Asymptomatic Malaria Reservoirs in Honduras: A Challenge for Elimination.

BACKGROUND: Efforts on a global scale for combating malaria have achieved substantial progress over the past twenty years. Two Central American nations have accomplished their goal of eliminating malaria: El Salvador and Belize. Honduras has decreased the incidence of malaria and now reports fewer than 4000 malaria cases annually, aspiring to reach elimination by 2030. To accomplish this goal, it is essential to assess the existing strategies employed for malaria control and to address the task of incorporating novel intervention strategies to identify asymptomatic reservoirs. METHODS: A survey for detecting asymptomatic cases was carried out in the community of Kaukira, in Gracias a Dios, Honduras, focusing on malaria transmission during 2023. Asymptomatic community members were recruited as participants, malaria screening was performed through a rapid diagnostic test in situ, and a blood sample was collected on filter paper. Highly sensitive molecular assays based on photo-induced electron transfer PCR (PET-PCR) were performed to detect the two species of Plasmodium circulating in Honduras: Plasmodium vivax and Plasmodium falciparum. In addition, the identification of the parasite species was verified by amplifying three genetic markers (Pvmsp3α, Pvmsp3ß, and Pfmsp1). RESULTS: A total of 138 participants were recruited, mostly adult women. All individuals tested negative on the rapid diagnostic test. Positive results for malaria were detected by PET-PCR in 17 samples (12.3%). Most samples (12 out of 17) were amplified with a Ct value between 37 and 42, indicating very low parasitemias. Out of the 17 samples, 16 of them also showed amplification in the species assays. There were nine cases of P. falciparum infections and seven cases of P. vivax infections that were further confirmed by nested PCR (nPCR) of Pvmsp3 and Pfmsp1. Parasitemias ranged from 100 p/µL to less than 0.25 p/µL. One sample showed mixed infection. CONCLUSIONS: The existence of asymptomatic malaria reservoirs in Honduras can contribute to disease transmission and pose a challenge that may hinder elimination efforts, requiring public health authorities to modify surveillance strategies to identify the disease and treat this population accordingly.

Molecular Characterization of Enteric Viruses Causing Acute Gastroenteritis among Children under 5 Years Old in Distrito Central, Honduras.

INTRODUCTION: Diarrheal diseases constitute a significant public health problem in terms of mortality and morbidity. In Honduras and around the world, RVs have consistently emerged as the single most important etiologic agent in acute childhood diarrhea. However, other viruses, such as NoVs and HAstVs, have also been shown to be responsible for viral gastroenteritis. Unfortunately, the country has limited information concerning the etiologic role of these viral agents in acute gastroenteritis. This study investigated the frequency, genotypes, and epidemiological characteristics of RV-A, NoVs, and HAstVs among children under 5 years old in Distrito Central, Honduras. METHODS: Stool samples and their corresponding epidemiological data were collected from children with acute gastroenteritis in three healthcare centers in Distrito Central. All samples were screened by immunoassays for RV-A and HAstVs. RV-A-positive samples were molecularly characterized by RT-PCR and genotyping assays. RT-PCR was also applied to confirm HAstVs positivity and to detect NoVs, followed by nucleotide sequencing to assign their genotypes. RESULTS: Our results show that at least one viral agent was detected in 31% of the children. The frequency of RV-A, NoVs, and HAstVs was 14%, 13%, and 5%, respectively. The most frequent RV-A genotype was G2P[4], occurring in 93% of cases. 92.3% of NoVs-positive samples belonged to genogroup II, with GII.4 and GII.16 being the most common. HAstVs were clustered into three genotypes: HAstV-1, HAstV-2, and HAstV-8. Only one sample showed coinfection with NoVs and HAstVs. CONCLUSION: This comprehensive molecular and epidemiological characterization of enteric viruses demonstrates the vast diversity of these agents and describes for the first time NoVs and HAstVs as causative agents of acute childhood gastroenteritis in Distrito Central, Honduras. This suggests that further in-depth studies of the pediatric population are necessary to develop and implement effective preventive and control measures in the country.

Caracterización del síndrome post COVID-19 en personal de un centro de salud. Honduras, 2022 / Characterization of post COVID syndrome in personnel of a health center. Honduras, 2022

