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1.
mBio ; : e0242423, 2024 Mar 12.
Artículo en Inglés | MEDLINE | ID: mdl-38470267

RESUMEN

Two growth modes have been described for the filamentous Streptomyces bacteria. Their classic developmental life cycle culminates in the formation of dormant spores, where movement to new environments is mediated through spore dispersal. In contrast, exploratory growth proceeds as a rapidly expanding vegetative mycelium that leads to extensive surface colonization and is associated with the release of volatile compounds that promote alkalinization (and reduced iron bioavailability) of its surrounding environment. Here, we report that exploratory growth in Streptomyces venezuelae can proceed in tandem with classic sporulating development in response to specific nutritional cues. Sporulating exploration is not accompanied by a rise in environmental pH but has the same iron acquisition requirements as conventional exploration. We found that mutants that were defective in their ability to sporulate were unaffected in exploration, but mutants undergoing precocious sporulation were compromised in their exploratory growth and this appeared to be mediated through premature activation of the developmental regulator WhiI. Cell envelope integrity was also found to be critical for exploration, as mutations in the cell envelope stress-responsive extracytoplasmic function sigma factor SigE led to a failure to explore robustly under all exploration-promoting conditions. Finally, in expanding the known exploration-promoting conditions, we discovered that the model species Streptomyces lividans exhibited exploration capabilities, supporting the proposal that exploration is conserved across diverse streptomycetes. IMPORTANCE: Streptomyces bacteria have evolved diverse developmental and metabolic strategies to thrive in dynamic environmental niches. Here, we report the amalgamation of previously disparate developmental pathways, showing that colony expansion via exploration can proceed in tandem with colony sporulation. This developmental integration extends beyond phenotype to include shared genetic elements, with sporulation-specific repressors being required for successful exploration. Comparing this new exploration mode with previously identified strategies has revealed key differences (e.g., no need for environmental alkalinization), and simultaneously allowed us to define unifying requirements for Streptomyces exploration. The "reproductive exploration" phenomenon reported here represents a unique bet-hedging strategy, with the Streptomyces colony engaging in an aggressive colonization strategy while transporting a protected genetic repository.

2.
BMJ Glob Health ; 9(3)2024 Mar 07.
Artículo en Inglés | MEDLINE | ID: mdl-38453517

RESUMEN

INTRODUCTION: Equitable access to vaccines for migrants and refugees is necessary to ensure their right to health and to achieve public health goals of reducing vaccine-preventable illness. Public health policies require regulatory frameworks and communication to effect uptake of effective vaccines among the target population. In Colombia, the National COVID-19 Vaccination Plan implicitly included Venezuelan refugees and migrants; however, initial communication of the policy indicated that vaccine availability was restricted to people with regular migration status. We estimated the impact of a public announcement, which clarified access for refugees and migrants, on vaccination coverage among Venezuelans living in Colombia. METHODS: Between 30 July 2021 and 5 February 2022, 6221 adult Venezuelans participated in a cross-sectional, population-based health survey. We used a comparative cross-sectional time-series analysis to estimate the effect of the October 2021 announcement on the average biweekly change in COVID-19 vaccine coverage of Venezuelans with regular and irregular migration status. RESULTS: 71% of Venezuelans had an irregular status. The baseline (preannouncement) vaccine coverage was lower among people with an irregular status but increased at similar rates as those with a regular status. After the announcement, there was a level change of 14.49% (95% CI: 1.57 to 27.42, p=0.03) in vaccination rates among individuals with irregular migration status with a 4.61% increase in vaccination rate per biweekly period (95% CI: 1.71 to 7.51, p=0.004). By February 2022, there was a 26.2% relative increase in vaccinations among individuals with irregular migration status compared with what was expected without the announcement. CONCLUSION: While there was no policy change, communication clarifying the policy drastically reduced vaccination inequalities across migration status. Lessons can be translated from the COVID-19 pandemic into more effective global, regional and local public health emergency preparedness and response to displacement.


