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BACKGROUND: Motivation for the study. There is an increase in obesity and diabetes mellitus cases in Cuba, so it is necessary to provide easy to use, fast and inexpensive tools for the identification of people with dysglycemia. Main findings. For the first time in CUBA, the optimal cut-off point for FINDRISC, LA-FINDRISC and modified FINDRISC for Cuba (CUBDRISC) questionnaires was established with its own anthropometric parameters to identify people with dysglycemia. Implications. The use of the CUBDRISC scale as a simple, fast and low-cost tool for the active screening of people with dysglycemia in Cuban population will be useful to establish timely intervention strategies for people with risk score to develop dysglycemia. OBJECTIVES.: To evaluate the Finnish Diabetes Risk Score (FINDRISC) modified for Cuba as a tool for the detection of prediabetes and undiagnosed diabetes in Cuban population. MATERIALS AND METHODS.: An analytical cross-sectional and secondary source epidemiological study was conducted in 3737 adults aged 19 years and older with at least one risk factor for diabetes, they did not have previous diagnosis of prediabetes and diabetes mellitus and underwent oral glucose tolerance test for the diagnosis of dysglycemia. We applied the FINDRISC and the FINDRISC modified for Latin America (LA-FINDRISC) and Cuba (CUBDRISC), each with their own anthropometric parameters. The ROC curve was used to establish the cut-off point of each scale for the diagnosis of dysglycemia. Sensitivity, specificity, predictive values and likelihood ratios were calculated. The concordance between scales was calculated with Cohen's Kappa coefficient. RESULTS.: We found that 34.5% (n=1289) of the subjects were diagnosed with dysglycemia (28.1% had prediabetes and 6.4% had type 2 diabetes without previous diagnosis). The LA-FINDRISC and CUBDRISC scales showed an almost perfect concordance with the FINDRISC scale for the different cut-off values from 11 to 16 (0.882-0.890 and 0.910-0.922, respectively). The optimal cutoff point for detecting persons with dysglycemia was ≥ 13 for the FINDRISC and CUBDRISC scales (sensitivity was 63.6% and 61.6%; specificity was 84.3% and 86.0%, respectively) and ≥11 for LA-FINDRISC (sensitivity 58.0% and specificity 88.0%). CONCLUSIONS.: We found almost perfect concordance between the diabetes risk scales. The FINDRISC score modified for Cuba proved to be a useful tool to identify persons with prediabetes and diabetes with a cut-off point of 13 in a Cuban population.

OBJETIVOS.: Evaluar el Finnish Diabetes Risk Score (FINDRISC) modificado para Cuba como herramienta para la detección de prediabetes y diabetes no diagnosticada en una población cubana. MATERIALES Y MÉTODOS.: Se realizó un estudio epidemiológico de corte transversal analítico y de fuente secundaria en 3737 adultos de 19 a mas años con al menos un factor de riesgo de diabetes, sin diagnóstico previo de prediabetes y diabetes mellitus, a los cuales se les realizó la prueba de tolerancia a la glucosa oral para el diagnóstico de disglucemia. Las puntuaciones de riesgo de diabetes aplicadas fueron la FINDRISC y las FINDRISC modificadas para Latinoamérica (LA-FINDRISC) y Cuba (CUBDRISC) con parámetros antropométricos propios. La curva ROC se utilizó para establecer el punto de corte de cada escala para el diagnóstico de disglucemia. Se calculó sensibilidad, especificidad, valores predictivos y razones de verosimilitud. La concordancia entre las escalas fue calculada con el coeficiente Kappa de Cohen. RESULTADOS.: El 34,5% (n=1289) de las personas se diagnosticó con disglucemia (28,1% prediabetes y 6,4% diabetes tipo 2 sin diagnóstico previo). Las escalas LA-FINDRISC y CUBDRISC mostraron un grado de acuerdo casi perfecto con la escala FINDRISC para los distintos valores de corte del 11 al 16 (0,882-0,890 y 0,910-0,922, respectivamente). El punto de corte óptimo para detectar personas con disglucemia fue ≥ 13 para las escalas FINDRISC y CUBDRISC (sensibilidad 63,6% y 61,6%; especificidad 84,3% y 86,0%, respectivamente) y ≥11 para LA-FINDRISC (sensibilidad 58,0% y especificidad 88,0%). CONCLUSIONES.: Existe una concordancia casi perfecta entre las escalas de riesgo de diabetes. El puntaje FINDRISC modificado para Cuba demostró ser una herramienta útil para identificar personas con prediabetes y diabetes con punto de corte 13 en una población cubana.