Antecedentes. Se ha observado una frecuencia considerable en la persistencia de síntomas en pacientes que han superado un episodio de COVID-19 agudo. El síndrome post COVID, lo presentan aquellos pacientes que mantienen signos o síntomas 3 meses tras el comienzo del episodio agudo. Objetivo. Caracterizar el síndrome post COVID, en el personal de salud del Triaje Mayangle, Tegucigalpa, abril 2022. Métodos. Estudio cuantitativo, descriptivo-transversal. El universo del estudio fue el personal (72) que laboraba en centro de Triaje. La recolección de la información se realizó a través de un cuestionario en línea, procesándose en Microsoft Excel versión 2017. Resultados. El 71% (51) eran mujeres y 29% (21) hombres, 66 personas afirmaron haber sufrido la infección COVID-19 confirmado con pruebas de laboratorio, (RT-PCR, detección de antígenos y/o detección de anticuerpos); 6 negaron haber cursado la enfermedad siendo excluidas del estudio. Un 68% (45/66) reportó reinfección. Las manifestaciones clínicas persistentes más frecuentes 4 semanas después del inicio de la enfermedad fueron dolor de cabeza 60.6%, fatiga 43.9%, tos 33.3%, pérdida del olfato 33.3%, caída de cabello 25.8%, insomnio 25.8%. Las manifestaciones que persistieron 12 semanas posteriores fueron dolor de cabeza 33.3%, fatiga 28.8%, caída de cabello 18.2%, tos 15.2%, pérdida del olfato 13.6% y dolor torácico 13.6%. Discusión. El 75.8% de los participantes que sufrieron COVID-19 persistieron con síntomas a las 12 semanas del diagnóstico. La estimación más reciente de personas que viven con la condición post COVID-19 a nivel mundial ha superado 65 millones y, sin opciones claras de diagnóstico o tratamiento...(AU)

Caracterización de la condición Post-COVID en mayores de 18 años en una comunidad de Honduras / Characterization of the Post-COVID condition in people over 18 years of age in a community from Honduras

Introducción: Se desconoce la magnitud exacta de la condición Post-COVID, diferentes estudios han reportado porcen- tajes entre 20-90% en pacientes con COVID-19. Objetivo: Descri- bir las características clínicas y factores asociados a la condición Post-COVID en personas ≥ 18 años, marzo-abril 2023, Jacaleapa, El Paraíso, Honduras. Métodos: Estudio descriptivo transversal con análisis de asociación, muestreo probabilístico, seleccionando un máximo de dos personas, bajo criterios de inclusión/exclusión. Se utilizó formulario para caracterización sociodemográfica, clínica y antecedentes. Actividad física se valoró usando Global Physical Activity Questionnaire (GPAQ) 2021 de la Organización Mundial de la Salud (OMS). Se realizó análisis univariado y bivariado mediante regresión logística multivariada (valor p<0.05 e IC95% fue consi- derado significativo). Se contó con aprobación del Comité de Ética. Resultados: Muestra de 334 personas, 63.8% (213) eran mujeres, mediana de edad de 47 años (RIQ 25%,75%=34,65), 44.9% (150) tenía comorbilidades, destacando hipertensión arterial con 34.4% (115); 60.2% (201) eran sedentarios. Se encontró prevalencia de COVID-19 de 31.1% (104/334), con severidad leve en 80.8% (84). 57.7% (60/104) desarrollaron Condición Post-COVID. De estos, 81.7% (49/60) presentó fatiga, 46.7% (28/60) eran hipertensos, y 86.7% (52/60) habían tenido COVID-19 leve. Se encontró asocia- ción entre condición Post-COVID e hipertensión arterial (OR=4.7, IC95% 1.3-7.5), grado de severidad de COVID-19: leve (OR=29.6, IC95% 3.0-289.0) y moderado-severo (OR=86.1, IC95% 3.7- 2017.2). Discusión: La magnitud de la condición Post-COVID fue alta, mostrando asociación con hipertensión arterial y grado de severidad de COVID-19 leve/moderado-severo comparado con asintomáticos. Todo paciente que se recupera de COVID-19 debe tener un seguimiento multidisciplinario integral para su recupera- ción...(AU)

[The role of nursing professionals in the development and care of adolescent health in HondurasPapel dos profissionais de enfermagem no desenvolvimento e na atenção à saúde de adolescentes em Honduras]. / El papel de los profesionales de enfermería en el desarrollo y atención de la salud adolescente en Honduras.

Objective: Identify and analyze the role of nursing professionals in the development and care of adolescent health in Honduras, by analyzing the curricular content of the training provided to nursing students with respect to adolescent health, and by studying policies on adolescent health. Methods: Mixed methods study, with a sequential explanatory approach, carried out from May to July 2023 through surveys of nursing schools, analysis of policy documents, a survey with nursing professionals, and a focus group. Quantitative data were analyzed using descriptive statistics and qualitative data, applying the theoretical framework of Walt and Gilson. Results: During the research, 18 documents were analyzed and seven nursing schools, 141 nurses, and 10 key actors in leadership positions participated. The results point to the need to update and disseminate the regulatory framework, ensure the necessary resources and structure to implement sustainable intersectoral programs, and train professionals. Schools are an important space for the implementation of actions; in this context, the adoption of school nursing programs could be beneficial. Nurses were identified as key figures in program implementation and should be taken into consideration when developing policies aimed at adolescents. Conclusions: Nurses participate in various stages of the policy implementation process and can make important contributions to school health at the first level of care. To this end, it is necessary to increase the capacities of nurses and nursing educators in relation to current and relevant issues in adolescent care.

