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1.
Artigo em Inglês | MEDLINE | ID: mdl-32030406

RESUMO

OBJECTIVES: We report the results of the reverse transcriptase (RT)/protease (PR) transmitted drug resistance (TDR) prevalence study in 2018, focusing on doravirine resistance-associated mutations and the differences observed when Stanford or French National Agency for AIDS Research (ANRS)/Spanish Network of AIDS Research (RIS)/IAS-USA resistance interpretation algorithms are used to describe clinically relevant resistance. METHODS: We used the WHO 2009 list to investigate the prevalence of NNRTI, NRTI and PI TDR, in treatment-naive HIV-1-infected patients, adding mutations E138A/G/K/Q/R, V106I, V108I, V179L, G190Q, H221Y, F227C/L/V, M230IDR, L234I, P236L and Y318F in RT. The prevalence of doravirine resistance-associated mutations, as described by Soulie et al. in 2019, was evaluated. Clinically relevant TDR was investigated using the latest versions of ANRS, RIS, IAS-USA and Stanford algorithms. RESULTS: NNRTI mutations were detected in 82 of 606 (13.5%) patients. We found 18 patients (3.0%) with NRTI mutations and 5 patients (0.8%) with PI mutations. We detected 11 patients harbouring doravirine resistance-associated mutations (prevalence of 1.8%). Furthermore, we observed important differences in clinically relevant resistance to doravirine when ANRS/RIS (0.7%), IAS-USA (0.5%) or Stanford algorithms (5.0%) were used. V106I, which was detected in 3.8% of the patients, was the main mutation driving these differences. V106I detection was not associated with any of the clinical, demographic or virological characteristics of the patients. CONCLUSIONS: The prevalence of NRTI and PI TDR remains constant in Spain. Doravirine TDR is very infrequent by RIS/ANRS/IAS-USA algorithms, in contrast with results using the Stanford algorithm. Further genotype-phenotype studies are necessary to elucidate the role of V106I in doravirine resistance.

2.
Travel Med Infect Dis ; 33: 101543, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31805400

RESUMO

BACKGROUND: From the first Zika virus (ZIKV) description, it has progressively widespread worldwide. We analyzed demographic, clinical, microbiologic and travel-related characteristic from returned patients from a ZIKV endemic country in a referral Tropical Medicine Unit. METHOD: A prospective cohort study performed in a Spanish referral center with the aim of determining the significant factors associated with confirmed Zika virus (ZIKV) infection. RESULTS: 817 patients, (56% women, median age 36 [IQR, Interquartile Range: 32-42]) were enrolled. Most had returned from Latin America (n = 486; 59.4%), travelled for tourism (n = 404; 49.4%) and stayed a median of 18 days (IQR: 10-30). 602 (73.6%) presented symptoms, but only 25 (4%) were finally diagnosed with confirmed ZIKV infection (including two pregnant women, without adverse fetal outcomes), 88% (n:22) presented with fever and 92% (n:23) with rash. 56% (n:14) arthralgia and/or myalgia and 28% (n:7) conjunctivitis. The presence of conjunctivitis, fever and rash were associated with an 8.9 (95% CI: 2.2-34.9), 6.4 (95% CI: 1.2-33.3) and 72.3 (95% CI: 9.2-563.5) times greater probability of confirmed ZIKV infection, respectively. CONCLUSION: Travel characteristics and clinical presentation may help clinicians to optimize requests for microbiological testing. Diagnosis of arboviriasis in travellers arriving form endemic areas remains a challenge for clinicians, but must be detected for the possible transmission outside endemic areas, where the vector is present.

3.
PLoS One ; 14(8): e0221231, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31469856

RESUMO

Treatment guidelines differ in their recommendation to determine baseline resistance associated substitutions (RAS) before starting a first-line treatment with direct-acting antivirals (DAAs). Here we analyze the efficacy of DAA treatment with baseline RAS information. We conducted a prospective study involving 23 centers collaborating in the GEHEP-004 DAA resistance cohort. Baseline NS5A and NS3 RASs were studied by Sanger sequencing. After issuing a comprehensive resistance report, the treating physician decided the therapy, duration and ribavirin use. Sustained virological response (SVR12) data are available in 275 patients. Baseline NS5A RAS prevalence was between 4.3% and 26.8% according to genotype, and NS3 RASs prevalence (GT1a) was 6.3%. Overall, SVR12 was 97.8%. Amongst HCV-GT1a patients, 75.0% had >800,000 IU/ml and most of those that started grazoprevir/elbasvir were treated for 12 weeks. In genotype 3, NS5A Y93H was detected in 9 patients. 42.8% of the HCV-GT3 patients that started sofosbuvir/velpatasvir included ribavirin, although only 14.7% carried Y93H. The efficacy of baseline resistance-guided treatment in our cohort has been high across the most prevalent HCV genotypes in Spain. The duration of the grazoprevir/elbasvir treatment adhered mostly to AASLD/IDSA recommendations. In cirrhotic patients infected with GT-3 there has been a high use of ribavirin.