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A febrile man in Italy who had traveled to Cuba in July 2024 was diagnosed with Oropouche fever. Reverse transcription PCR detected prolonged shedding of Oropouche virus RNA in whole blood, serum, urine, and semen. Sixteen days after symptom onset, replication-competent virus was detected in semen, suggesting risk for sexual transmission.

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On 27 May 2024, the Cuban Ministry of Health reported the first outbreak of Oropouche fever on the island. The etiologic agent, Oropouche virus (OROV), is a poorly understood arbovirus that has been known since the 1960s and represents a public health burden in Latin America. We report the whole-genome characterization of the first European OROV isolate from a returning traveler from Cuba with Oropouche fever-like symptoms. The isolate was obtained from the patient's serum; whole-genome sequencing was performed by next-generation sequencing, followed by phylogenetic analysis and genetic variability studies. The analysis showed that the most closely related sequence was from the French Guiana 2020 outbreak. Interestingly, our isolate is a reassortant virus, included in a highly supported monophyletic clade containing recent OROV cases (Brazil 2015-Colombia 2021), separated from the other four previously known genotypes. More deeply, it was found to be included in a distinct branch containing the sequences of the Brazil 2022-2024 outbreak. The reassortment event involved the S and L segments, which have high similarity with sequences belonging to a new cluster (here defined as OROV_SCDC_2024), while the M segment shows high similarity with older sequences. These results likely describe the viral strain responsible for the current outbreak in Cuba, which may also reflect the ongoing outbreak in Latin America. Further studies are needed to understand how OROV evolves towards traits that facilitate its spread and adaptation outside its original basin, and to track its spread and evolution in the European continent.

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Beginning in late 2023, Oropouche virus was identified as the cause of large outbreaks in Amazon regions with known endemic transmission and in new areas in South America and the Caribbean. The virus is spread to humans by infected biting midges and some mosquito species. Although infection typically causes a self-limited febrile illness, reports of two deaths in patients with Oropouche virus infection and vertical transmission associated with adverse pregnancy outcomes have raised concerns about the threat of this virus to human health. In addition to approximately 8,000 locally acquired cases in the Americas, travel-associated Oropouche virus disease cases have recently been identified in European travelers returning from Cuba and Brazil. As of August 16, 2024, a total of 21 Oropouche virus disease cases were identified among U.S. travelers returning from Cuba. Most patients initially experienced fever, myalgia, and headache, often with other symptoms including arthralgia, diarrhea, nausea or vomiting, and rash. At least three patients had recurrent symptoms after the initial illness, a common characteristic of Oropouche virus disease. Clinicians and public health jurisdictions should be aware of the occurrence of Oropouche virus disease in U.S. travelers and request testing for suspected cases. Travelers should prevent insect bites when traveling, and pregnant persons should consider deferring travel to areas experiencing outbreaks of Oropouche virus disease.

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Oropouche virus is the aetiological agent of Oropouche fever. At present, this is currently considered one of the most important vector-borne diseases in Latin America. On 27 May 2024, the Ministry of Public Health of Cuba reported the first ever outbreak of Oropouche fever. In this report, we describe three human cases of Oropouche virus infection with symptoms and signs of neurological disease and clinical diagnosis of Guillain-Barré Syndrome. This study offers insights regarding that Oropouche virus is a causal agent of neurological disorders and it could be involved in the etiology of the Guillain-Barré Syndrome.