Asunto(s)
Vacunas contra la COVID-19 , COVID-19 , Refugiados , Pueblos Sudamericanos , Migrantes , Adulto , Humanos , Colombia/epidemiología , Comunicación , COVID-19/prevención & control , Estudios Transversales , Política de Salud , Pandemias , Vacunación
3.
J Nat Prod ; 2024 Mar 22.
Artículo en Inglés | MEDLINE | ID: mdl-38517947

RESUMEN

Investigation of the secondary metabolites of Streptomyces virginiae CMB-CA091 isolated from the quartz-rich (tepui) soil of a cave in Venezuela yielded two new dimeric phenazine glycosides, tepuazines A and B (1 and 2); three new monomeric phenazine glycosides, tepuazines C-E (3-5); and a series of known analogues, baraphenazine G (6), phenazinolin D (7), izumiphenazine C (8), 4-methylaminobenzoyl-l-rhamnopyranoside (9), and 2-acetamidophenol (10). Structures were assigned to 1-10 on the basis of detailed spectroscopic analysis and biosynthetic considerations, with 1 and 2 featuring a rare 2-oxabicyclo[3.3.1]nonane-like ring C/D bridge shared with only a handful of known Streptomyces natural products. We propose a plausible convergent biosynthetic relationship linking all known members of this structure class that provides a rationale for the observed ring C/D configuration.

4.
Open Forum Infect Dis ; 11(2): ofad683, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38328492

RESUMEN

Leishmaniasis is a vector-borne disease uncommonly encountered in the United States. This case report describes a 54-year-old man presenting with rapidly progressing, pruritic, painful ulcerative lesions after recently immigrating from Venezuela. A punch biopsy confirmed infection with Leishmaniasis braziliensis. He was successfully treated with amphotericin B and miltefosine.

6.
Lancet Reg Health Am ; 30: 100669, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38298201

RESUMEN

Background: Population-based estimates of syphilis prevalence are critical to informing public health response. We aimed to measure syphilis prevalence among Venezuelan refugees and migrants in Colombia to inform public health programming. Methods: Between July 2021 and February 2022, we surveyed 6221 adult Venezuelan refugees and migrants in four cities in Colombia using respondent-driven sampling (RDS). Participants completed a survey and dual-rapid HIV/treponemal syphilis screening. Confirmatory laboratory-based rapid plasma reagin testing was conducted on whole blood samples. Active syphilis infection was defined as RPR titer ≥ 1:8 and no self-reported syphilis treatment. We used multivariable regression models to identify associations with active syphilis infection among subgroups by gender and history of pregnancy (cisgender men n = 2123, cisgender women n = 4044, transgender/nonbinary people n = 47, pregnant women n = 150). Findings: Population (RDS-weighted) prevalence of laboratory-confirmed syphilis was 5.1% (95% CI: 4.6-5.6). Syphilis prevalence was 5.8% (weighted) among men; lifetime sexually transmitted infections (STI) diagnosis, same-sex relationships, HIV infection, and partner number were independently associated with syphilis infection. Syphilis prevalence was 4.6% (weighted) in women; correlates of infection included: lifetime STI diagnosis, food insecurity, current engagement in sex work, current pregnancy, any unsafe night in Colombia, irregular migration status, and no healthcare utilization in Colombia. 14.9% (unweighted) of transgender participants had syphilis infection; correlates of infection included partner number and HIV infection. The prevalence of syphilis was 9.0% (weighted) among pregnant women, which was associated with lifetime STI diagnosis. Interpretation: Syphilis among Venezuelans in Colombia is high. Correlates of infection are distinct among demographic groups, spanning sexual and social vulnerabilities, suggesting tailored public health strategies. Funding: US President's Emergency Plan for AIDS Relief through the U.S. Centers for Disease Control and Prevention.