4.
J Hepatol ; 71(5): 876-888, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31279901

RESUMO

BACKGROUND & AIMS: Most hepatitis C virus (HCV)-infected patients failing NS5A inhibitors develop resistance-associated substitutions (RASs). Here we report the use of resistance-guided retreatment of patients who failed prior NS5A inhibitor-containing regimens in the GEHEP-004 cohort. This is the largest direct-acting antiviral (DAA)-resistance cohort study conducted in Spain. We aim to provide indications on how to use resistance information in settings where sofosbuvir/velpatasvir/voxilaprevir may not be available. METHODS: GEHEP-004 is a prospective multicenter cohort enrolling HCV-infected patients treated with interferon (IFN)-free DAA regimens. Prior to retreatment, population-based sequencing of HCV NS3, NS5A and NS5B genes was performed. After receiving a comprehensive resistance interpretation report, the retreatment regimen was chosen and the sustained virological response (SVR) at 12 weeks after treatment completion (SVR12) was recorded. RESULTS: A total of 342 patients experiencing virological failure after treatment with sofosbuvir/ledipasvir±ribavirin (54%), sofosbuvir/daclatasvir±ribavirin (23%), or paritaprevir-ritonavir/ombitasvir±dasabuvir±ribavirin (20%) were studied. After a resistance report, 186 patients were retreated. An SVR12 was achieved for 88.1% of the patients who failed after sofosbuvir/ledipasvir±ribavirin, 83.3% of the patients who failed after sofosbuvir/daclatasvir±ribavirin, 93.7% of the patients who failed after paritaprevir-ritonavir+ombitasvir±dasabuvir±ribavirin. CONCLUSIONS: In our study, we show how resistance-guided retreatment in conjunction with an interpreted report allows patients to achieve SVR rates close to 90%. We hypothesize that SVR rates may even be improved if resistance data are discussed between experienced virologists and treating clinicians. We believe that our data may be relevant for countries where the access to new DAA combination regimens is limited. LAY SUMMARY: Hepatitis C infection can be cured with currently available antiviral agents. Only a small proportion of patients experience treatment failure, however, in absolute numbers, a high number of patients may require retreatment. Highly effective combinations of antivirals are also available for retreatment. However, these antivirals might not be available in resource-limited settings. Herein, we show how, by analyzing the cause of resistance, retreatment efficacy with old drugs can get very close to the efficacy of new drug combinations.

5.
J Antimicrob Chemother ; 74(6): 1693-1700, 2019 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-30838386

RESUMO

BACKGROUND: Integrase strand-transfer inhibitors (INSTIs) constitute at present one of the pillars of first-line ART. OBJECTIVES: To study the prevalence of and the trend in transmitted drug resistance (TDR) to INSTIs in ART-naive patients in Spain. METHODS: During the period 2012-17, 1109 patients from CoRIS were analysed. The Stanford algorithm v8.7 was used to evaluate TDR and transmission of clinically relevant resistance. To describe individual mutations/polymorphisms, the most recent IAS list (for INSTIs) and the 2009 WHO list update (for the backbone NRTIs used in combination with INSTIs in first-line treatment) were used. RESULTS: Clinically relevant resistance to the INSTI class was 0.2%: T66I, 0.1%, resistance to elvitegravir and intermediate resistance to raltegravir; and G163K, 0.1%, intermediate resistance to raltegravir and elvitegravir. No clinical resistance to dolutegravir or bictegravir was observed. The prevalence of INSTI TDR following the IAS-USA INSTI mutation list was 2.6%, with no trend towards changes in the prevalence throughout the study period. The overall prevalence of NRTI WHO mutations was 4.3%, whereas clinically relevant resistance to tenofovir, abacavir and emtricitabine/lamivudine was 1.7%, 1.9% and 0.7%, respectively. CONCLUSIONS: Given the low prevalence of clinically relevant resistance to INSTIs and first-line NRTIs in Spain, it is very unlikely that a newly diagnosed patient will present with clinical resistance to a first-line INSTI-based regimen. These patients may not benefit from INSTI and NRTI baseline resistance testing.

