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The growing cancer burden particularly among less developed countries requires local data to plan and evaluate cancer control measures. This article describes the development of a population-based cancer registry network (PBCRN) in Mexico that took place between 2017 and 2020 and present related data. The PBCRN, led by the National Cancer Institute (Incan), included nine registries representing 11.3% of the Mexican population. Definitions, coding, and operative processes were based on international standards. All cities were visited to set up local structure; personnel were hired by Incan and trained in basic cancer registration in Merida. A specific software was developed. Regular virtual meetings took place for data verification and quality control. Data collection included institutions of the public and private health system. Personnel included 34 registrars, nine local leaders, and 12 staff members at the Incan. A total of 13 517 cases were recorded between 2017-2020, 64% percent of them were among females. Breast cancer was the more frequent malignancy (23.3%), followed by digestive organs with (18.4%) and female genital cancers (13.5%). Childhood (0-14 years) and adolescents cancer represented 4.4% of the total new cancer cases. The network was suspended in 2020. The present effort lacked sustainability and data were only partial. However, the experience provides valuable insights to be considered for the renewed cancer registration efforts that are currently ongoing in Mexico.
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Introducción: El informe médico sobre el estado de salud del paciente ingresado a los servicios de emergencia se ha modificado, debido al necesario distanciamiento por la epidemia de COVID-19. Por esto, es importante conocer la percepción que tienen los familiares informados sobre el reporte médico telefónico implementado. Objetivo: Determinar la percepción de los parientes sobre la atención de pacientes internados por COVID-19, a través del informe médico telefónico entregado a las familias en el servicio de emergencia de un hospital terciario del Seguro Social de Salud (EsSalud), Lima, Perú. Métodos: Estudio transversal observacional, mediante encuesta a familiares de pacientes con COVID-19 ingresados durante los meses de julio y agosto del año 2020. Se usó como base la "Encuesta de satisfacción de usuario externo del Ministerio de Salud" adaptada a esta realidad, no habiéndose realizado ningún trabajo similar a este en forma previa. Se consideraron las dimensiones información, respeto al usuario, eficacia, accesibilidad, oportunidad, seguridad y satisfacción global. Se seleccionó la muestra para poblaciones finitas de 2936 familiares, obteniéndose 347 encuestas de 641 llamadas realizadas. Se les llamó telefónicamente y, previa aceptación, se les envió la encuesta vía en formato . Recibida la encuesta, se procedió a su análisis mediante técnicas de estadística descriptiva. Resultados: Se realizaron 641 llamadas telefónicas con una tasa de respuesta de 54,1% obteniéndose 347 encuestas. La edad promedio fue de 40,12 años (desviación estándar de 11,93), de los cuales 61,4% era del sexo femenino y 38% estaban casados. El 65,1% de los entrevistados tenía educación superior. Dentro de los distritos de procedencia, Chorrillos tuvo más encuestados con 10,1%. El 42,4% de los encuestados fueron hijos de los pacientes internados, 17,3% fueron cónyuges y el 85% no era personal de salud. Las dimensiones con percepción de acuerdo fueron: información 88,8%, respeto de usuario 82,1%, eficacia 70,3%; accesibilidad 75,8%; oportunidad 79,0% y seguridad 87,9%. La satisfacción global obtuvo un 73,2% de acuerdo. Conclusiones: La información médica telefónica entregada a los familiares de pacientes internados por COVID-19 en las salas de emergencia, encontró una satisfacción global de 73,2% de acuerdo. La información médica telefónica es una alternativa importante para mejorar la calidad de atención durante la epidemia por COVID-19.