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AIM OF STUDY: The study aims to assess the growing public health threat posed by Oropouche virus (OROV), focusing on its epidemiology, transmission patterns, and the challenges in diagnosis and control. By analyzing the recent spread of OROV to new regions, including Cuba and Colombia, the study seeks to highlight the need for improved surveillance, enhanced diagnostic capabilities, and research into potential treatments and vaccines. Additionally, the study investigates the clinical similarities between Oropouche fever and other arboviruses, which often lead to diagnostic difficulties and mismanagement in affected regions. RESULTS: The virus has caused over 500,000 cases in Brazil alone, with recent outbreaks reporting fatalities, suspected vertical transmission, and potential associations with microcephaly in newborns. Underreporting and limited surveillance have likely led to the underestimation of the true burden of Oropouche fever. Current diagnostic methods, such as serology and RT-PCR, are often inaccessible in low-resource settings, further complicating efforts to control the spread of the virus. The study highlights the importance of improving diagnostic capacity, enhancing surveillance, and conducting further research into vector control, antiviral treatments, and vaccine development. CONCLUSION: This study emphasizes the urgent need for coordinated international efforts to address the rising threat of Oropouche virus. Considering its rapid spread and potential for global transmission, comprehensive public health measures are necessary to protect vulnerable populations and mitigate the impact of this emerging disease. Enhanced surveillance and the development of accessible diagnostics, vaccines, and treatment options are critical to containing OROV and preventing further outbreaks.

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Phylogenetic analyses showed that the virus responsible for a May 2024 Oropouche fever outbreak in Cuba was closely related to viruses from Brazil in 2023. Pools of Ceratopogonidae spp. biting midges and Culex quinquefasciatus mosquitoes were positive for Oropouche viral RNA. No cases were severe. Virus extension to new areas may increase case numbers and severity.

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Oropouche fever is caused by Oropouche virus (OROV), transmitted primarily through the bite of infected midges, particularly of the genus Culicoides. The virus is mainly circulating in Central and South America where several countries reported an ongoing outbreak. We report here two imported cases of OROV infection identified in Italy, late May-early June 2024. These cases indicate that in the shadow of a massive dengue outbreak in the Americas, the Oropouche outbreak might be more widespread than previously estimated.

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Trypanosomatids are obligate parasites of animals, predominantly insects and vertebrates, and flowering plants. Monoxenous species, representing the vast majority of trypanosomatid diversity, develop in a single host, whereas dixenous species cycle between two hosts, of which primarily insect serves as a vector. To explore in-depth the diversity of insect trypanosomatids including their co-infections, sequence profiling of their 18S rRNA gene was used for true bugs (Hemiptera; 18% infection rate) and flies (Diptera; 10%) in Cuba. Out of 48 species (molecular operational taxonomic units) belonging to the genera Vickermania (16 spp.), Blastocrithidia (7), Obscuromonas (4), Phytomonas (5), Leptomonas/Crithidia (5), Herpetomonas (5), Wallacemonas (2), Kentomonas (1), Angomonas (1) and two unnamed genera (1 + 1), 38 species have been encountered for the first time. The detected Wallacemonas and Angomonas species constitute the most basal lineages of their respective genera, while Vickermania emerged as the most diverse group. The finding of Leptomonas seymouri, which is known to rarely infect humans, confirms that Dysdercus bugs are its natural hosts. A clear association of Phytomonas with the heteropteran family Pentatomidae hints at its narrow host association with the insect rather than plant hosts. With a focus on multiple infections of a single fly host, using deep Nanopore sequencing of 18S rRNA, we have identified co-infections with up to 8 trypanosomatid species. The fly midgut was usually occupied by several Vickermania species, while Herpetomonas and/or Kentomonas species prevailed in the hindgut. Metabarcoding was instrumental for analysing extensive co-infections and also allowed the identification of trypanosomatid lineages and genera.

