Metabolic Syndrome in HIV-patients in Antiretroviral Therapy.

INTRODUCTION: The global prevalence of metabolic syndrome (MS) among people living with HIV/AIDS varies from 20% to 33%. OBJECTIVE: to estimate the prevalence of metabolic syndrome and associated factors in a group of HIV-infected patients on antiretroviral therapy. METHODS: This is a cross-sectional study with HIV-infected patients from a reference center in Bahia, Brazil. We evaluated clinical, socio-demographic and anthropometric data. MS was defined according to the guidelines of International Diabetes Federation. RESULTS: We evaluated 152 patients with mean age of 47.3±11.6 years, 59.2% male. The main comorbidities detected were diabetes (3.3%) hypertriglyceridemia (9.3%) and metabolic syndrome (MS,38.2%). Patients with MS were predominantly women (55.2% vs 31.9%; p=0.005), older [52.1 (10.4) vs 44.3 (11.3); p<0.001], and had overweight (74.1% vs 23.4%; p<0.001). After multivariate analysis MS remained associated with age (OR = 1.076; 95% CI: 1.030 - 1.125), female sex (OR = 2.452; 95% CI: 1.114 - 5.374) and family history of hypertension (OR = 3.678; 95% CI: 1.431 - 9.395). CONCLUSION: Almost half of the HIV-infected patients in Bahia presents with MS which seems to be driven by classical risk factors.

High Prevalence of AH in HIV Patients on ART, in Bahia, Brazil.

INTRODUCTION: The prevalence of arterial hypertension (AH) in HIV-patients is highly variable and its association with antiretroviral therapy (ART) is controversial. OBJECTIVE: To estimate the prevalence of AH and associated factors in HIV-patients on ART. METHODS: This cross-sectional study was conducted in HIV-patients attended in a referral center in Salvador, Brazil. We evaluated clinical, socio-demographic and anthropometric data. Student's ttests or Mann-Whitney's and Pearson's chi-square tests were used to compare the groups. Values of p <0.05 were considered significant. The variables that presented a value of p <0.20 were included in a logistic regression model. RESULTS: We evaluated 196 patients (60.7% male) with a mean age of 46.8 ± 11.7 years and a mean body mass index of 24.9 ± 5.3 kg / m2. The median elapsed time since HIV diagnosis and ART use was 11.8 (4.4 - 18.1) and 7.2 (2.7 - 15.3) years, respectively. The prevalence of AH was 41.8%. For individuals > 50 years old, there was a significant association between the increased abdominal circumference and AH and patients ≤ 50 years old presented significant association between AH and overweight, increased abdominal circumference and number of previous ART regimens. After multivariate analysis, age [OR:1.085; 95% CI 1,039 - 1,133], overweight [OR: 4.205; 95% CI 1,841 - 9,606], family history of AH [OR: 2.938; 95% CI 1,253 - 6.885], increased abdominal circumference [OR: 2.774; 95% CI 1.116 - 6.897] and life-time number of ART regimens used [OR: 3.842; 95% CI 1.307 - 11.299] remained associated with AH. CONCLUSION: AH was highly prevalent and was associated not only with classical risk factors for arterial hypertension, but also with specific ART regimens.

[Long-lasting insecticide - treated bednet ownership, retention and usage one year after their distribution in Loreto, Peru]. / Posesión, retención y uso de mosquiteros tratados con insecticidas de larga duración luego de un año de su distribución en Loreto, Perú

OBJECTIVES: To assess long-lasting insecticide - treated bednet (LLITN) ownership, retention and usage one year after their distribution in Loreto, Peru. MATERIALS AND METHODS: From July to September 2007, 26,185 LLITNs Olyset Net ® were delivered in 194 targeted communities in the Peruvian Amazon region, covering 45,331 people. Two cross-sectional community-based surveys in December 2007 and July 2008 were undertaken in a sample of 60 targeted communities (30.9% out of the total). A semi-structured questionnaire was used to collect necessary data to calculate LLITN ownership, retention and usage indicators. RESULTS: High LLITN household ownership was showed in both surveys (99.9% and 98.7%, respectively). LLITN/ person ratio decreased from 0.58 at the end of the LLITN delivery to 0.51 in the second survey, estimating LLITN retention of 87% after 1 year of intervention. In the first survey, 99.0% of all children <5 years and 96,0% of pregnant women slept under a LLITN the previous night, while in the second survey, 77.7% of children <5 years and 66.3% of pregnant women slept under a LLITN the previous night. Big mesh size of LLITN had low people's acceptability, reaching only 39.0% in the second survey. CONCLUSIONS: Although universal LLITN household ownership remained high, their LLITN usage levels have decreased during one-year follow-up period.