Introduction: Medical reports of patients admitted to the emergency services has been modified due to the social distancing needed in the COVID-19 epidemic. For this reason, it is essential to know the family members' perceptions about telephone medical reports. Objective: To determine the perception of care by family members of patients hospitalized due to COVID-19 on telephone medical reports in a tertiary hospital's emergency room in Lima, Peru. Methods: A non-experimental cross-sectional study, through a survey of family members of patients with COVID-19 admitted during July and August 2020. The "External user satisfaction survey of the Ministry of Health" adapted to this setting was used due to the absence of similar studies. Information, respect for the user, efficiency, accessibility, suitability, security, and overall satisfaction were considered. The sample size for finite populations was selected from 2 936 family members, obtaining 347 surveys from 641 calls. Relatives were called by phone, and after acceptance, the survey was sent to them via WhatsApp in Google Forms format. Once the survey was received, it was analyzed using descriptive statistical techniques. Results: We made 641 telephone calls with a response rate of 54.1%, obtaining 347 surveys. The mean age was 40.12 years (standard deviation: 11.93 years), with 61.4% of females and 38.0% married. We found that 65.1% received higher education and that Chorrillos was the most prevalent district (10.1%). Moreover, 42.4% of those surveyed were children of hospitalized patients, 17.3% were spouses, and 85% were not health personnel. We found a high level of agreement in overall satisfaction (73.2%) and in most dimensions, including information (88.8%), respect for the user (82.1%), efficiency (70.3%), accessibility (75.8%), suitability (79.0%), and security (87.9%). Conclusion: The telephone medical reports to relatives of patients hospitalized due to COVID-19 in the emergency room found an overall satisfaction of 73.2% . Telephone medical reports are essential alternatives to improve the quality of care during the COVID-19 epidemic.
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Humanos , Feminino , Criança , Adulto , COVID-19 , Percepção , Telefone , Família , Estudos Transversais , Inquéritos e Questionários , Serviço Hospitalar de Emergência , Centros de Atenção TerciáriaRESUMO
PURPOSE: Population-based cancer registries (PBCRs) are critical for national cancer control planning, yet few low- and middle-income countries (LMICs) have quality PBCRs. The Central America Four region represents the principal LMIC region in the Western hemisphere. We describe the establishment of a PBCR in rural Western Honduras with first estimates for the 2013-2017 period. METHODS: The Western Honduras PBCR was established through a collaboration of academic institutions and the Honduras Ministry of Health for collection of incident cancer data from public and private health services. Data were recorded using the Research Electronic Data Capture (REDCap) web-based platform with data monitoring and quality checks. Crude and age-standardized rates (ASRs) were calculated at the regional level, following WHO methodology. RESULTS: The web-based platform for data collection, available ancillary data services (eg, endoscopy), and technical support from international centers (United States and Colombia) were instrumental for quality control. Crude cancer incidence rates were 112.2, 69.8, and 154.6 per 100,000 habitants overall, males, and females, respectively (excluding nonmelanoma skin cancer). The adjusted ASRs were 84.2, 49.6, and 118.9 per 100,000 overall habitants, males, and females, respectively. The most common sites among men were stomach (ASR 26.0, 52.4%), colorectal (ASR 5.11, 10.15%), and prostate (ASR 2.7, 5.4%). The most common sites in women were cervix (ASR 34.2, 36.7%), breast (ASR 11.2, 12.3%), and stomach (ASR 10.8, 11.7%). CONCLUSION: The Copán-PBCR represents a successful model to develop cancer monitoring in rural LMICs. Innovations included the use of the REDCap platform and leverage of Health Ministry resources. This provides the first PBCR data for Honduras and the Central America Four and confirms that infection-driven cancers, such as gastric and cervical, should be priority targets for cancer control initiatives.
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Neoplasias , América Central/epidemiologia , Feminino , Honduras/epidemiologia , Humanos , Incidência , Masculino , Neoplasias/epidemiologia , Sistema de RegistrosRESUMO
Chronic Obstructive Pulmonary Disease (COPD) main cause is attributed to active smokers, but there's a small percentage that comes from risk factors that have been less considered. The aim of this research was to identify the risk factors and the clinical presentation of the population over 64 years of age that lead to the development of COPD. A systematic review and a meta-analysis was performed. From the 92 studies interpreted, we identified seven studies on the presence of COPD in nonsmokers older adults, having a universe of 14,920 patients. The primary risk factor to trigger the development of COPD was secondhand smoking. The study defined the most common risk factors that currently trigger COPD development among nonsmokers and provided an insight into the potential clinical differences between nonsmokers and smokers.
