The Chikungunya virus: A reemerging cause of acute febrile illness in the high jungle of northern Peru.

BACKGROUND: The Chikungunya virus (CHIKV) is an emerging arthropod-borne virus (arbovirus) that causes undifferentiated acute febrile illness. Cases of CHIKV may be under-reported in Peru, given the various difficulties in diagnosing it, such as lack of diagnostic tests in remote areas, the passive nature of epidemiological surveillance, and co-circulation of other arthropod-borne pathogens. Therefore, a study was conducted in the high jungle of northern Peru to determine the prevalence of CHIKV among febrile patients and describe their clinical characteristics. METHODS: A cross-sectional study was conducted in the province of Jaen, Cajamarca, located in the high jungle of northern Peru. Patients attending primary healthcare centers within Cajamarca's Regional Health Directorate were enrolled. The study took place from June 2020 through June 2021. Patients were eligible if they sought outpatient healthcare for a clinical diagnosis of acute febrile illness (AFI). Serum samples were collected from all patients, and the diagnosis of CHIKV was determined using real-time RT-PCR, as well as the detection of IgM antibodies by ELISA. A logistic regression model was employed to identify the risk factors for CHIKV, and the odds ratios (ORs) were calculated, along with their corresponding 95% confidence intervals (95% CI). RESULTS: A total of 1 047 patients with AFI were included during the study period. CHIKV was identified in 130 patients of 1 047 (12.4%). Among the CHIKV positive cases, 84 of 130 (64.6%) were diagnosed by RT-PCR, 42 of 130 (32.3%) by IgM ELISA detection, and 4 of 130 (3.1%) by both assays. The majority of patients with CHIKV infection fell within the 18-39 years age group (50.0%), followed by the 40-59 years age group (23.9%) and those with 60 years or older (10.8%). The most common clinical symptoms observed in patients with CHIKV infection were headache (85.4%), myalgias (72.3%), and arthralgias (64.6%). The highest number of positive CHIKV cases occurred in May (23.1%), followed by March (20.0%) and February (13.8%) of 2021. CONCLUSION: The study reports a considerable frequency of CHIKV infections among patients with AFI from the high jungle of northern Peru. These findings highlight the importance of recognizing CHIKV as an ongoing pathogen with continuous transmission in various areas of Peru. It is crucial to enhance epidemiological surveillance by implementing reliable diagnostic techniques, as the clinical symptoms of CHIKV infection can be nonspecific.

Detection of SARS-CoV-2 antibodies in febrile patients from an endemic region of dengue and chikungunya in Peru.

INTRODUCTION: The rapid expansion of the novel SARS-CoV-2 virus has raised serious public health concerns due to the possibility of misdiagnosis in regions where arboviral diseases are endemic. We performed the first study in northern Peru to describe the detection of SARS-CoV-2 IgM antibodies in febrile patients with a suspected diagnosis of dengue and chikungunya fever. MATERIALS AND METHODS: A consecutive cross-sectional study was performed in febrile patients attending primary healthcare centers from April 2020 through March 2021. Patients enrolled underwent serum sample collection for the molecular and serological detection of DENV and CHIKV. Also, serological detection of IgM antibodies against SARS-CoV-2 was performed. RESULTS: 464 patients were included during the study period, of which (40.51%) were positive for one pathogen, meanwhile (6.90%) presented co-infections between 2 or more pathogens. The majority of patients with monoinfections were positive for SARS-CoV-2 IgM with (73.40%), followed by DENV 18.09% and CHIKV (8.51%). The most frequent co-infection was DENV + SARS-CoV-2 with (65.63%), followed by DENV + CHIKV and DENV + CHIKV + SARS-CoV-2, both with (12.50%). The presence of polyarthralgias in hands (43.75%, p<0.01) and feet (31.25%, p = 0.05) were more frequently reported in patients with CHIKV monoinfection. Also, conjunctivitis was more common in patients positive for SARS-CoV-2 IgM (11.45%, p<0.01). The rest of the symptoms were similar among all the study groups. CONCLUSION: SARS-CoV-2 IgM antibodies were frequently detected in acute sera from febrile patients with a clinical suspicion of arboviral disease. The presence of polyarthralgias in hands and feet may be suggestive of CHIKV infection. These results reaffirm the need to consider SARS-CoV-2 infection as a main differential diagnosis of acute febrile illness in arboviruses endemic areas, as well as to consider co-infections between these pathogens.

Further insight into the geographic distribution of Leishmania species in Peru by cytochrome b and mannose phosphate isomerase gene analyses.

To obtain further insight into geographic distribution of Leishmania species in Peru, a countrywide survey, including central to southern rainforest areas where information on causative parasite species is limited, was performed based on cytochrome b (cyt b) and mannose phosphate isomerase (mpi) gene analyses. A total of 262 clinical samples were collected from patients suspected of cutaneous leishmaniasis (CL) in 28 provinces of 13 departments, of which 99 samples were impregnated on FTA (Flinders Technology Associates) cards and 163 samples were Giemsa-stained smears. Leishmania species were successfully identified in 83 (83.8%) of FTA-spotted samples and 59 (36.2%) of Giemsa-stained smear samples. Among the 142 samples identified, the most dominant species was Leishmania (Viannia) braziliensis (47.2%), followed by L. (V.) peruviana (26.1%), and others were L. (V.) guyanensis, L. (V.) lainsoni, L. (V.) shawi, a hybrid of L. (V.) braziliensis and L. (V.) peruviana, and Leishmania (Leishmania) amazonensis. Besides the present epidemiological observations, the current study provided the following findings: 1) A hybrid of L. (V.) braziliensis and L. (V.) peruviana is present outside the Department of Huanuco, the only place reported, 2) Many cases of CL due to L. (V.) lainsoni, an uncommon causative species in Peru, were observed, and 3) L. (V.) shawi is widely circulating in southern Amazonian areas in Peru.