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Havana Syndrome is used to describe the array of deficits seen in diplomats stationed in Cuba from August 2016 to September 2017.1 Patients from this cohort were clinically studied, investigating their symptoms, audition and vestibular deficits, and imaging abnormalities seen on MRI.1-3 The primary studies were retrospective, looking at how these symptoms could be classified or fit into diagnostic criteria. The cohort had many similarities: a sound at the onset of symptoms, a mix of neurologic and otologic symptoms, and persistent symptoms that lasted for months.1-3 Theories of the cause of Havana Syndrome have led to no conclusive answer. Potential viral etiologies, mass psychogenic illness, and head trauma were examined as causes.1-5 Diseases with established diagnostic criteria were used to compare the patients' symptoms to try to find a disease that fits Havana Syndrome.3 Recent information from the Office of the Director of National Intelligence suggested the most likely cause to be mass psychogenic illness. With the cause of Havana Syndrome still unknown, a review of reported cases and reports helps otolaryngologists understand Havana Syndrome so they diagnose it only when appropriate and do not miss other conditions that may present with similar symptoms and that might respond well to targeted treatment.

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BACKGROUND:  The Latin American region represents a hotspot for oral cancer incidence and mortality. To reduce oral cancer mortality rates, screening for early detection of subjects with suspicious or innocuous oral lesions has been promoted. A systematic review was performed to assess the outcomes of oral cancer screening in the Latin American region. MATERIAL AND METHODS:  An electronic search was conducted in eight databases and grey literature. The eligibility criteria included screening where adult participants underwent any screening test during an organized screening program. Screening programs were assessed to understand trends in oral cancer diagnosis. Rates of oral cancers diagnosed in screening programs were classified as increase, decrease, or stable based on each year assessed. RESULTS:  Following our searches, twelve studies conducted in Brazil and Cuba were included. The screening tests reported were visual oral examination (VOE) and in one study in addition light-based fluorescence testing. 13,277,608 individuals were screened and a total of 1,516 oral cancers were detected (0.01%). Only two studies aimed to screen high-risk individuals (smokers and drinkers). Oral cancer cases diagnosed during screening programs were proportionately stable over the years 1997 to 2009 but increased from 2010 to 2021. The fluorescence-associated VOE test demonstrated a sensitivity of 100% and a specificity of 90%. Similarly, the VOE test alone exhibited a sensitivity of 100%, with specificity ranging from 75% to 90%. CONCLUSIONS:  Screening studies conducted in Latin American countries had serious limitations both in methodology (lack of examiner training) and in reporting data (lack of description of clinical categories of screen positives). Capacitation of health workers to perform VOE in well-designed screening programs should be implemented.

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In Cuba, despite a high sero-prevalence of bluetongue virus (BTV), circulating serotypes remain unknown. The aim of this study was to identify circulating BTV serotypes in farms throughout the western region of Cuba. Blood samples were collected from 200 young cattle and sheep between May and July 2022 for virological analyses (PCR, viral isolation and virus neutralization) and genome sequencing. The results confirmed viral circulation, with viro-prevalence of 25% for BTV. The virus was isolated from 18 blood samples and twelve BTV serotypes were identified by sequencing RT-PCR products targeting the segment 2 of the BTV genome (BTV-1, 2, 3, 6, 10, 12, 13, 17, 18, 19, 22 and 24). Finally, the full genome sequences of 17 Cuban BTV isolates were recovered using a Sequence Independent Single Primer Amplification (SISPA) approach combined to MinION Oxford Nanopore sequencing technology. All together, these results highlight the co-circulation of a wide diversity of BTV serotypes in a quite restricted area and emphasize the need for entomological and livestock surveillance, particularly in light of recent changes in the global distribution and nature of BTV infections.