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Doença Pulmonar Obstrutiva Crônica/epidemiologia , Poluição por Fumaça de Tabaco/efeitos adversos , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Incidência , Masculino , Prevalência , Doença Pulmonar Obstrutiva Crônica/etiologia , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Fatores de RiscoRESUMO
BACKGROUND: The literature is limited regarding the prevalence of functional gastrointestinal disorders (FGIDs) in Central America, and the role of dietary factors. METHODS: The Rome IV diagnostic questionnaire and National Cancer Institute Diet History questionnaire were administered in one-on-one interviews to a distributed cross section of the general adult population of Western Honduras. Our aim was to estimate prevalence of common FGIDs and symptoms and their relationships to dietary habits. RESULTS: In total, 815 subjects were interviewed, of whom 151 fulfilled criteria for an FGID (18.5%). Gastroduodenal FGIDs were noted in 9.4%, with epigastric pain syndrome (EPS) more common than postprandial distress syndrome, 8.5% versus 1.6%. Among bowel disorders, functional abdominal bloating (FAB) was most prevalent (6.3%), followed by irritable bowel syndrome (3.6%), functional diarrhea (FDr; 3.4%), and functional constipation (1.1%). A significant inverse association was noted between regular bean intake and any FGID (OR 0.41, 95% CI 0.27-0.63), driven by IBS and FDr. Vegetable consumption was associated with lower prevalence of functional diarrhea (OR 0.12; 95% CI 0.04-0.35) and any diarrheal disorder (OR 0.11; 95% CI 0.04-0.31). Subjects with a median daily intake of ≥ 4 corn tortillas had 1.75 (95% CI 1.22-2.50) times the odds of having any FGID. CONCLUSIONS: FGIDs were common in this rural low-resource setting in Central America, with an intriguing distribution of specific FGIDs. EPS and FAB were common, but IBS was not. Local dietary factors were associated with specific FGIDs, suggesting that diet may play a role in global variations of FGIDs.
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Comportamento Alimentar , Gastroenteropatias , Avaliação de Sintomas/estatística & dados numéricos , Adulto , Estudos Transversais , Feminino , Gastroenteropatias/classificação , Gastroenteropatias/diagnóstico , Gastroenteropatias/epidemiologia , Honduras/epidemiologia , Humanos , Masculino , Prevalência , Saúde da População Rural/estatística & dados numéricos , Inquéritos e QuestionáriosRESUMO
During 2014, cutaneous lesions were reported in dairy cattle and farmworkers in the Amazon Region of western Colombia. Samples from 6 patients were analyzed by serologic and PCR testing, and results demonstrated the presence of vaccinia virus and pseudocowpox virus. These findings highlight the need for increased poxvirus surveillance in Colombia.
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Infecções por Poxviridae/virologia , Vírus da Pseudovaríola das Vacas/isolamento & purificação , Vaccinia virus/isolamento & purificação , Vacínia/virologia , Adolescente , Adulto , Animais , Bovinos , Criança , Colômbia/epidemiologia , Fazendeiros , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Filogenia , Infecções por Poxviridae/epidemiologia , Vacínia/epidemiologia , Vaccinia virus/genética , Adulto JovemRESUMO
Introducción. La leptospirosis es una zoonosis reemergente de distribución mundial causada por una espiroqueta del género Leptospira. Durante los últimos años en Colombia aumentó el número de casos en humanos y animales. Objetivo. Caracterizar epidemiológicamente los casos de leptospirosis notificados al Sistema Nacional de Vigilancia en Salud Pública de Colombia y hacer una aproximación para conocer los serogrupos que circulan en el país. Materiales y métodos. Se diseñó un estudio observacional de corte retrospectivo, con registros del proceso de vigilancia de los casos reportados por el software Sivigila y muestras enviadas al Grupo de Microbiología de la Red Nacional de Laboratorios, durante el periodo 2007 a 2011. Se registraron variables de tipo sociodemográficas y se analizaron 17 serogrupos de Leptospira . En el análisis se utilizaron medidas de frecuencia, tendencia central y dispersión. Resultados. Se procesaron 11.786 registros, confirmándose 4.621 casos de leptospirosis. Las entidades territoriales con mayor registro fueron Valle del Cauca, Antioquia, Risaralda, Atlántico y Barranquilla; y las de incidencia más alta fueron Guaviare, Risaralda, San Andrés, Santa Marta y Barranquilla. El mayor número de casos reportados perteneció al área urbana, con mayor frecuencia de hombres (77 %), estudiantes (19,4 %) y amas de casas (13,6 %), con una mediana por edad de 29 años (rango intercuartílico: 45-19). Se evidenció la circulación de 17 serogrupos en el país; los más frecuentes fueron Australis (24,89 %), Hebdomadis (9,33 %) y Sejroe (8,0 %). Conclusión. En Colombia se ha mejorado la notificación y clasificación final de los casos, lo que ha permitido identificar al serogrupo Australis como el de mayor circulación.