[COMPARATIVE STUDY OF ALBENDAZOLE VERSUS NITROFURANS AND NITROIMIDAZOLES IN THE TREATMENT OF GIARDIASIS IN CHILDREN] / Comparación de Albendazol con nitrofuranos y nitroimidazoles en el tratamiento de giardiasis en ni os.

A prospective, longitudinal, comparative, open and aleatory study in Jaen (Cajamarca--Peru), was performed during November 1997 and January of 1998. The objective was to demonstrate the efficacy and tolerance of Albendazol compared with Metronidazol, Furazolidona, Tinidazol and Secnidazol in the treatment of giardiasis in children. 79 children with giardiasis, confirmed by parasitologic studies were evaluated and distributed randorrily for aleatory code in A,B,C,D and E groups. The A group received Albendazol (5 days), the B group Metronidazol (10 days), the C group Furazolidona (10 days), the D group Tinidazol (1 d a) and the E group Secnidazol (1 d a); Clinical controls and coproparasitologic studies were performad during and after the treatment. The cl nical efficacy in the groups was of 100% and the efficacy coproparas tological of 94.1% with Albendazol, 93.3% with Secnidazol and 100% with Metronidazol. Furazolidona and Tinidazol. The global efficacy was excel lent with Al bendazol in 64,7% and in less than 40% with the other drugs, being the biggest pharmacological tolerance with Albendazol (82,3%) and Secnidazol (80%). We conclude that Albendazol is as effective as Metronidazol, Furazolidona, Tinidazol and Secnidazol but faster in eradicating the Giardia lambila in children and with better tolerance that Metronidazol, Furazolidona and Tinidazol. We consider necessary to control Epidemiological factor associated, to eradicate the parasite permanently.

Comparación de albendazol con nitrofuranos y nitroimidazoles en el tratamiento de giardiasis en niños / Comparative study of albendazole versus nitrofurans and nitroimidazoles in the treatment of giardiasis in children

Se realizó un estudio prospectivo, longitudinal, comparativo, abierto y aleatorio en Jaén (Cajamarca-perú), desde noviembre de 1997 a enero de 1998. El objetivo fue demostrar la eficacia y tolerancia de Albendazol comparado con Metronidazol, Furazolidona, Tinidazol y Secnidazol en el tratamiento de giardiasis en niños. Se evaluaron 79 niños con diagnóstico de giardiasis, confirmado parasitológicamente, distribuidos randomizadamente por código aleatorio en grupos A,B,C,D y E. El grupo A recibió Albendazol (5 días), el grupo B Metronidazol (10 días), el grupo C Furazolidona (10 días), el grupo D Tinidazol (1 día) y el grupo E Secnidazol (1 día); realizándose controles clínicos y coproparasitológicos durante y después de los tratamientos. La eficacia clínica en los grupos fue del 100 por ciento y la eficacia coproparasitológica de 94.1 por ciento con Albendazol, 93.3 por ciento con Secnidazol y 100 por ciento con Metronidazol, Furazolidona y Tinidazol. La eficacia global fue excelente con Albendazol en 64.7 por ciento y en menos de 40 por ciento con los demás fármacos, siendo la tolerancia farmacológica mayor con Albendazol (82.3 por ciento) y Secnidazol (80 por ciento). Concluimos que Albendazol es tan eficaz como Metronidazol, Furazolidona, Tinidazol y Secnidazol pero más rápido en erradicar la Giardia lamblia en niños y con mejor tolerancia que Metronidazol, Furazolidona y Tinidazol. Consideramos necesario controlar factores epidemiológicos asociados, para erradicar permanentemente al parásito.

Prevalencia y distribución de enteroparasitosis en escolares en el distrito de Jaén / Prevalence and distribution of enteroparasitoses in school children from Jaen district

El objetivo principal del estudio fue determinar la prevalencia y distribución de enteroparasitosis en la población pediátrica escolar en el distrito de Jaén. Contribuyendo con el perfil epidemiológico de esta patología y la orientación en la sospecha diagnóstica al personal médico. El presente es un estudio observacional prospectivo de tipo transversal durante el mes de noviembre de 1997 realizándose un despitaje de enteroparasitosis a 418 escolares entre 3 y 15 años de edad pertenecientes a 14 centros educativos entre iniciales y primarios distribuidos en el distrito seleccionados mediante método probabilístico. Las muestras fecales se estudiaron por el método directo en lámina y de concentración por flotación en el Laboratorio referencial de Sub Región de Salud I - Jaén. Los datos fueron registrados en fichas de recolección. El diagnóstico coproparasitológico demostró una prevalencia de enteroparasitosis de 77 por ciento, siendo los grupos etáreoa más comprometidos de 3 a 5 años (27,3 por ciento) y de 9 a 11 años (24,2 por ciento). La forma más prevalente de enteroparasitosis es el monoparasitismo (55,5 por ciento) seguido del biparasitismo (35,4 por ciento). La especie parasitaria más frecuente es Giardia lamblia con 43 por ciento y Ascaris lumbricoides con 28,2 por ciento principalmente urbana y periurbana. La distribución de prevalencia de enteroparasitosis según zonas geográficas muestra un 82,97 por ciento en la zona rural y 75,2 por ciento en la zona urbana. Concluimos que existe una elevada prevalencia de enteroparasitosis siendo la giardiasis la más frecuente explicado por las características propias de cada zona geográfica y las malas condiciones de saneamiento básico del distrito. Se demostró la contaminación del agua con quistes de Giardia lamblia en los centros educativos a través de los exámenes parasitológicos.