Objetivo: Identificar e analisar o papel dos profissionais de enfermagem no desenvolvimento e na atenção à saúde de adolescentes em Honduras por meio de análise do conteúdo da formação dos estudantes de enfermagem em saúde de adolescentes e das políticas relacionadas aos adolescentes. Métodos: Estudo de métodos mistos, com abordagem sequencial explanatória, realizado de maio a julho de 2023 por meio de um questionário aplicado a escolas de enfermagem, análise de documentos de política, um questionário aplicado a profissionais de enfermagem e um grupo focal. Os dados quantitativos foram analisados mediante estatísticas descritivas, e os qualitativos, usando o modelo teórico de Walt e Gilson. Resultados: Durante a pesquisa, foram analisados 18 documentos. Sete escolas de enfermagem, 141 profissionais de enfermagem e 10 atores-chave em cargos de liderança participaram do estudo. Os resultados apontam para a necessidade de atualizar e divulgar o marco normativo, garantir recursos e estrutura para a implementação de programas intersetoriais e sustentáveis e capacitar os profissionais. A escola representa um espaço importante para a implementação de ações, contexto no qual a adoção da enfermagem escolar pode ser proveitosa. Os profissionais de enfermagem foram identificados como atores-chave na implementação dos programas e devem ser levados em consideração no desenvolvimento de políticas voltadas para esse público. Conclusões: Os profissionais de enfermagem estão envolvidos em vários estágios do processo de implementação de políticas e podem fazer aportes importantes para a saúde escolar no nível da atenção primária. Para isso, é necessário aumentar a capacitação dos profissionais e docentes de enfermagem em tópicos atuais e relevantes da atenção a adolescentes.

Path Analysis of Adverse Childhood Experiences, Early Marriage, Early Pregnancy, and Exposure to Intimate Partner Violence Among Young Women in Honduras.

Purpose: The pathways by which adverse childhood experiences (ACEs) are associated with early marriage and early pregnancy are poorly understood. Early marriage and early pregnancy may be risk factors for adulthood intimate partner violence (IPV). The aim of this study was to assess the relationships among ACEs, early marriage, early pregnancy, and IPV among women in Honduras. Method: We used weighted data from 1,436 women aged 18-24 years from the nationally representative 2017 Honduras Violence Against Children and Youth Survey. We used path analysis to estimate relationships and accounted for sample design, non-response, and within-country clustering. Results: We found that ACEs had differential relationships with outcomes of interest. For example, witnessing violence in the community was directly associated with increased probability of early pregnancy (10 percentage points (PP); 95% CI: 0.04, 0.15) and IPV (6 PP; 95% CI: 0.01, 0.10), while emotional violence was not directly or indirectly associated with any outcome. Early marriage and early pregnancy had no direct or indirect effect on IPV, but the total effect of early marriage on IPV was significant. Conclusions: Understanding the relationship between ACEs, early marriage, early pregnancy, and IPV may help inform prevention efforts. For example, programs aiming to reduce early pregnancy may consider addressing sexual violence experienced in childhood.

Mapping Human Resources to Guide Ophthalmology Capacity-Building Projects in Honduras: Sub-national Analyses of Physician Distribution and Surgical Practices.

Objective: To map ophthalmologist locations and surgical practices as they vary sub-nationally within Honduras to maximize the impact of efforts to develop cataract surgical capacity. Methods: An anonymous survey was sent to all Honduran ophthalmologists with questions on surgical volume, department-level location, type of facility in which they work, surgical methods, and age. Surgical volume, population, and poverty data sourced through the Oxford Poverty Human Development Initiative were mapped at the department level, and cataract surgical rates (CSR; surgeries per million population per year) were calculated and mapped. Results: Sixty-one of the 102 Honduran ophthalmologists contacted responded. Of those, 85% perform cataract surgery, and 49% work at least part time in a non-profit or governmental facility. Honduras has fewer surgical ophthalmologists per million than the global average, and though national CSR appears to be increasing, it varies significantly between departments. The correlation between CSR and poverty is complex, and outliers provide valuable insights. Conclusion: Mapping ophthalmological surgical practices as they relate to population and poverty at a sub-national level provides important insights into geographic trends in the need for and access to eye care. Such insights can be used to guide efficient and effective development of cataract surgical capacity.

First Report of the Emerging Pathogen Kodamaea ohmeri in Honduras.

Kodamaea ohmeri is an environmental yeast considered a rare emerging pathogen. In clinical settings, the correct identification of this yeast is relevant because some isolates are associated with resistance to antifungals. There is a lack of available data regarding the geographical distribution, virulence, and drug resistance profile of K. ohmeri. To contribute to the knowledge of this yeast, this study aimed to describe in depth three isolates of K. ohmeri associated with fungemia in Honduras. The identification of the isolates was carried out by sequencing the ribosomal ITS region. In addition, the susceptibility profile to antifungals was determined, and some properties associated with virulence were evaluated (exoenzyme production, biofilm formation, cell adhesion, and invasion). The isolates showed strong protease, phospholipase, and hemolysin activity, in addition to being biofilm producers. Adherence and invasion capacity were evident in the HeLa and Raw 264.7 cell lines, respectively. This study expands the understanding of the underlying biological traits associated with virulence in K. ohmeri, and it is the first report of the detection and identification of K. ohmeri in Honduras as a cause of human infection.

Systematic review of existing literature regarding the prevalence of pediatric atopic dermatitis in Honduras.

