del año 2007 y la proyección de esta población al 2013. Resultados y Conclusiones: Se encontró que el porcentaje de hogares con canes fue de 58,2% y que la media de canes por vivienda fue de 1,6. La relación persona: can fue 7:1. Con datos del censo del INEI del 2007, la proyección estimada total de canes que fue de 82 794. La estimación de perros ajustado al tipo de vivienda y la relación persona: can fue de 83 845, difiriendo en 1051 (1.01%). Considerando la proyección del crecimiento poblacional para el año 2013 y manteniendo la relación persona: can, se estimó un total de 96 164 canes lo que representaría una tasa de crecimiento de 16,1% para el periodo 2007-2013. Se espera que los resultados del estudio ofrezcan información que favorezca la labor del sector salud y autoridades municipales en el desarrollo y planificación de las campañas de vacunación antirrábica y los programas relacionados con la tenencia responsable de los animales de compañía...

The aim of this study was to determine demographic indicators and to estimate the population of owned dogs in the district of San Martin de Porres using surveys. Methods: This was carried out with the help of school students under authorities approval and supervision. To calculate the dogÆs population we used the INEIÆs Population Census from 2007 and their projection to the year 2013. Results and Conclusions: Results showed that the percentage of households with dogs was 58,2%, the average per house was 1,6 dogs, and the human:can ratio was 7:1. Using the INEI´s census data from 2007, the total dog´s population estimated was 82 794, however we estimated the dogsÆ population, adjusted to the type of housing and the human: can ratio, to be 83 845, which differed in 1051 (1.01%). Taking in consideration the projected population growth by 2013, and keeping the human: can ratio, there will be a total of 96164 dogs which could represent a growth rate of 16,1% for 2007 to 2013. The results of this study will provide valuable information to promote the work from the health and local authorities to plan rabies vaccination campaigns and to develop programs related to a responsible pet ownership in the community...

Accidentes ocupacionales en personal que labora en clínicas y consultorios de animales de compañía, Lima 2010 / Ocupational injuries among Veterinarians in Peru

La práctica veterinaria es considerada como una actividad de alto riesgo y la posibilidad de sufrir daños a la salud producto de accidentes ocupacionales es latente. Objetivo: identificar los accidentes ocupacionales asociados a la actividad laboral de los profesionales que laboran en consultorios y clínicas veterinarias de animales de compañía en la ciudad de Lima durante el año 2010. Metodología: Se elaboró y aplicó una encuesta semi estructurada a Médicos Veterinarios y personal técnico que laboraban en estos lugares, para identificar datos generales de los accidentes producidos durante la actividad laboral y una percepción acerca de este problema por parte de los encuestados. Resultados y Conclusiones: Se encuestaron a 400 personas. La edad y tiempo de experiencia en la actividad fue de 29.3 (18-63) y 5.5 (1-40) años en promedio, respectivamente. El 55% fueron varones y 45% mujeres. El 80.8% sufrieron al menos un accidente en el 2010. Los accidentes más frecuentes producidos por animales fueron mordeduras (31.1%) y arañazos (26.6%); y los producidos por elementos inanimados fueron pinchazos (21.5%) y cortes (8.7%). Los manos (68.9%) y brazos (20.2%) fueron las regiones anatómicas más afectadas y las cicatrices la secuela más común (49.9%). El 44.5% reportó problemas musculo esqueléticas en espalda, cuello y/o extremidades. El área de trabajo fue considerada cómoda para el 89% y seguras para el 79% de los trabajadores. Se hace necesario capacitar a los trabajadores de esta área sobre prácticas de seguridad y bioseguridad en el ambiente laboral.

Veterinary practice is considered as a high-risk activity and the possibility of suffering any health injury due to occupational accidents is latent. Aim: To identify worked-related accidents in professionals who labor in animal centers and veterinary clinics of small animals in Lima city during 2010. Methods: A semi-structured survey was elaborated and applied among 400 Veterinarians and technicians who worked in these places, gathering general information of the accidents produced during work activity and the perception of this problematic among them. Results and Conclusions: The age and experience time in this type of work was 29.3 (18-63) and 5.5 (1-40) years old on average, respectively. 55% of the respondents were males and 45% females. At least 80.8% had an injury during 2010. The work-related accidents most frequently produced by animals were bites (31.1%) and scratches (26.6%); also lesions produced by inanimate elements were pinch (21.5%) and cuts (8.7%). Hands (68.9%) and arms (20.2%) were the anatomic regions most affected, and scars were the most commonly sequel reported (49.9%). 44.5% of the respondents reported musculoskeletal problems on back, neck and/or extremities. The work environment was indicated as comfortable for the 89.0% of people surveyed and secure for the 79.0% of workers. There is a need to train workers in the area of environmental health and safety.