6.
Malar J ; 17(1): 399, 2018 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-30376868

RESUMO

BACKGROUND: Few previous retrospective studies suggest that Plasmodium ovale wallikeri seems to have a longer latency period and produces deeper thrombocytopaenia than Plasmodium ovale curtisi. Prospective studies were warranted to better assess interspecies differences. METHODS: Patients with imported P. ovale spp. infection diagnosed by thick or thin film, rapid diagnostic test (RDT) or polymerase chain reaction (PCR) were recruited between March 2014 and May 2017. All were confirmed by DNA isolation and classified as P. o. curtisi or P. o. wallikeri using partial sequencing of the ssrRNA gene. Epidemiological, analytical and clinical differences were analysed by statistical methods. RESULTS: A total of 79 samples (35 P. o. curtisi and 44 P. o. wallikeri) were correctly genotyped. Males predominate in wallikeri group (72.7%), whereas were 48.6% in curtisi group. Conversely, 74.3% of curtisi group were from patients of African ethnicity, whilst 52.3% of Caucasians were infected by P. o. wallikeri. After performing a multivariate analysis, more thrombocytopaenic patients (p = 0.022), a lower number of platelets (p = 0.015), a higher INR value (p = 0.041), and shorter latency in Caucasians (p = 0.034) were significantly seen in P. o. wallikeri. RDT sensitivity was 26.1% in P. o. curtisi and 42.4% in P. o. wallikeri. Nearly 20% of both species were diagnosed only by PCR. Total bilirubin over 3 mg/dL was found in three wallikeri cases. Two patients with curtisi infection had haemoglobin under 7 g/dL, one of them also with icterus. A wallikeri patient suffered from haemophagocytosis. Chemoprophylaxis failed in 14.8% and 35% of curtisi and wallikeri patients, respectively. All treated patients with various anti-malarials which included artesunate recovered. Diabetes mellitus was described in 5 patients (6.32%), 4 patients of wallikeri group and 1 curtisi. CONCLUSIONS: Imported P. o. wallikeri infection may be more frequent in males and Caucasians. Malaria caused by P. o. wallikeri produces more thrombocytopaenia, a higher INR and shorter latency in Caucasians and suggests a more pathogenic species. Severe cases can be seen in both species. Chemoprophylaxis seems less effective in P. ovale spp. infection than in P. falciparum, but any anti-malarial drug is effective as initial treatment. Diabetes mellitus could be a risk factor for P. ovale spp. infection.


Assuntos
Doenças Transmissíveis Importadas/epidemiologia , Malária/epidemiologia , Plasmodium ovale/fisiologia , Adulto , África/etnologia , Doenças Transmissíveis Importadas/classificação , Doenças Transmissíveis Importadas/complicações , Doenças Transmissíveis Importadas/parasitologia , Europa (Continente)/epidemiologia , Europa (Continente)/etnologia , Feminino , Genótipo , Humanos , Incidência , Malária/classificação , Malária/complicações , Malária/parasitologia , Masculino , Pessoa de Meia-Idade , Plasmodium ovale/classificação , Plasmodium ovale/genética , Prevalência , Estudos Prospectivos , Fatores Sexuais , Especificidade da Espécie , Adulto Jovem
7.
Enferm. infecc. microbiol. clín. (Ed. impr.) ; 36(6): 357-361, jun.-jul. 2018. tab
Artigo em Espanhol | IBECS | ID: ibc-176586

RESUMO

Introducción: Nuestro objetivo principal fue revisar los aspectos clínicos, microbiológicos y epidemiológicos de la infección asociada a Clostridium difficile en pediatría (2010-2015), comparando los diagnósticos realizados por detección de toxinas en heces y por PCR a tiempo real del gen de la toxina B. Métodos: Este estudio retrospectivo incluyó a 82 pacientes pediátricos. La detección de C. difficile toxigénico se realizó de manera secuencial, en heces diarreicas y bajo solicitud expresa. Resultados: El 39% de los pacientes procedían de Hemato-Oncología y >50% recibió previamente cefalosporinas. La presencia de fiebre asociada a diarrea fue más frecuente en el grupo de detección positiva de toxinas y no recibir antibioterapia específica fue más frecuente en el grupo con PCR positiva, sin diferencias estadísticamente significativas. Conclusión: Destacamos la presencia de infecciones en niños menores de 2 años. Sería recomendable realizar un diagnóstico de infección asociada a C. difficile en pacientes pediátricos, siempre que la sospecha clínica lo requiera