Background: Atopic dermatitis (AD) is an inflammatory skin condition, often multifactorial in origin, and most commonly manifests during childhood. Although there remains a deficit in literature, current data suggest Honduras may have the highest prevalence and severity of AD among all Latin American countries. Objective: To assess the current prevalence of pediatric AD in Honduras and evaluate existing gaps in available literature to monitor disease burden. Methods: A comprehensive literature search was performed in March 2023. Articles were removed if they were published before 2007, were of the incorrect study design, or were focused on countries outside of Honduras. The articles were independently reviewed by 2 authors. Results: The initial literature search yielded 174 studies, of which 7 met inclusion criteria. AD prevalence rates in children in Honduras ranged from 0.7% to 40.0%. Limitations: Limitations include elements of study design, analytic methods, study populations, and limited articles. Conclusion: There appears to be a disproportionately higher prevalence and disease burden of pediatric AD in Honduras. Future research should acquire accurate data to further understand the prevalence, incidence, and severity of AD in Honduras.

El papel de los profesionales de enfermería en el desarrollo y atención de la salud adolescente en Honduras / The role of nursing professionals in the development and care of adolescent health in Honduras / Papel dos profissionais de enfermagem no desenvolvimento e na atenção à saúde de adolescentes em Honduras

RESUMEN Objetivo. Identificar y analizar el papel de los profesionales de enfermería en el desarrollo y la atención de la salud adolescente en Honduras, por medio del análisis de los contenidos de la formación de los estudiantes de enfermería y de las políticas relacionadas con la salud de los adolescentes. Métodos. Estudio de métodos mixtos, con enfoque explicativo secuencial, desarrollado de mayo a julio del 2023 por medio de encuesta con escuelas de enfermería, análisis de los documentos políticos, encuesta con profesionales de enfermería y grupo focal. Datos cuantitativos analizados mediante estadística descriptiva y datos cualitativos analizados mediante el marco teórico de Walt y Gilson. Resultados. Durante la investigación, se analizaron 18 documentos y participaron siete escuelas de enfermería, 141 enfermeras y 10 actores clave en posición de liderazgo. Los resultados apuntan a la necesidad de actualizar y difundir el marco normativo, garantizar recursos y estructura para implementar programas intersectoriales y sostenibles, y capacitar a los profesionales. La escuela representa un espacio importante para la implementación de acciones, contexto en el que la adopción de la enfermera escolar puede ser provechosa. Las enfermeras fueron identificadas como protagonistas en la aplicación de los programas y deben ser consideradas en el desarrollo de políticas dirigidas a este público. Conclusiones. Las enfermeras participan en diversas etapas del proceso de implementación de políticas y pueden hacer importantes contribuciones a la salud escolar en el primer nivel de salud. Para ello, es necesario aumentar la capacidad de las enfermeras y docentes de enfermería en temas actuales y relevantes en la atención a los adolescentes.

ABSTRACT Objective. Identify and analyze the role of nursing professionals in the development and care of adolescent health in Honduras, by analyzing the curricular content of the training provided to nursing students with respect to adolescent health, and by studying policies on adolescent health. Methods. Mixed methods study, with a sequential explanatory approach, carried out from May to July 2023 through surveys of nursing schools, analysis of policy documents, a survey with nursing professionals, and a focus group. Quantitative data were analyzed using descriptive statistics and qualitative data, applying the theoretical framework of Walt and Gilson. Results. During the research, 18 documents were analyzed and seven nursing schools, 141 nurses, and 10 key actors in leadership positions participated. The results point to the need to update and disseminate the regulatory framework, ensure the necessary resources and structure to implement sustainable intersectoral programs, and train professionals. Schools are an important space for the implementation of actions; in this context, the adoption of school nursing programs could be beneficial. Nurses were identified as key figures in program implementation and should be taken into consideration when developing policies aimed at adolescents. Conclusions. Nurses participate in various stages of the policy implementation process and can make important contributions to school health at the first level of care. To this end, it is necessary to increase the capacities of nurses and nursing educators in relation to current and relevant issues in adolescent care.

RESUMO Objetivo. Identificar e analisar o papel dos profissionais de enfermagem no desenvolvimento e na atenção à saúde de adolescentes em Honduras por meio de análise do conteúdo da formação dos estudantes de enfermagem em saúde de adolescentes e das políticas relacionadas aos adolescentes. Métodos. Estudo de métodos mistos, com abordagem sequencial explanatória, realizado de maio a julho de 2023 por meio de um questionário aplicado a escolas de enfermagem, análise de documentos de política, um questionário aplicado a profissionais de enfermagem e um grupo focal. Os dados quantitativos foram analisados mediante estatísticas descritivas, e os qualitativos, usando o modelo teórico de Walt e Gilson. Resultados. Durante a pesquisa, foram analisados 18 documentos. Sete escolas de enfermagem, 141 profissionais de enfermagem e 10 atores-chave em cargos de liderança participaram do estudo. Os resultados apontam para a necessidade de atualizar e divulgar o marco normativo, garantir recursos e estrutura para a implementação de programas intersetoriais e sustentáveis e capacitar os profissionais. A escola representa um espaço importante para a implementação de ações, contexto no qual a adoção da enfermagem escolar pode ser proveitosa. Os profissionais de enfermagem foram identificados como atores-chave na implementação dos programas e devem ser levados em consideração no desenvolvimento de políticas voltadas para esse público. Conclusões. Os profissionais de enfermagem estão envolvidos em vários estágios do processo de implementação de políticas e podem fazer aportes importantes para a saúde escolar no nível da atenção primária. Para isso, é necessário aumentar a capacitação dos profissionais e docentes de enfermagem em tópicos atuais e relevantes da atenção a adolescentes.