Costos de la atención de pacientes con Equinococosis Quistica Humana en un hospital de niños en Lima- Perú, periodo 2006-2010 / Health Care Expenses in patients with Cystic Echinococcosis in a Children Hospital at Lima-Peru, Period 2006-2010

Objetivo: Determinar los costos de la atención de pacientes con diagnóstico de Equinococosis Quística Humana (EQH) en el Instituto Nacional de Salud del Niño, durante el periodo 2006-2010. Metodología: Se revisó las historias clínicas de 143 pacientes diagnosticados con EQH de las cuales se obtuvo información del sexo, edad, así como los costos de: consultorio externo, estancia hospitalaria, farmacia, exámenes de laboratorio, imagenología e intervenciones quirúrgicas. Las historias clínicas fueron solicitadas a la Unidad de Registros Médicos de la Oficina de Estadística e Informática y los costos fueron proporcionados por la Unidad de Cuentas Corrientes y el Servicio de Farmacia. Resultados y Conclusiones: La mayoría de pacientes atendidos estuvieron en el rango de edad de 5 a 9 años (48.2%). El promedio de estancia hospitalaria fue de 34 días, con un rango de 2 a 227 días. La ubicación pulmonar del quiste fue la de mayor ocurrencia (39.9%). El costo de todos los pacientes atendidos fue 130 743,1 dólares de Estados Unidos y el costo promedio según el tipo de paciente se dio de la siguiente manera: pacientes hospitalizados con cirugía fue de 914,3 dólares, pacientes hospitalizados sin cirugía fue de 298,7 dólares y pacientes sin hospitalización fue de 88,1 dólares. En farmacia se reportó el mayor costo el cual corresponde al 53.7% del total. Por la importancia de esta zoonosis se requiere acción inmediata, decidida y combinada de los servicios de sanidad animal y salud pública para controlarla.

Aim: To determine the expenses in the medical care of patients diagnosed with Cyst Echinococcosis (CE) at the Instituto Nacional de Salud del Niño, during 2006 to 2010. Methodology: Medical records of 143 patients with diagnosis of CE were reviewed and information such as gender, age, and cost of medical visit, hospitalization, pharmacy, laboratory tests, imaging and surgical intervention were gathered. Medical records were requested at the Unidad de Registros Médicos de la Oficina de Estadística e Informática, and the expenses information were provided by the Unidad de Cuentas Corrientes y el Servicio de Farmacia. The majority of patients treated were in the age range of 5 to 9 years (48.2%). The mean of hospitalization was 34 days with a range of 2 to 227 days. Pulmonary cyst (39.9%) was the most common diagnosis. The total cost of patients care was 130 743,1 United States dollars and the mean cost according to the type of patients was the following: cost of patients hospitalized with surgery, 914,3 US dollars, patients hospitalized without surgery, 298,7 US dollars; and patients without hospitalization, 88,1 US dollars. The pharmacy section cost was 53.7% of the total cost. Because of the importance of this zoonosis, there is a need to have immediate action and decision of the services in animal and public health to control this disease.

Impacto de un terremoto sobre los animales de compañia en tres distritos de la provincia de Chincha, Perú / The impact of an earthquake on tenure and welfare of animals in Perú

Evaluar el impacto del terremoto ocurrido el año 2007 sobre la tenencia y bienestar de los animales de compañía y de crianza de traspatio en tres distritos de la Provincia de Chincha, departamento de Ica-Perú. Metodología: Se desarrolló una encuesta que contenía datos demográficos y de tenencia de animales en el periodo pre y post desastre (2007 y 2012). Además, información de muertes y desapariciones post desastre. Resultados y Conclusiones: Se recolectaron 300 encuestas de las cuales 49% correspondió a Chincha Alta, 40% a Pueblo Nuevo y 11% a Tambo de Mora. El 49% de encuestados fueron varones y 51% mujeres. Según las encuestas, antes del terremoto existían 262 perros. De ellos, 27.9% (73) murieron en el desastre, 26% (68) desaparecieron y 46.1% (121) se encontraron vivos. Al momento de la encuesta, se reportó 150 animales, lo que indica una disminución de la población de perros del 42.7%. Respecto a los gatos, ante del terremoto existía 153 animales. De ellos, 24.2% (37) murieron en el desastre, 23.5% (36) desaparecieron y 52.3% (80) se encontraron vivos. Al momento de la encuesta, se reportó 95 animales, representando una disminución de la población del 37.9%. En ambos casos, la composición etárea varío significativamente (p < 0.05) entre lo encontrado antes del terremoto y la actualidad. En el caso de animales de traspatio, antes del terremoto se registró 777 animales, entre aves, porcinos, bovinos, cuyes, entre otros. De ellos 9.9% (77) murieron en el desastre, 5% (39) desaparecieron y 85.1% (661) se encontraron vivos. Se concluye que el terremoto del 2007 produjo un impacto negativo sobre la población de animales de compañía en la zona, afectando su número y composición etárea, situación que no se observó en los animales de traspatio...