7.
Microorganisms ; 12(2)2024 Jan 29.
Artículo en Inglés | MEDLINE | ID: mdl-38399694

RESUMEN

Lichens are not only fungal-algal symbiotic associations but also matrices for association with bacteria, and the bacterial diversity linked to lichens has been receiving more attention in studies. This study compares the diversity and possible metabolism of lichen-associated bacteria from saxicolous foliose and fruticose taxa Alectoria, Canoparmelia, Crocodia, Menegazzia, Usnea, and Xanthoparmelia from the Venezuelan Guiana Shield and the South African Highveld Plateau. We used DNA extractions from the lichen thalli to amplify the eukaryotic 18S rRNA gene (rDNA) and the V3-V4 region of the bacterial 16S rDNA, of which amplicons were then Sanger- and MiSeq-sequenced, respectively. The V3-V4 sequences of the associated bacteria were grouped into operational taxonomic units (OTUs) ascribed to twelve bacterial phyla previously found in the rock tripe Umbilicaria lichens. The bacterial OTUs emphasized the uniqueness of each region, while, at the species and higher ranks, the regional microbiomes were shown to be somewhat similar. Nevertheless, regional biomarker OTUs were screened to predict relevant metabolic pathways, which implicated different regional metabolic features.

8.
Artículo en Inglés | MEDLINE | ID: mdl-38397657

RESUMEN

Refugees and migrants experience an elevated risk for mental health problems and face significant barriers to receiving services. Interpersonal counseling (IPC-3) is a three-session intervention that can be delivered by non-specialists to provide psychological support and facilitate referrals for individuals in need of specialized care. We piloted IPC-3 delivered remotely by eight Venezuelan refugee and migrant women living in Peru. These counselors provided IPC-3 to Venezuelan refugee and migrant clients in Peru (n = 32) who reported psychological distress. Clients completed assessments of mental health symptoms at baseline and one-month post-intervention. A subset of clients (n = 15) and providers (n = 8) completed post-implementation qualitative interviews. Results showed that IPC-3 filled a gap in the system of mental health care for refugees and migrants in Peru. Some adaptations were made to IPC-3 to promote its relevance to the population and context. Non-specialist providers developed the skills and confidence to provide IPC-3 competently. Clients displayed large reductions in symptoms of depression (d = 1.1), anxiety (d = 1.4), post-traumatic stress (d = 1.0), and functional impairment (d = 0.8). Remote delivery of IPC-3 by non-specialists appears to be a feasible, acceptable, and appropriate strategy to address gaps and improve efficiency within the mental health system and warrants testing in a fully powered effectiveness study.


Asunto(s)
COVID-19 , Refugiados , Migrantes , Humanos , Femenino , Refugiados/psicología , Proyectos Piloto , Perú/epidemiología , Pandemias , COVID-19/epidemiología , Consejo
9.
BMC Pregnancy Childbirth ; 24(1): 157, 2024 Feb 23.
Artículo en Inglés | MEDLINE | ID: mdl-38395816

RESUMEN

BACKGROUND: It is estimated that since 2014, approximately 7.3 million Venezuelan migrants/refugees have left the country. Although both male and female migrants/refugees are vulnerable, female migrants/refugees are more likely to face discrimination, emotional, physical, and sexual violence. Currently there is a lack of literature that explores the experiences of pregnant Venezuelan migrants/refugees. Our aim is to better understand the experience of this vulnerable population to inform programming. METHODS: In the parent study, Spryng.io's sensemaking tool was used to gain insight into the gendered migration experiences of Venezuelan women/girls. A total of 9339 micronarratives were collected from 9116 unique participants in Peru, Ecuador and Brazil from January to April 2022. For the purpose of this analysis, two independent reviewers screened 817 micronarratives which were identified by the participant as being about someone who was pregnant, ultimately including 231 as part of the thematic analysis. This was an exploratory study and an open thematic analysis of the narratives was performed. RESULTS: The mean age and standard deviation of our population was 25.77 ± 6.73. The majority of women in the sample already had at least 1 child (62%), were married at the time of migration (53%) and identified as low socio-economic status (59%). The qualitative analysis revealed the following main themes among pregnant Venezuelan migrants/refugees: xenophobia in the forms of racial slurs and hostile treatment from health-care workers while accessing pregnancy care; sexual, physical, and verbal violence experienced during migration; lack of shelter, resources and financial support; and travelling with the hopes of a better future. CONCLUSION: Pregnant Venezuelan migrants/refugees are a vulnerable population that encounter complex gender-based and societal issues that are rarely sufficiently reported. The findings of this study can inform governments, non-governmental organizations, and international organizations to improve support systems for pregnant migrants/refugees. Based on the results of our study we recommend addressing xenophobia in health-care centres and the lack of shelter and food in host countries at various levels, creating support spaces for pregnant women who experience trauma or violence, and connecting women with reliable employment opportunities and maternal healthcare.