Introduction: Our main objective was a revision of clinical, microbiological and epidemiological results of Clostridium difficile-associated infection in paediatric patients (2010-2015). We compared the diagnoses performed by detection of toxins in feces and those performed by real-time PCR. Methods: This retrospective study included 82 paediatric patients. Detection of toxigenic C. difficile was performed sequentially, in diarrheal feces and under clinical request. Results: A total of 39% of the patients were attended at Haematology-oncology Unit and >50% of them had previously received cephalosporins. Fever associated with diarrhea was more frequent in the group of toxin detection, whereas not receiving specific antibiotic treatment was more frequent in the group of positive PCR, without statistically significant differences. Conclusions: We highlight the presence of C. difficile infection in children under 2 years old. A diagnostic testing in selected paediatric patients would be advisable when there is clinical suspicion of infection


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Clostridium difficile/genética , Infecções por Clostridium/diagnóstico , Infecções por Clostridium/microbiologia , Toxinas Bacterianas/genética , Fezes/microbiologia , Diarreia/microbiologia , Reação em Cadeia da Polimerase em Tempo Real , Estudos Retrospectivos
8.
Artigo em Inglês | IBECS | ID: ibc-170107

RESUMO

Introduction: A considerable increase of imported Zika virus (ZIKV) infection has been reported in Europe in the last year. This is the result of the large outbreak of the disease in the Americas, along with the increase in the numbers of travellers and immigrants arriving from ZIKV endemic areas. Methods: A descriptive study was conducted in the Tropical Medicine Unit of Hospital La Paz-Carlos III in Madrid on travellers returning from an endemic area for ZIKV from January to April 2016. Demographic, clinical and microbiological data were analyzed. Results: A total of 185 patients were screened for ZIKV (59.9% women, median age of 37.7±10.3 years). Main purpose of the travel was tourism to Colombia, Brazil, and México. Just under three-quarters (73%) were symptomatic, mostly with fever and headache. A total of 13 patients (7% of those screened) were diagnosed with ZIKV infections, of which four of them were pregnant. All of them were symptomatic patients, the majority immigrants, and mainly from Colombia. Diagnostic tests were based on positive neutralization antibodies (8 cases, 61.6%) and a positive RT-PCR in different organic fluids (7 cases, 53.8%) The four infected pregnant women underwent a neurosonography every 3 weeks, and no alterations were detected. RT-PCR in amniotic fluid was performed in three of them, with negative results. One of the children has already been born healthy. Conclusions: Our cases series represents the largest cohort of imported ZIKV to Spain described until now. Clinicians must increase awareness about the progression of the ZIKV outbreak and the affected areas so that they can include Zika virus infection in their differential diagnosis for travellers from those areas (AU)