To evaluate the impact of 2007 earthquake on tenure and welfare of pets and backyard breeding in three districts in the province of Chincha, Ica, Perú. Methods: We developed a survey containing demographic data, tenure of different types of animals during a pre-disaster period (2007) and now (2012), besides information on deaths and disappearances post disaster. Results and Conclusions: 300 surveys were collected, 49% corresponded to Chincha Alta, 40% to Pueblo Nuevo and 11% to Tambo de Mora. 49% respondents were male and 51% female. According to surveys, before the earthquake there were 262 dogs. 27.9% (73) died in the disaster, 26% (68) disappeared and 46.1% (121) were found alive. At the time of the survey, 150 animals were reported, which means dog population was decrease by 42.7%. Regarding cats, before the earthquake were 153 animals. 24.2% (37) died in the disaster, 23.5% (36) disappeared and 52.3% (80) were found alive. At the time of the survey, 95 animals were reported, representing a decrease by 37.9% in population. Both cases, age composition varied significantly (p < 0.05) between the findings before the earthquake and now. For backyard animals 777 animals were recorded before the earthquake, including birds, pigs, cattle, guinea pigs, among others. 9.9% (77) of them died in the disaster, 5% (39) disappeared and 85.1% (661) were found alive. In conclusion, the earthquake in 2007 had a negative impact on pet population in the area, affecting the number and age composition, which is not observed in backyard animals...

Costos de hospitalización de los accidentes por mordedura de canes en un hospital de niños en Lima-Perú, periodo 2006-2010 / Cost of hospitalization for dogs bite accidents in a children's hospital in Lima, Peru, 2006-2010 period

Objetivos: Determinar los costos de los pacientes hospitalizados por mordedura de canes atendidos en el Instituto Nacional de Salud del Niño Lima- Perú (INSN), periodo 2006-2010. Material y Métodos: Se revisó las historias clínicas de 72 pacientes con diagnóstico de mordedura canina de las cuales se obtuvo información tal como sexo, procedencia, edad, estancia hospitalaria, medicamentos usados, exámenes auxiliares y procedimientos médicos. Los costos fueron proporcionados por el Servicio de Farmacia y el Servicio de Cirugía Plástica del INSN. Resultados: Del total de hospitalizados, 68% pertenecieron al sexo masculino y 32% al femenino. El 79% de pacientes asumieron los costos hospitalarios mediante financiamiento propio, mientras, que en el 21% de los pacientes el costo fue subvencionado por el INSN. El 78% de los casos pertenecieron a Lima y Callao y el 22% a regiones del interior del país. El rango de edad de los pacientes afectados fue de 1 a 4 años (53%) y el promedio de estancia hospitalaria fue de 7 días, con un rango de 1 a 32 días. Se obtuvo que el costo total fue de 15 181,5 US dólares y el costo promedio por día fue de 30,6 US dólares. El rubro en el que se produjo el mayor costo es el de farmacia en el que se encuentra incluido principalmente materiales quirúrgicos y productos de fluidoterapia. Conclusiones: Los accidentes por mordedura canina producen costos de hospitalización elevados, por lo que se debe establecer programas de control a fin de disminuir su incidencia.

Objectives: Dog bites are an important problem in public health which involves physical and physiological injuries, zoonotics diseases and mean a high cost in the community. For this reason the objective of this research was to define the costs of hospitalization for patients at Instituto Nacional de Salud del Niño Lima-Perú (INSN), during the 2006-2010 period. Material and methods: Medical history of 72 patients diagnosed with dog bites were reviewed in which we obtained information about sex, place of origin, age, hospital staying, drugs used, tests, and surgical procedures. Cost information was provided by the Pharmacy Service and Plastic Surgery Service of INSN. Results: From all the hospitalized, 68% were male and 32% were female. 79% of patients assumed the cost of hospitalization through their own funding and for 21% of the patients the cost was subsidized by the INSN. 78% of the cases belonged to Lima and Callao and 22% to the countryÆs interior regions. The age range of affected patients was from 1 to 4 years (53%). The average hospital staying was 7 days, with a range from 1 to 32 days. The total cost was 15 181,5. US dollars and the average cost per day was 30,6 US dollars. The item which produces the major cost is the pharmacy (involving surgical and fluid products). Conclusions: Dog bites accidents produce high hospital cost, so it must be established control programs to reduce its incidence.