Posesión, retención y uso de mosquiteros tratados con insecticidas de larga duración luego de un año de su distribución en Loreto, Perú / Long-lasting insecticide - treated bednet ownership, retention and usage one year after their distribution in Loreto, Peru

Objetivos. Evaluar la posesión, retención y uso de mosquiteros tratados con insecticida de larga duración (MTILD) luego de un año de su distribución en Loreto, Perú. Materiales y métodos. De julio a septiembre de 2007 se distribuyeron 26 185 MTILD Olyset Net® en 194 comunidades objetivo de Loreto, que protegieron a 45 331 personas. Posteriormente, se realizaron visitas de monitoreo (primera en diciembre de 2007 y segunda en julio de 2008) a los hogares de una muestra de 60 comunidades objetivo (30,9 por ciento del total), colectándose mediante un cuestionario semiestructurado los datos necesarios para el cálculo de indicadores de posesión, retención y uso de los MTILD. Resultados. En ambas visitas, la posesión de MTILD en hogares fue elevada (99,9 por ciento y 98,7 por ciento, respectivamente). La razón MTILD/persona disminuyó de 0,58 al momento de la distribución a 0,51 en la segunda visita, estimándose una retención al año de MTILD de 87 por ciento. En la primera visita, 99,0 por ciento de los niños <5 años y 96,0 por ciento de las embarazadas durmieron bajo un MTILD la noche anterior, mientras que en la segunda visita, 77,7 por ciento de los niños<5 años y 66,3 por ciento de las embarazadas durmieron bajo un MTILD la noche anterior. El tamaño de los agujeros de la trama de los MTILD tuvo una baja aceptabilidad por parte del a población durante la segunda visita (39,0 por ciento). Conclusiones. Si bien la posesión de MTILD en los hogares se ha mantenido elevada, su uso por la población beneficiada ha disminuido durante el año de seguimiento.

Objectives. To assess long-lasting insecticide - treated bednet (LLITN) ownership, retention and usage one year after their distribution in Loreto, Peru. Materials and methods. From July to September 2007, 26,185 LLITNs Olyset Net ® were delivered in 194 targeted communities in the Peruvian Amazon region, covering 45,331 people. Two cross-sectional community-based surveys in December 2007 and July 2008 were undertaken in a sample of 60 targeted communities (30.9 percent out of the total). A semi-structured questionnaire was used to collect necessary data to calculate LLITN ownership, retention and usage indicators. Results. High LLITN household ownership was showed in both surveys (99.9 percent and 98.7 percent, respectively). LLITN/ person ratio decreased from 0.58 at the end of the LLITN delivery to 0.51 in the second survey, estimating LLITN retention of 87 percent after 1 year of intervention. In the first survey, 99.0 percent of all children <5 years and 96,0 percent of pregnant women slept under a LLITN the previous night, while in the second survey, 77.7 percent of children <5 years and 66.3 percent of pregnant women slept under a LLITN the previous night. Big mesh size of LLITN had low people´s acceptability, reaching only 39.0 percent in the second survey. Conclusions. Although universal LLITN household ownership remained high, their LLITN usage levels have decreased during one-year follow-up period.

Evaluación de un programa controlado de tuberculosis en un centro periférico de Lima / Tuberculosis control programme evaluation in a shantytown of Lima

Objetivo: Evaluar y analizar la evolución de la tuberculosis desde el año 2000 al 2004 en una zona urbano marginal de Lima. Materiales y métodos: Este es un estudio observacional de reporte de casos, realizado en Pampas de San Juan desde Enero del 2000 hasta Diciembre del 2004. Los datos se obtuvieron del Libro de Sintomáticos respiratorios y del Libro de Evolución y seguimiento de casos de tuberculosis del programa. Resultados: Se diagnosticaron 694 casos de tuberculosis en el periodo de estudio, de los cuales 528 casos eran nuevos (76,1 por ciento). La forma pulmonar fue la más diagnosticada con 530 casos, teniendo el 82,1 por ciento baciloscopía positiva. La incidencia ha disminuido desde 208.96 hasta 187.05 por 100000 habitantes. La condición de egreso hasta fines del 2003 fue de 427 curados (87,5 por ciento), 27 abandonos (5,5 por ciento), 13 fracasos (2,7 por ciento) y 21 fallecidos durante el tratamiento (4,3 por ciento). Conclusiones: En este estudio se demuestra la caída sostenida de los casos informados de tuberculosis en una zona marginal de Lima. Aunque los recursos son escasos, estos deben ser aprovechados al máximo para controlar la tuberculosis con los nuevos problemas que acarrea, como la asociación con la infección por VIH, las formas multi-resistentes y la mayor diseminación por el hacinamiento secundario a la pobreza existente en el lugar.