Introduction: Leptospirosis is a reemerging zoonosis of worldwide distribution, caused by a spirochete of the genus Leptospira . In Colombia, the disease represents a major public health issue, and there has been an increased number of cases in humans and animals. Objective: To characterize epidemiologically cases of leptospirosis reported to the National Public Health Surveillance in Colombia, and to make an approach to determine the serogroups circulating in the country. Materials and methods: A retrospective observational study was designed using a process of monitoring records, which included cases reported by the software SIVIGILA and samples sent to the Microbiology Group of the National Laboratory Network (GM-RNL), for the period 2007-2011. We registered socio-demographic variables and analyzed 17 serogroups of Leptospira . Results: A total of 11,786 records were processed, with 4,621 confirmed cases of leptospirosis. The geographic places which reported the highest number of cases were: Valle del Cauca, Antioquia, Risaralda, Atlántico and Barranquilla, and those with the highest incidence were Guaviare, Risaralda, San Andres, Santa Marta and Barranquilla. The largest number of cases was from urban areas, and more commonly in men (77%), students (19.4%) and housewives (13.6%). A median age of 29 years (IQR 45-19) was observed. There was evidence of 17 serogroups circulating in the country, from which the three most frequent were Australis (24.89%), Hebdomadis (9.33%) and Sejroe (8.0%). Conclusions: In Colombia, the reported cases have improved as well as their final classification, allowing us to determine the Australis serogroup as the most widely circulating one.
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Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Leptospirose/epidemiologia , Vigilância da População , Distribuição por Idade , Colômbia/epidemiologia , Leptospira/classificação , Leptospira/isolamento & purificação , Ocupações , Estudos Retrospectivos , Sorogrupo , Distribuição por Sexo , Fatores SocioeconômicosRESUMO
INTRODUCTION: Leptospirosis is a reemerging zoonosis of worldwide distribution, caused by a spirochete of the genus Leptospira . In Colombia, the disease represents a major public health issue, and there has been an increased number of cases in humans and animals. OBJECTIVE: To characterize epidemiologically cases of leptospirosis reported to the National Public Health Surveillance in Colombia, and to make an approach to determine the serogroups circulating in the country. MATERIALS AND METHODS: A retrospective observational study was designed using a process of monitoring records, which included cases reported by the software SIVIGILA and samples sent to the Microbiology Group of the National Laboratory Network (GM-RNL), for the period 2007-2011. We registered socio-demographic variables and analyzed 17 serogroups of Leptospira . RESULTS: A total of 11,786 records were processed, with 4,621 confirmed cases of leptospirosis. The geographic places which reported the highest number of cases were: Valle del Cauca, Antioquia, Risaralda, Atlántico and Barranquilla, and those with the highest incidence were Guaviare, Risaralda, San Andres, Santa Marta and Barranquilla. The largest number of cases was from urban areas, and more commonly in men (77%), students (19.4%) and housewives (13.6%). A median age of 29 years (IQR 45-19) was observed. There was evidence of 17 serogroups circulating in the country, from which the three most frequent were Australis (24.89%), Hebdomadis (9.33%) and Sejroe (8.0%). CONCLUSIONS: In Colombia, the reported cases have improved as well as their final classification, allowing us to determine the Australis serogroup as the most widely circulating one.