Accidentes por animales ponzoñosos en pacientes internados en un hospital de niños en Lima, Perú. Estudio retrospectivo en el periodo 2000-2009 / Accidents by venomous animals in patients hospitalized children in Lima, Perú. Retrospective study during the 2000 û 2009 period

Se caracterizó los accidentes por animales ponzoñosos en pacientes internados en un hospital de niños en LimaPerú, período 2000 û 2009. De 105 historias clínicas revisadas, 85,7% (90) fueron casos de aracneísmo y 12,4% (13) de ofidismo; además de un accidente por alacrán y uno por larva de lepidóptero. Entre los accidentados por arácnidos, la edad media fue 7,1 años. Se presentó casos de loxoscelismo cutáneo (51,1%) y loxoscelismo víscero hemolítico cutáneo (48,9%), producido por Loxosceles laeta. La hospitalización media fue de 13,2 días. Las lesiones se ubicaron en: cara, cabeza y cuello (25,5%); miembro superior (32,1%); tórax y abdomen (18,9%) y miembros inferiores (23,3%). Los signos y síntomas frecuentes fueron edema (83,3%), dolor (81,1%), eritema (76,7%) y flogosis (56,7%). El 66,7% de los casos recibió suero antiloxoscélico monovalente. Las complicaciones frecuentes fueron infecciones de piel (57,8%), insuficiencia renal aguda (32,2%) y fasceitis necrotizante (3,3%). Hubo dos fallecimientos. Entre los accidentados por ofidios, la edad media fue 8,3 años. El 46,2% fueron casos moderados y 53,8% severos., producidos por Bothrops atrox (92,3%) y Bothrops pictus (7,7%). La hospitalización media fue de 33,8 días. Las lesiones se ubicaron en: cabeza (7,7%), miembro superior (38,5%) y miembros inferiores (53,9%). Los signos y síntomas frecuentes fueron edema (84,6%), dolor (84,6%) y necrosis (69,2%). El 84,6% de los casos recibió suero antibotrópico polivalente. Las complicaciones frecuentes fueron síndrome compartimental (38,5%), fascitis necrotizante (30,8 %) e infecciones de piel (15,4%). Se reportó un fallecimiento.

Was characterized the accidents by poisonous animals in patients hospitalized children in Lima, Peru, period 2000 - 2009. Of 105 medical records reviewed, 85.7% (90) were cases of arachnid and 12.4% (13) of snakebite, and a scorpion and an accident by lepidopteran larvae. Among those injured by spiders, the mean age was 7.1 years. Loxoscelism cutaneous cases was presented (51.1%) and viscero hemolytic loxoscelism (48.9%) produced by Loxosceles laeta. The hospital average length of stay was 13.2 days. The lesions were located in: face, head and neck (25.5%) upper limb (32.1%), thorax and abdomen (18.9%) and lower limbs (23.3%). The common signs and symptoms were edema (83.3%), pain (81.1%), erythema (76.7%) and phlogosis (56.7%). The 66.7% of victims received antiloxoscelis monovalent serum. Frequent complications were skin infections (57.8%), acute renal failure (32.2%) and necrotizing fasciitis (3.3%). There were two deaths. Among those injured by snakes, the mean age was 8.3 years. 46.2% were moderate and 53.8% severe, produced by Bothrops atrox (92.3%) and Bothrops pictus (7.7%). The hospitalization average length was 33.8 days. The lesions were located in: head (7.7%), upper limb (38.5%) and lower limbs (53.9%). The frecuent signs and symptoms were edema (84.6%), pain (84.6%) and necrosis (69.2%). The 84.6% of the stories reported the administration of botropic multipurpose serum. The common complications were compartment syndrome (38.5%), necrotizing fasciitis (30.8%) and skin infections (15.4%). One death was reported.