Frequency of strongyloidiasis and associated factors: Analysis of 13 years of laboratory results in a tertiary referral hospital in Honduras, 2010-2022. / Frecuencia de estrongiloidiasis y factores asociados: análisis de 13 años de resultados de laboratorio en un hospital de tercer nivel de Honduras, 2010-2022

INTRODUCTION: The frequency of detected strongyloidiasis is affected by the selected laboratory method in the studied population. Considering that Honduras has few community-based studies, the analysis of the laboratory record data can provide information helping to understand this parasitosis. OBJECTIVE: To estimate the frequency and to identify the factors associated with strongyloidiasis, analyzing the laboratory records of the Servicio de Parasitología at Hospital Escuela in Tegucigalpa (Honduras) between 2010 and 2022. MATERIALS AND METHODS: We carried out a descriptive, cross-sectional, analytical study. The laboratory diagnosis consisted of stool samples' examination by direct smear and modified Baermann technique. We estimated frequencies and percentages. The statistical association was calculated with prevalence ratios and a 95% confidence interval. Software R, version 4.2.0, and epiR package, version 2.0.46, were used to perform the analysis. RESULTS: The frequency of strongyloidiasis was 0.29% (112/38,085). It was higher with the modified Baermann technique (0.87%; 40/4,575) among male patients (0.44%; 70/15,758). Regarding the age, strongyloidiasis was higher in the 20-40 years old group (0.41%; 28/6,886) with direct smear and 41-61 years old (1.14%; 14/1,232) group with the modified Baermann technique. Among the factors associated with strongyloidiasis were age between 20 and 61 years old (PR=2.26, CI 95%=1.53-3.31), male patients (PR=2.34, CI 95%=1.60­3.44), mucus (PR=1.86, CI 95%=1.22-2.83) and Charcot-Leyden crystals in stool (PR=8.47, CI 95%=5.14-13.96); watery stool (PR=2.39, CI 95%=1.55-3.68), and other helminthiases (PR=6.73, CI 95%=3.98-11.38). Associated factors to cases detected with the modified Baermann technique were outpatient consultation (PR=4.21, CI 95%=1.91-9.28) and formed stools (PR=3.99, CI 95%=1.94-8.19). CONCLUSIONS: The modified Baermann technique increased the detection of strongyloidiasis almost four times. Most cases were distributed among male adults. The cases diagnosed exclusively with the modified Baermann technique have differences from those with observed larvae in the direct smear. It is necessary to develop community-based population studies.

Introducción: La detección de estrongiloidiasis depende del método de diagnóstico utilizado y la población estudiada. Dado que en Honduras hay pocos estudios poblacionales, el análisis de los datos de laboratorio puede generar información que ayude a entender esta parasitosis. Objetivo: Estimar la frecuencia e identificar los factores asociados a la estrongiloidiasis mediante el análisis de los registros de laboratorio del Servicio de Parasitología del Hospital Escuela en Tegucigalpa (Honduras) durante el periodo 2010-2022. Materiales y métodos: Se llevó a cabo un estudio descriptivo, transversal y analítico. El diagnóstico de laboratorio consistió en el análisis de muestras de heces con los métodos directo y Baermann modificado. Se estimaron frecuencias y porcentajes, y la asociación estadística se calculó con razón de prevalencia e intervalos de confianza del 95 %. Se utilizaron los programas R, versión 4.2.0, y el paquete epiR, versión 2.0.46, para ejecutar los análisis estadísticos. Resultados: La frecuencia general de estrongiloidiasis fue 0,29 % (112/38.085). Dicha frecuencia de detección fue mayor con el método de Baermann modificado (0,87 %; 40/4.575), entre pacientes masculinos (0,44 %; 70/15.758). También fue mayor en el rango de edad 20-40 años (0,41%; 28/6.886) por examen directo y entre los 41-61 años (1,14%; 14/1.232) con el método de Baermann modificado. Entre los factores asociados con la estrongiloidiasis se encontraron: edad entre los 20 y los 61 años (RP=2,26; IC 95%=1,53-3,31), sexo masculino (RP=2,34; IC 95% =1,60-3.44), moco (RP=1,86; IC 95%=1,22-2,83) y cristales de Charcot-Leyden en heces (RP=8,47, IC 95%=5,14-13,96), heces líquidas (RP=2,39, IC 95%=1,55-3,68) y otras helmintiasis (RP=6,73, IC 95%=3,98-11,38). Como factores asociados a los casos detectados con el método de Baermann modificado están consulta externa (RP=4,21, IC 95%=1,91-9,28) y heces formadas (RP=3,99, IC 95%=1,94-8,19). Conclusiones: El método de Baermann modificado aumentó la frecuencia de detección de estrongiloidiasis casi cuatro veces. La mayoría de los casos se distribuyeron entre pacientes masculinos adultos. Los casos diagnosticados exclusivamente con el método de Baermann modificado tuvieron diferencias con los casos diagnosticados por examen directo. Es necesario realizar estudios poblacionales.