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Leptospirose/epidemiologia , Vigilância da População , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Colômbia/epidemiologia , Feminino , Humanos , Lactente , Leptospira/classificação , Leptospira/isolamento & purificação , Masculino , Pessoa de Meia-Idade , Ocupações , Estudos Retrospectivos , Sorogrupo , Distribuição por Sexo , Fatores Socioeconômicos , Adulto JovemRESUMO
Introducción: estudios de árboles del género Maytenus, especies forsskaoliana, ilicifolia y krukovii revelan efectos depresores a nivel cardiovascular sobre la presión arterial y frecuencia cardiaca. Objetivos: analizar experimentalmente los efectos de las hojas de Maytenus macrocarpa "chuchuhuasi" sobre la frecuencia cardiaca, patrones electrocardiográficos, frecuencia respiratoria, y temperatura. Métodos: investigación de tipo exploratorio, analítico y experimental. Se utilizaron ratas albinas en 9 grupos de 8 ratas. Grupo 1 (control: Halatal), grupo 2 (placebo: agua destilada), grupo 3 (adrenalina), grupo 4 (atropina), grupo 5 (acetilcolina), grupo 6 (propranolol), grupo 7 (chuchuhuasi 500 mg/kg), grupo 8 (chuchuhuasi 1 000 mg/kg) y grupo 9 (chuchuhuasi 1 500 mg/kg). La temperatura rectal se midió con termómetro de mercurio, la frecuencia respiratoria, por conteo directo; el electrocardiograma y la frecuencia cardiaca, mediante el uso de polígrafo. El programa MATLAB se utilizó para analizar los datos obtenidos en el electrocardiograma. Para la validación estadística se usó la prueba de ANOVA, pruebas de Tuckey, Wilconxon y Shapiro-Wilk. Resultados: Maytenus macrocarpa mostró mayor actividad depresora sobre la frecuencia cardiaca (promedio 308,6 ppm), mayor efecto inotrópico negativo (promedio onda P: 0,08300 mv, promedio onda R: 0,1539 mv), marcada bradipnea (promedio 51,6 rpm) e hipotermia (promedio: 31,84 °C) a dosis de 1 500 mg/kg. Conclusiones: Maytenus macrocarpa demostró efecto bradicardizante, depresor de la frecuencia respiratoria y la temperatura corporal.
Introduction: studies on Maytenus trees comprising forsskaoliana, krukovii, and ilicifolia species showed depressing effects on the blood pressure and the heart rate. Objectives: to experimentally analyze the effects of Maytenus macrocarpa leaves on the heart rate, the electrocardiographic patterns, the respiratory rate, and the temperature. Method: this study was exploratory, analytical, and experimental. Albino rats were grouped in 9 groups of 8 rats each. Group 1 (control: Halatal), group 2 (placebo: distillated water), group 3 (adrenaline), group 4 (atropine), group 5 (acetylcholine), group 6 (propranolol), group 7 (500 mg/kg chuchuhuasi), group 8 (1 000 mg/kg chuchuhuasi), and group 9 (1 500 mg/kg chuchuhuasi). The rectal temperature was measured with a mercury thermometer, whereas the direct count allowed measuring the respiratory frequency. The polygraph registered electrocardiogram and heart rate as well. The MATLAB program analyzed data from the electrocardiogram. The statistic validation was performed with ANOVA, Tuckey, Wilcoxon, and Shapiro-Wilk tests. Results: Maytenus macrocarpa showed depressing effects on the cardiac frequency, being more effective at 1 500 mg/kg doses (average 308.6 ppm), higher negative inotropic effect at 1 500 mg/kg doses (average P wave 0.08300 mv, average R wave 0.1539 mV). Severe bradypnea was shown at 1 500 mg/kg doses (average RF 51.6 rpm), as well as hypothermia (average T° 31.84 °C). Conclusion: Maytenus macrocarpa demonstrated bradycardic as well as depressing effects on respiratory frequency and body temperature.
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Linear scleroderma "en coup de sabre" (LSCS) is a form of localized scleroderma presents as band-like sclerotic lesions of the frontoparietal area. It has been reported in association with diverse neurological manifestations like seizures, migraine, neuromyotonia, dystonia and abnormalities in MRI and CT studies as cerebral atrophy, white matter lesions, intraparenchymal calcification, meningeocortical alterations, and skull atrophy. We describe a patient with LSCS associated with two abnormal movements: permanent myokimia of right masseter muscle and recurrent spasmodic retraction of right cigomatic and depressor labii inferioris muscles. He was initially treated with methotrexate and steroids without response, so later on he underwent repeated Botox injections with remarkable improvement.