Conocimientos y buenas prácticas de manufactura en personas dedicadas a la elaboración y expendio de alimentos preparados, en el distrito de Los Olivos, Lima Perú / Knowledge and good manufacturing practices in people engaged in the development and sale of prepared foods, in the district of Los Olivos, Lima - Peru

Objetivo: Evaluar el impacto de las capacitaciones sanitarias ofrecidas por un gobierno local sobre la persistencia y aplicaciones de los conocimientos de buenas prácticas de manufactura (BPM) en 60 manipuladores de alimentos de 11 mercados y 23 restaurantes del Distrito de los Olivos. Material y Métodos: Se utilizó un test post capacitación y dos meses después de la misma y se evaluó in situ la aplicación de las BPM en el manipulador de alimentos a través de una tabla de cotejo diseñada para el estudio. Resultados: Se encontró que los cursos de manipulación de alimentos aumentan el nivel de conocimientos sobre prácticas de manipulación de alimentos, pero que no necesariamente éstos se aplican en la preparación de los mismos. Se reportó que un aspecto crítico post capacitación fue el desconocimiento de la contaminación cruzada y sus implicancias. Se observó importantes omisiones en la aplicación de la BPM durante la manipulación de alimentos en la actividad rutinaria, entre ellas la inadecuada separación de alimentos en el momento de su preparación y la presencia de equipos inservibles en el lugar de trabajo. Conclusiones: Se hace necesario desarrollar capacitaciones constantes a fin de lograr la persistencia de los conocimientos sobre BPM y la supervisión de su aplicación por parte de los manipuladores de alimentos a fin de prevenir potenciales brotes de enfermedades transmitidas por alimentos.

Objective: The aim of the study was to assess the health impact of the sanitary training offered by a local government on the persistence and applications of knowledge of good manufacturing practices (GMP) in 60 food handlers from 11 markets and 23 restaurants in the District of Los Olivos. Material and methods: In order of that we used a post-training test and two months after training it was in situ assessed the application of GMP in the food handlers through a comparison table previously designed for the study. Results: The results show that food handling courses increase the level of knowledge about food handling practices, but that does not necessarily mean that they are applied in the food preparation, reporting that a critical post-training was the lack of cross-contamination and its implications. It was found significant omissions in the application of the GMP during food handling in the routine activity, including inadequate separation of food at the time of its preparation and the presence of non-functional equipment in the workplace. Conclusions: It is necessary to develop continuous training to achieve the persistence of GMP knowledge and supervision of its application by the food handlers in order to prevent food-borne diseases.

Fauna silvestre y productos derivados decomisados durante el período 2000-2007, Lima-Perú / Wildlife and wildlife products confiscated during the period 2000-2007, Lima - Peru

Describir las características del decomiso de animales silvestres y productos derivados realizado por la Administración Técnica Forestal y de Fauna Silvestre (ATFFS) durante el período 2000 - 2007 en la ciudad de Lima - Perú. Material y métodos: Para ello, se revisó la base de datos de decomisos de la ATFFS para el período de estudio. Resultados: se encontró 17 932 animales vivos y 81 564 productos derivados decomisados en el período 2000-2007. Entre los animales vivos, el 47,3% (8479) fueron aves, 34,1% (6111) anfibios, 13,1% (2341) reptiles y 5,6% (1001) mamíferos. La mayor cantidad de especies decomisadas corresponde a las aves de la familia Psittacidae. De los productos derivados de animales silvestres, el 98,3% (80216) correspondió a animales taxidermizados, 0,8% (627) pieles, 0,7% (600) instrumentos y 0,1% (121) carnes. También se encontró ejemplares no identificados lo que no permite obtener información necesaria para la evaluación de la situación actual de las especies sujetas a tráfico ilegal. Conclusiones: Debido a la magnitud del tráfico de animales silvestres y productos derivados se hace necesario buscar nuevas alternativas para reducir este tipo de actividad ilícita que afecta a la biodiversidad del país...

Objectives: To describe the characteristics of the confiscation wildlife and products made by the Technical Administration of Forestry and Wildlife (ATFFS) during the period from 2000 to 2007 in the city of Lima - Peru. Methods: To do this, we reviewed the database ATFFS for the study period Results: 17932 live animals and 81564 products confiscated in the period 2000-2007. Among living animals, 47.3% (8479) were birds, 34.1% (6111) amphibian, 13.1% (2341) Reptiles and 5,6% (1001) mammals. Most species of birds confiscated corresponds to family Psittacidae. Of wildlife products, 98.3% (80216) corresponded to animal taxidermy, 0.8% (627) furs, 0.7% (600) instruments and 0.1% (121) bush meat. Also found an unidentified specimen which does not allow obtaining information necessary for the evaluation of the current status of the species subject to trade. Conclusions: Because of the extent of trade of wildlife and their products is necessary to find new ways to reduce this kind of illegal activity affecting the countryÆs biodiversity...