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Limited evidence suggests that the SARS-CoV-2 infection can accelerate the progression of neurodegenerative diseases, but this has been not verified in the spinocerebellar ataxias (SCA). The objective of this study is to assess the impact of COVID-19 on the mental health and motor features of SCA2. A follow-up study was carried out in 170 Cuban SCA2 subjects and 87 community controls between 2020 and 2021. All subjects underwent a structured questionnaire to assess the risks of exposure to COVID-19, the confirmation of COVID-19 diagnosis, and the Hospital Anxiety and Depression Scale (HADS). Moreover, 36 subjects underwent the Scale for the Assessment and Rating of ataxia (SARA). The risk of exposure to SARS-CoV-2 and the frequency of COVID-19 were similar between the ataxia cohort and the community controls. Within the ataxia group, significantly increased HADS scores existed at the 2nd visit in both groups, but this increase was more evident for the infected group regarding the depression score. Moreover, a significant within-group increase of SARA score was observed in the infected group but not the non-infected group, which was mainly mediated by the significant increase of the speech item score in the infected group. Similar results were observed within the subgroup of preclinical carriers. Our study identified no selective vulnerability nor protection to COVID-19 in SCA2, but once infected, the patients experienced a deterioration of mental health and speech function, even at preclinical disease stage. These findings set rationales for tele-health approaches that minimize the detrimental effect of COVID-19 on SCA2 progression and identify SCA2 individuals as clinical model to elucidate the link between SARS-CoV-2 infection and neurodegeneration.

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OBJECTIVE: The Latin American Epidemiologic study of ALS (LAENALS) aims to gather data on ALS epidemiology, phenotype, and risk factors in Cuba, Chile, and Uruguay, to understand the impact of genetic and environmental factors on ALS. METHODS: A harmonized data collection protocol was generated, and a Latin-American Spanish language Register was constructed. Patient data were collected in Uruguay in 2018, in Chile from 2017 to 2019, and in Cuba between 2017 and 2018. Statistical analysis was performed using SPSS 25.0.0 software. Crude cumulative incidence, standardized incidence, and prevalence were calculated in the population aged 15 years and older. RESULTS: During 2017-2019, 90 people with ALS from Uruguay (55.6% men), 219 from Chile (54.6% men), and 49 from Cuba (55.1% men) were included. The cumulative crude incidence in 2018 was 1.73/100,000 persons in Uruguay, 1.08 in Chile and 0.195 in Cuba. Crude prevalence in 2018 was 2.19 per 100,000 persons in Uruguay, 1.39 in Chile and 0.55 in Cuba. Mean age at onset was 61.8 ± 11.96 SD years in Uruguay, 61.9 ± 10.4 SD years in Chile, and 60.21 ± 12.45 SD years in Cuba (p = 0.75). Median survival from onset was 32.43 months (21.93 - 42.36) in Uruguay, 24 months (13.5 - 33.5) in Chile, and 29 months (15 - 42.5) in Cuba (p = 0.006). CONCLUSIONS: These preliminary data from LAENALS confirm the lower incidence and prevalence of ALS in counties with admixed populations. The LAENALS database is now open to other Latin American countries for harmonized prospective data collection.

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BACKGROUND: Since 2016, an array of claims and public discourse have circulated in the medical community over the origin and nature of a mysterious condition dubbed "Havana Syndrome," so named as it was first identified in Cuba. In March 2023, the United States intelligence community concluded that the condition was a socially constructed catch-all category for an array of health conditions and stress reactions that were lumped under a single label. AIMS: To examine the history of "Havana Syndrome" and the many factors that led to its erroneous categorization as a novel clinical entity. METHOD: A review of the literature. RESULTS/CONCLUSIONS: Several factors led to the erroneous classification of "Havana Syndrome" as a novel entity including the failure to stay within the limitations of the data; the withholding of information by intelligence agencies, the prevalence of popular misconceptions about psychogenic illness, the inability to identify historical parallels; the role of the media, and the mixing of politics with science.

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Intestinal parasites are widely distributed around the world and children are the most common affected group. The prevalence of intestinal parasites and associated risk factors by a cross-sectional study among children at a primary school in the Union de Reyes municipality, Matanzas province, Cuba, was carried out during April-May, 2022. Blastocystis spp. and Giardia intestinalis were the most common parasites found.