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Distribution of potentially nitrogen-fixing bacteria and its relationship with physicochemical parameters in soils with three vegetation types in the southern Colombian Amazon region. Potentially nitrogen-fixing microaerobic and aerobic bacteria were isolated from several Colombian Amazon soils (forest, pastures and chagras) and two landscapes (floodable and non floodable areas). The abundance and distribution of bacteria were evaluated, as well as their relationship with soil physical and chemical characteristics. Landscape had a direct influence on the abundance of the microaerobic bacteria, with higher numbers in forest and pasture soils in non- floodable zones. The aerobic isolates (N=51) were grouped into 19 morphologies, with the highest numbers found in forest soil in floodable zones. A higher number of aerobic morphologies was shared among forest sites (Nonmetric Multidimensional Scaling and Analysis of Similarity p<0.05), and 40% of the distribution was explained by lime percentage and Al concentration. Rev. Biol. Trop. 57 (4): 915- 927. Epub 2009 December 01.
Se evaluó la abundancia y distribución de bacterias microaerófilas y aerobias potencialmente fijadoras de nitrógeno aisladas a partir de suelos bajo coberturas de bosque, pastizal y chagra en dos paisajes, terraza y llanura inundable, en el sur de trapecio amazónico. Se relacionó el recuento en placa en el medio Ashby de estas bacterias aerobias con las características físicas y químicas del suelo. Se encontró mayor abundancia de bacterias aerobias y microaerofilas en suelos bajo cobertura de pastizal. Se observó influencia directa del paisaje sobre la abundancia de bacterias microaerófilas registrando mayores recuentos los suelos bajo terraza en las coberturas de bosque y pastizal. Los aislamientos aerobios obtenidos (51) se agruparon en 19 morfologías, de las cuales se obtuvo mayor número en suelos bajo bosque y en el paisaje de llanura inundable. A través del análisis multidimensional no métrico (NMDS) y análisis de similaridades (ANOSIM) (p<0.05) se comprobó que entre los sitios de muestreo bajo la cobertura de bosque se comparten mayor número de morfologías de bacterias aerobias que bajo las demás coberturas. El programa BIOENV indicó que esta distribución fue explicada en un 40% por las variables % limo y Al (meq/100 g).
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Bactérias Aeróbias/metabolismo , Fixação de Nitrogênio , Microbiologia do Solo , Solo/análise , Árvores , Bactérias Aeróbias/classificação , Bactérias Aeróbias/isolamento & purificação , Colômbia , Contagem de Colônia MicrobianaRESUMO
Objetivos En marzo de 2008 ocurrió en el municipio de Santander de Quilichao- Cauca, Colombia, un brote de rabia de origen silvestre con 2 víctimas humanas. El presente artículo apunta a describir las técnicas diagnósticas de laboratorio, las acciones de investigación de campo y control de foco empleadas, y su significado epidemiológico e implicaciones en salud pública. Métodos La rabia se diagnosticó por inmunofluorescencia directa, prueba biológica en ratón, histopatología e inmunohistoquímica, y se tipificó utilizando anticuerpos monoclonales. La investigación de campo se enfocó en la búsqueda de contactos humanos y animales, identificación de casos sospechosos y búsqueda institucional de accidentes rábicos. El control de foco consistió en aplicación de tratamiento post exposición a la población expuesta, vacunación canina y felina, recolección y eliminación de animales callejeros y educación a la comunidad. Resultados Dos casos de rabia en humanos fueron diagnosticados y uno en gato por nexo epidemiológico. La variante antigénica 3 fue aislada de los casos humanos. Se vacunaron en total 11 369 caninos, 3 325 felinos y 217 humanos. Conclusiones Se confirma la amenaza para los humanos que representa la rabia en el ecosistema silvestre. El brote tuvo origen en vampiro y el transmisor a los humanos fue un gato confirmando a esta especie doméstica como vínculo entre la rabia de origen silvestre y el ecosistema urbano, por ende su importancia en el enfoque de las acciones de prevención y control de la rabia. Se resalta la necesidad de implementar y mantener acciones para el control de la rabia silvestre que permitan minimizar su impacto en humanos.