Alta proporción de macrodisco en pacientes de dos centros oftalmológicos en el occidente de Honduras / High proportion of macrodisc in patients from two ophthalmological centers in western Honduras

Antecedentes: Cuando el nervio óptico presenta una superficie mayor a 2.5 mm2 , y sin patologías asociadas, se trata de un macrodisco, cuya excavación es proporcional al tamaño aumentado del mismo. Con base en la distribución bajo la curva de Gauss, se define como "macrodisco" cuando está por encima de 2 desviaciones estándar arriba de la media. Se espera que solo el 2.3% de la población exceda estos límites. Objetivo: Determinar el tamaño promedio del disco óptico y proporción de macrodisco en la población sin glaucoma ni patologías retinianas que acude a dos clínicas oftalmológicas del occidente de Honduras, en el periodo de julio 2021 hasta julio 2022. Métodos: Estudio retrospectivo descriptivo. Se midieron los parámetros morfométricos del disco óptico mediante Tomografía de Coherencia Óptica ZEISS Cirrus HD Model 4000. Se definió macrodisco como: área del disco óptico >2.5 mm 2 y área del disco más 2 o más desviaciones estándar arriba de la media. Resultados: La proporción de macrodisco fue de 31% tomando en cuenta la definición de área de disco >2.5 mm2 , y 3% considerando la definición con base a la distribución bajo la curva de Gauss (>3.17mm2 ). Se obtuvo un promedio de área de disco óptico de 2.28±0.45 mm 2 , ratio copa/disco (C/D) de 0.59±0.13, ratio C/D vertical de 0.56±0.13, área de anillo neuroretiniano de 1.37±0.22 mm 2 , espesor de Capa de Fibras Nerviosas Retinianas (CFNR) de 97.4±10.664µm. Discusión: El área de disco promedio obtenido es mayor que los caucásicos, similar a lo reportado en los hispánicos, y menor que afrodescendientes y asiáticos...(AU)

Producción científica del Instituto Antonio Vidal, Honduras: análisis bibliométrico 1993-2023 / Scientific production of the Instituto Antonio Vidal, Honduras: bibliometric analysis 1993-2023

Antecedentes: En 2023 se conmemora el trigésimo aniversario del Instituto de Enfermedades Infecciosas y Parasito- logía Antonio Vidal (IAV), Tegucigalpa, Honduras, una fundación privada sin fines de lucro. Objetivo: Analizar la producción científica en cuya autoría al menos uno de los autores cuenta con afiliación institucional IAV, periodo 1993-2023. Métodos: Estudio bibliométrico recopilando datos a través de la búsqueda en la Biblioteca Virtual en Salud de Honduras (http://www.bvs.hn/RMH/ html5) y bases de datos (Google académico, Scopus y Web of Science [(WOS]) que ofrecen perfiles de la actividad investigativa de autores e instituciones. Se creó base de datos Excel utilizando los campos: autores, títulos, afiliaciones institucionales nacionales e internacionales, colaboración en la autoría por país, formato de publicación (libro/artículo científico), tipo de artículo, revistas nacionales e internacionales, año de publicación y número de citaciones. Resultados: Se identificaron 55 publicaciones, 44.8% (22) en idioma inglés, 87.3% (48) publicadas entre 2014 y 2023; 89.1% (49) se publicó en revistas científicas, 7.3% (4) en formato tipo libro/manual y 3.6% (2) preprint. De 49 artículos publicados, 51.0% (26) recibió 575 citas según Google Académico, 63.0% (14) recibió 217 citas según Scopus y 66.0% (15) recibió 306 citas según WOS. Discusión: A tres décadas de su constitución, el IAV aumentó el número de miembros y la producción científica. Aproximadamente la mitad de los artículos se han publicado en revistas internacionales con algún índice de impacto gracias a la red de colaboración y alianzas estratégicas de diferentes grupos de investigación a nivel global...(AU)

Frequency of strongyloidiasis and associated factors: Analysis of 13 years of laboratory results in a tertiary referral hospital in Honduras, 2010-2022 / Frecuencia de estrongiloidiasis y factores asociados: análisis de 13 años de resultados de laboratorio en un hospital de tercer nivel de Honduras, 2010-2022