Introducción: En el último año se ha registrado un importante aumento de casos de infección por virus Zika (ZIKV) importados en Europa. Este hecho es un reflejo de la epidemia que actualmente se está produciendo en las Américas, así como del aumento del número de viajeros e inmigrantes que proceden de zonas endémicas. Métodos: Estudio descriptivo de los viajeros retornados de área endémica para ZIKV en la Unidad de Medicina Tropical del Hospital La Paz-Carlos III en Madrid, de enero a abril de 2016. Se recogieron y analizaron datos demográficos, clínicos y microbiológicos. Resultados: Se cribaron para ZIKV un total de 185 pacientes (59,9% mujeres, mediana de edad de 37,7±10,3 años). El propósito por el que habían realizado el viaje fue por turismo a Colombia, Brasil y México. El 73% de los inicialmente cribados presentaron síntomas, fundamentalmente fiebre y cefalea. Se diagnosticó infección por ZIKV a 13 pacientes (7% de los cribados); 4 de ellos eran gestantes. Todos los casos con infección confirmada estaban sintomáticos, y la mayoría eran inmigrantes colombianos. El diagnóstico se basó en la presencia de anticuerpos neutralizantes positivos (8 casos, 61,6%) y RT-PCR positiva en diferentes fluidos orgánicos (7 casos, 53,8%). A las 4 gestantes infectadas se les realizó neurosonografía fetal seriada cada 3 semanas, no detectándose alteraciones en ninguna de ellas. En 3 casos se realizó RT-PCR en líquido amniótico, que fue negativo. Uno de los niños ha nacido, y está completamente sano. Conclusiones: Nuestra serie representa la cohorte más grande de infección por ZIKV importada en España hasta la fecha. Los clínicos deben estar alerta sobre la evolución de la epidemia del ZIKV y las zonas a las que afecta, para poder incluir la infección por ZIKV dentro del diagnóstico diferencial de viajeros que regresan de esas áreas (AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Infecção por Zika virus/epidemiologia , Infecção por Zika virus/prevenção & controle , Doenças Endêmicas/prevenção & controle , Medicina de Viagem/métodos , Infecções por Arbovirus/diagnóstico , Infecções por Arbovirus/microbiologia , Infecção por Zika virus/microbiologia , Espanha/epidemiologia , Medicina de Viagem/história , Medicina de Viagem/tendências , Infecções por Arbovirus/epidemiologia , Arbovirus/isolamento & purificação , Estudos Retrospectivos
9.
Enferm Infecc Microbiol Clin ; 36(6): 357-361, 2018.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-28689671

RESUMO

INTRODUCTION: Our main objective was a revision of clinical, microbiological and epidemiological results of Clostridium difficile-associated infection in paediatric patients (2010-2015). We compared the diagnoses performed by detection of toxins in feces and those performed by real-time PCR. METHODS: This retrospective study included 82 paediatric patients. Detection of toxigenic C. difficile was performed sequentially, in diarrheal feces and under clinical request. RESULTS: A total of 39% of the patients were attended at Haematology-oncology Unit and >50% of them had previously received cephalosporins. Fever associated with diarrhea was more frequent in the group of toxin detection, whereas not receiving specific antibiotic treatment was more frequent in the group of positive PCR, without statistically significant differences. CONCLUSIONS: We highlight the presence of C. difficile infection in children under 2years old. A diagnostic testing in selected paediatric patients would be advisable when there is clinical suspicion of infection.


Assuntos
Infecções por Clostridium/microbiologia , Clostridium difficile/isolamento & purificação , Adolescente , Proteínas de Bactérias/análise , Proteínas de Bactérias/genética , Toxinas Bacterianas/análise , Toxinas Bacterianas/genética , Cefalosporinas/efeitos adversos , Cefalosporinas/uso terapêutico , Criança , Pré-Escolar , Infecções por Clostridium/epidemiologia , Clostridium difficile/genética , Diarreia Infantil/etiologia , Enterocolite Pseudomembranosa/epidemiologia , Enterocolite Pseudomembranosa/etiologia , Enterocolite Pseudomembranosa/microbiologia , Enterotoxinas/genética , Fezes/química , Feminino , Febre/epidemiologia , Febre/etiologia , Genes Bacterianos , Humanos , Lactente , Recém-Nascido , Masculino , Reação em Cadeia da Polimerase em Tempo Real , Estudos Retrospectivos , Centros de Atenção Terciária/estatística & dados numéricos
10.
Enferm Infecc Microbiol Clin ; 36(1): 4-8, 2018 01.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-27743683

RESUMO

INTRODUCTION: A considerable increase of imported Zika virus (ZIKV) infection has been reported in Europe in the last year. This is the result of the large outbreak of the disease in the Americas, along with the increase in the numbers of travellers and immigrants arriving from ZIKV endemic areas. METHODS: A descriptive study was conducted in the Tropical Medicine Unit of Hospital La Paz-Carlos III in Madrid on travellers returning from an endemic area for ZIKV from January to April 2016. Demographic, clinical and microbiological data were analyzed. RESULTS: A total of 185 patients were screened for ZIKV (59.9% women, median age of 37.7±10.3 years). Main purpose of the travel was tourism to Colombia, Brazil, and México. Just under three-quarters (73%) were symptomatic, mostly with fever and headache. A total of 13 patients (7% of those screened) were diagnosed with ZIKV infections, of which four of them were pregnant. All of them were symptomatic patients, the majority immigrants, and mainly from Colombia. Diagnostic tests were based on positive neutralization antibodies (8 cases, 61.6%) and a positive RT-PCR in different organic fluids (7 cases, 53.8%) The four infected pregnant women underwent a neurosonography every 3 weeks, and no alterations were detected. RT-PCR in amniotic fluid was performed in three of them, with negative results. One of the children has already been born healthy. CONCLUSIONS: Our cases series represents the largest cohort of imported ZIKV to Spain described until now. Clinicians must increase awareness about the progression of the ZIKV outbreak and the affected areas so that they can include Zika virus infection in their differential diagnosis for travellers from those areas.