Objectives A sylvatic rabies outbreak during March 2008 caused two human deaths in the town of Santander de Quilichao in Cauca, Colombia. This article describes the diagnostic laboratory techniques used, the field investigation and focus control used, as well as this outbreak's epidemiological significance and implications for public health. Methods Rabies was diagnosed by direct immunofluorescence, biological tests involving inoculating mice, histopathology and immunohistochemistry and then typed by using monoclonal antibodies. Field investigation focused on searching for human and animal contacts, identifying suspicious cases and conducting an institutional search for rabid accidents. Focus control consisted of post-exposure treatment of the exposed population, vaccinating dogs and cats, collecting and eliminating stray animals and educating the community. Results Two human rabies cases were confirmed in the laboratory and another was inferred in a cat by epidemiological nexus. Antigenic variant 3 was isolated from the human cases. 11,369 dogs, 3,325 cats and 217 humans were vaccinated. Conclusions This study confirmed that rabies in the wild represents a threat for humans. The outbreak described here originated in vampire bats and was transmitted to humans by a cat, pointing out the nexus between wild rabies and the urban ecosystem which cats represent, thereby becoming a target for rabies' control and prevention activities. This study underlines the urgency of implementing and maintaining rabies control and prevention activities in the wild to minimise its impact on humans.
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Animais , Gatos , Criança , Humanos , Masculino , Surtos de Doenças , Raiva/epidemiologia , Raiva/transmissão , Doenças do Gato/transmissão , Colômbia , Raiva/veterináriaRESUMO
Potentially nitrogen-fixing microaerobic and aerobic bacteria were isolated from several Colombian Amazon soils (forest, pastures and chagras) and two landscapes (floodable and non floodable areas). The abundance and distribution of bacteria were evaluated, as well as their relationship with soil physical and chemical characteristics. Landscape had a direct influence on the abundance of the microaerobic bacteria, with higher numbers in forest and pasture soils in non-floodable zones. The aerobic isolates (N=51) were grouped into 19 morphologies, with the highest numbers found in forest soil in floodable zones. A higher number of aerobic morphologies was shared among forest sites (Nonmetric Multidimensional Scaling and Analysis of Similarity p<0.05), and 40% of the distribution was explained by lime percentage and Al concentration.
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Bactérias Aeróbias/metabolismo , Fixação de Nitrogênio , Microbiologia do Solo , Solo/análise , Árvores , Bactérias Aeróbias/classificação , Bactérias Aeróbias/isolamento & purificação , Colômbia , Contagem de Colônia MicrobianaRESUMO
OBJECTIVES: A sylvatic rabies outbreak during March 2008 caused two human deaths in the town of Santander de Quilichao in Cauca, Colombia. This article describes the diagnostic laboratory techniques used, the field investigation and focus control used, as well as this outbreak's epidemiological significance and implications for public health. METHODS: Rabies was diagnosed by direct immunofluorescence, biological tests involving inoculating mice, histopathology and immunohistochemistry and then typed by using monoclonal antibodies. Field investigation focused on searching for human and animal contacts, identifying suspicious cases and conducting an institutional search for rabid accidents. Focus control consisted of post-exposure treatment of the exposed population, vaccinating dogs and cats, collecting and eliminating stray animals and educating the community. RESULTS: Two human rabies cases were confirmed in the laboratory and another was inferred in a cat by epidemiological nexus. Antigenic variant 3 was isolated from the human cases. 11,369 dogs, 3,325 cats and 217 humans were vaccinated. CONCLUSIONS: This study confirmed that rabies in the wild represents a threat for humans. The outbreak described here originated in vampire bats and was transmitted to humans by a cat, pointing out the nexus between wild rabies and the urban ecosystem which cats represent, thereby becoming a target for rabies' control and prevention activities. This study underlines the urgency of implementing and maintaining rabies control and prevention activities in the wild to minimise its impact on humans.