Introduction. The frequency of detected strongyloidiasis is affected by the selected laboratory method in the studied population. Considering that Honduras has few community-based studies, the analysis of the laboratory record data can provide information helping to understand this parasitosis. Objective. To estimate the frequency and to identify the factors associated with strongyloidiasis, analyzing the laboratory records of the Servicio de Parasitología at Hospital Escuela in Tegucigalpa (Honduras) between 2010 and 2022. Materials and methods. We carried out a descriptive, cross-sectional, analytical study. The laboratory diagnosis consisted of stool samples' examination by direct smear and modified Baermann technique. We estimated frequencies and percentages. The statistical association was calculated with prevalence ratios and a 95% confidence interval. Software R, version 4.2.0, and epiR package, version 2.0.46, were used to perform the analysis. Results. The frequency of strongyloidiasis was 0.29% (112/38,085). It was higher with the modified Baermann technique (0.87%; 40/4,575) among male patients (0.44%; 70/15,758). Regarding the age, strongyloidiasis was higher in the 20-40 years old group (0.41%; 28/6,886) with direct smear and 41-61 years old (1.14%; 14/1,232) group with the modified Baermann technique. Among the factors associated with strongyloidiasis were age between 20 and 61 years old (PR=2.26, CI 95%=1.53-3.31), male patients (PR=2.34, CI 95%=1.60-3.44), mucus (PR=1.86, CI 95%=1.22-2.83) and Charcot-Leyden crystals in stool (PR=8.47, CI 95%=5.14-13.96); watery stool (PR=2.39, CI 95%=1.55-3.68), and other helminthiases (PR=6.73, CI 95%=3.98-11.38). Associated factors to cases detected with the modified Baermann technique were outpatient consultation (PR=4.21, CI 95%=1.91-9.28) and formed stools (PR=3.99, CI95% =1.94-8.19). Conclusions. The modified Baermann technique increased the detection of strongyloidiasis almost four times. Most cases were distributed among male adults. The cases diagnosed exclusively with the modified Baermann technique have differences from those with observed larvae in the direct smear. It is necessary to develop community-based population studies.

Introducción. La detección de estrongiloidiasis depende del método de diagnóstico utilizado y la población estudiada. Dado que en Honduras hay pocos estudios poblacionales, el análisis de los datos de laboratorio puede generar información que ayude a entender esta parasitosis. Objetivo. Estimar la frecuencia e identificar los factores asociados a la estrongiloidiasis mediante el análisis de los registros de laboratorio del Servicio de Parasitología del Hospital Escuela en Tegucigalpa (Honduras) durante el periodo 2010-2022. Materiales y métodos. Se llevó a cabo un estudio descriptivo, transversal y analítico. El diagnóstico de laboratorio consistió en el análisis de muestras de heces con los métodos directo y Baermann modificado. Se estimaron frecuencias y porcentajes, y la asociación estadística se calculó con razón de prevalencia e intervalos de confianza del 95 %. Se utilizaron los programas R, versión 4.2.0, y el paquete epiR, versión 2.0.46, para ejecutar los análisis estadísticos. Resultados. La frecuencia general de estrongiloidiasis fue 0,29 % (112/38.085). Dicha frecuencia de detección fue mayor con el método de Baermann modificado (0,87 %; 40/4.575), entre pacientes masculinos (0,44 %; 70/15.758). También fue mayor en el rango de edad 20-40 años (0,41%; 28/6.886) por examen directo y entre los 41-61 años (1,14%; 14/1.232) con el método de Baermann modificado. Entre los factores asociados con la estrongiloidiasis se encontraron: edad entre los 20 y los 61 años (RP=2,26; IC 95%=1,53-3,31), sexo masculino (RP=2,34; IC95%=1,60-3.44), moco (RP=1,86; IC 95%=1,22-2,83) y cristales de Charcot-Leyden en heces (RP=8,47, IC 95%=5,14-13,96), heces líquidas (RP=2,39, IC 95%=1,55-3,68) y otras helmintiasis (RP=6,73, IC 95%=3,98-11,38). Como factores asociados a los casos detectados con el método de Baermann modificado están consulta externa (RP=4,21, IC 95%=1,91-9,28) y heces formadas (RP=3,99, IC 95%=1,94-8,19). Conclusiones. El método de Baermann modificado aumentó la frecuencia de detección de estrongiloidiasis casi cuatro veces. La mayoría de los casos se distribuyeron entre pacientes masculinos adultos. Los casos diagnosticados exclusivamente con el método de Baermann modificado tuvieron diferencias con los casos diagnosticados por examen directo. Es necesario realizar estudios poblacionales.

Optimization of Physical Activation Process by CO2 for Activated Carbon Preparation from Honduras Mahogany Pod Husk.

In this work, the Honduras Mahogany (Swietenia macropnylla King, SMK) seed husk was used as a novel biomass resource for producing activated carbon by physical activation. The texture characteristics and chemical characterization of resulting products were investigated in correlation with the process parameters. Based on the thermochemical properties of the SMK biomass, the process conditions were set to a rate of about 10 °C/min under nitrogen (N2) flow of 500 cm3/min heated to 500 °C, then switched to carbon dioxide (CO2) flow of 100 cm3/min in the specified activation conditions (i.e., temperature of 700-850 °C for holding times of 0-60 min). Our findings showed that the texture characteristics (i.e., surface area and pore volume) increased with an activation temperature increase from 700 to 800 °C for a holding time of 30 min but gradually decreased as the temperature increased thereafter. Similarly, the texture characteristics also indicated an increasing trend with the residence time extending from 0 min to 30 min but slightly decreased as the time was extended to 60 min. Therefore, the optimal activation conditions for producing SMK-based activated carbon should be set at 800 °C for a holding time of 30 min to obtain the maximal texture characteristics (i.e., BET surface area of 966 m2/g and total pore volume of 0.43 cm3/g). On the other hand, the chemical characteristics were analyzed by energy dispersive X-ray spectroscopy (EDS) and Fourier Transform infrared spectroscopy (FTIR), showing oxygen complexes contained on the hydrophilic surface of the resulting activated carbon.