Assuntos
Doenças Transmissíveis Importadas , Infecção por Zika virus , Adulto , Américas , Doenças Transmissíveis Importadas/diagnóstico , Doenças Transmissíveis Importadas/epidemiologia , Feminino , Humanos , Masculino , Estudos Retrospectivos , Espanha/epidemiologia , Viagem , Infecção por Zika virus/diagnóstico , Infecção por Zika virus/epidemiologia
12.
Rev Esp Enferm Dig ; 109(11): 801, 2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-29072084

RESUMO

Acute hepatitis C virus (HCV) is now a major health problem, mainly in men who have sexual relations with other men (MSM). Hepatitis E virus (HEV) causes sporadic cases of acute hepatitis. In this article, we describe two cases of acute hepatitis due to HCV with an interesting clinical progress.


Assuntos
Soropositividade para HIV/complicações , Hepatite C/complicações , Hepatite E/complicações , Homossexualidade Masculina , Minorias Sexuais e de Gênero , Terapia Antirretroviral de Alta Atividade , Soropositividade para HIV/tratamento farmacológico , Hepatite C/virologia , Hepatite E/virologia , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Carga Viral
16.
Emerg Infect Dis ; 20(3): 409-16, 2014 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-24572501

RESUMO

Sequencing data from Plasmodium ovale genotypes co-circulating in multiple countries support the hypothesis that P. ovale curtisi and P. ovale wallikeri are 2 separate species. We conducted a multicenter, retrospective, comparative study in Spain of 21 patients who had imported P. ovale curtisi infections and 14 who had imported P. ovale wallikeri infections confirmed by PCR and gene sequencing during June 2005-December 2011. The only significant finding was more severe thrombocytopenia among patients with P. ovale wallikeri infection than among those with P. ovale curtisi infection (p = 0.031). However, we also found nonsignificant trends showing that patients with P. ovale wallikeri infection had shorter time from arrival in Spain to onset of symptoms, lower level of albumin, higher median maximum core temperature, and more markers of hemolysis than did those with P. ovale curtisi infection. Larger, prospective studies are needed to confirm these findings.


Assuntos
Malária/epidemiologia , Malária/parasitologia , Plasmodium ovale/classificação , Adolescente , Adulto , Criança , Comorbidade , Feminino , História do Século XXI , Humanos , Malária/complicações , Malária/diagnóstico , Malária/história , Masculino , Pessoa de Meia-Idade , Plasmodium ovale/genética , Estudos Retrospectivos , Espanha/epidemiologia , Trombocitopenia/diagnóstico , Trombocitopenia/etiologia , Adulto Jovem
19.
Rev Esp Quimioter ; 26(3): 253-60, 2013 Sep.
Artigo em Espanhol | MEDLINE | ID: mdl-24080893

RESUMO

Chagas disease is a chronic and systemic infection caused by Trypanosoma cruzi. According to estimates from WHO, 10 million people are affected by this parasite. In the last years, birthrate among the immigrant women from Latin America settled in the Comunidad Autónoma de Madrid has been increasing, and as T. cruzi can be transmitted from mother to child, in fact 11 cases of congenital Chagas disease have been confirmed. Therefore, the aim of this paper is encouraging improvements in the coverage of the anti-T. cruzi antibodies detection in pregnant women from endemic areas. By this strategy, an active search for infected pregnant women and early detection of her infected newborns could be conducted, and then an early specific treatment could be administrated. Thus, there could be an important contribution to the control of Chagas disease in non-endemic area.


Assuntos
Doença de Chagas/terapia , Trypanosoma cruzi , Adulto , Anticorpos Antiprotozoários/análise , Doença de Chagas/diagnóstico , Doença de Chagas/parasitologia , Consenso , Doenças Endêmicas , Feminino , Humanos , Recém-Nascido , Controle de Infecções , América Latina , Gravidez
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