Análisis bibliométrico de la producción científica del Dr. Antonio Vidal Mayorga (1895-1968), Revista Médica Hondureña / Bibliometric analysis of the scientific production of Dr. Antonio Vidal Mayorga (1895-1968), Revista Médica Hondureña

Antecedentes: El Instituto de Enfermedades Infecciosas y Parasitología Antonio Vidal conmemora el trigésimo aniversario de su creación (1993-2023). Objetivo: Realizar un análisis bibliométrico de la producción científica del Dr. Antonio Vidal Mayorga en la Revista Médica Hondureña (RMH). Métodos: Análisis bibliométrico y revisión de alcance mediante búsquedas digitales en la Biblioteca Virtual en Salud de Honduras (https:// honduras.bvsalud.org/) y la RMH (https://revistamedicahondurena. hn/), y archivos físicos del Instituto Antonio Vidal. Los artículos fueron clasificados por tipo, año de publicación, tema específico (enfermedades transmisibles, agentes etiológicos y vectoriales, enfermedades crónicas no transmisibles, otros) y tema general (especialidades médicas, enfermedades, reseñas biográficas, actividades asistenciales y de salud pública, otros). Resultados: En los primeros 18 años de la RMH (1930-1947), el Dr. Vidal publicó 79 artículos: caso clínico 19, opinión 18, original 17, revisiones bibliográficas 11, reseñas de revistas 7 y libros 2, editoriales 5. Los años con mayor número de publicaciones fueron 1934 (10) y 1945 (16). Los temas generales con el mayor número de publicaciones fueron malaria (22) y deficiencias nutricionales (9). Se destacan sus observaciones originales con caracterizaciones clínicas, resultados de laboratorio y observaciones epidemiológicas en el campo, incluyendo observaciones entomológicas, y los artículos de opinión con propuestas sobre la organización y administración de la salud pública del país. Discusión: El Dr. Antonio Vidal Mayorga, médico y maestro ejemplar, se distingue en el contexto de la época en que vivió. Su obra fue impulsada por su capacidad de conjuntar la clínica, la epidemiología, el laboratorio, la salud pública, la investigación, la docencia y la proyección social...(AU)

PET-PCR reveals low parasitaemia and submicroscopic malarial infections in Honduran Moskitia.

BACKGROUND: Malaria remains a main parasitic disease of humans. Although the largest number of cases is reported in the African region, there are still endemic foci in the Americas. Central America reported 36,000 malaria cases in 2020, which represents 5.5% of cases in the Americas and 0.015% of cases globally. Most malaria infections in Central America are reported in La Moskitia, shared by Honduras and Nicaragua. In the Honduran Moskitia, less than 800 cases were registered in 2020, considering it an area of low endemicity. In low endemicity settings, the number of submicroscopic and asymptomatic infections tends to increase, leaving many cases undetected and untreated. These reservoirs challenge national malaria elimination programmes. This study aimed to assess the diagnostic performance of Light Microscopy (LM), a nested PCR test and a photoinduced electron transfer polymerase chain reaction (PET-PCR) in a population of febrile patients from La Moskitia. METHODS: A total of 309 febrile participants were recruited using a passive surveillance approach at the Puerto Lempira hospital. Blood samples were analysed by LM, nested PCR, and PET-PCR. Diagnostic performance including sensitivity, specificity, negative and positive predictive values, kappa index, accuracy, and ROC analysis was evaluated. The parasitaemia of the positive samples was quantified by both LM and PET-PCR. RESULTS: The overall prevalence of malaria was 19.1% by LM, 27.8% by nPCR, and 31.1% by PET-PCR. The sensitivity of LM was 67.4% compared to nPCR, and the sensitivity of LM and nPCR was 59.6% and 80.8%, respectively, compared to PET-PCR. LM showed a kappa index of 0.67, with a moderate level of agreement. Forty positive cases by PET-PCR were not detected by LM. CONCLUSIONS: This study demonstrated that LM is unable to detect parasitaemia at low levels and that there is a high degree of submicroscopic infections in the Honduran Moskitia.

The Honduran diaspora and infectious diseases: An urgent need for action.

Recently, there has been a significant increase in irregular migration from Central America's northern triangle (Honduras, Guatemala and El Salvador). Hondurans who migrate to North America face numerous risks to their lives and health. Infectious diseases are one of the most serious threats to migrants both during the migration process and once they arrive in the host country. The major infectious diseases affecting both migrants and the health services in non-endemic countries that care for these migrants are discussed.