Asunto(s)
Refugiados , Migrantes , Femenino , Humanos , Embarazo , Brasil , Ecuador , Perú , Refugiados/psicología , Investigación Cualitativa
10.
medRxiv ; 2024 Feb 03.
Artículo en Inglés | MEDLINE | ID: mdl-38352566

RESUMEN

Madariaga virus (MADV) and Venezuelan equine encephalitis virus (VEEV) are emerging arboviruses affecting rural and remote areas of Latin America. However, there are limited clinical and epidemiological reports available, and outbreaks are occurring at an increasing frequency. We addressed this gap by analyzing all the available clinical and epidemiological data of MADV and VEEV infections recorded since 1961 in Panama. A total of 168 of human alphavirus encephalitis cases were detected in Panama from 1961 to 2023. Here we describe the clinical signs and symptoms and epidemiological characteristics of these cases, and also explored signs and symptoms as potential predictors of encephalitic alphavirus infection when compared to those of other arbovirus infections occurring in the region. Our results highlight the challenges clinical diagnosis of alphavirus disease in endemic regions with overlapping circulation of multiple arboviruses.

11.
Acta Parasitol ; 2024 Jan 31.
Artículo en Inglés | MEDLINE | ID: mdl-38294711

RESUMEN

PURPOSE: Trypanosoma cruzi and Leishmania spp. coexist in several endemic areas, and there are few studies of Chagas disease and leishmaniasis coinfection worldwide; for this reason, the objective of this work was to determine the Chagas disease and leishmaniasis coinfection in several rural communities co-endemic for these diseases. METHODS: A total of 1107 human samples from six co-endemic rural communities of Cojedes state, Venezuela, were analyzed. Serum samples were evaluated by ELISA, indirect hemagglutination, and indirect immunofluorescence for Chagas disease diagnosis, and individuals were evaluated for leishmaniasis by leishmanin skin test (LST). Approximately, 30% of the individuals were also analyzed by PCR (blood clot samples) for T. cruzi and for Leishmania spp. RESULTS: The 14.7% of the individuals were positive to Trypanosoma cruzi infection by serology, and 25.8% were positive to Leishmania spp. current or past infection by LST. Among the group with PCR results, 7.8% were positive for T. cruzi, and 9.4% for Leishmania spp. The coinfection T. cruzi/Leishmania spp. was 6.5%. The T. cruzi DTUs of the positive blood clot samples were TcI, revealed using the molecular markers: (i) intergenic region of the miniexon, (ii) D7 divergent domain of the 24Sα rDNA, (iii) size-variable domain of the 18S rDNA, and (iv) hsp60-PCR-RFLP (EcoRV). The Leishmania species identified were L. (Leishmania) mexicana and L. (Viannia) braziliensis. CONCLUSION: A high prevalence was found for T. cruzi and Leishmania spp. single and coinfections in almost all communities studied, being these results of relevance for the implementation of control programs in co-endemic areas.

12.
PLOS Glob Public Health ; 4(1): e0002763, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38232087

RESUMEN

The impact of the humanitarian crisis in Venezuela on care for noncommunicable diseases (NCDs) such as diabetes is unknown. This study aims to document health system performance for diabetes management in Venezuela during the humanitarian crisis. This longitudinal study on NCDs is nationally representative at baseline (2014-2017) and has follow-up (2018-2020) data on 35% of participants. Separate analyses of the baseline population with diabetes (n = 585) and the longitudinal population with diabetes (n = 210) were conducted. Baseline analyses constructed a weighted care continuum: all diabetes; diagnosed; treated; achieved glycaemic control; achieved blood pressure, cholesterol, and glycaemic control; and achieved aforementioned control plus non-smoking. Weighted multinomial regression models controlling for region were used to estimate the association between socio-demographic characteristics and care continuum stage. Longitudinal analyses constructed an unweighted care continuum: all diabetes; diagnosed; treated; and achieved glycaemic control. Unweighted multinomial regression models controlling for region were used to estimate the association between socio-demographic characteristics and changes in care continuum stage. Among 585 participants with diabetes at baseline, 71% were diagnosed, 51% were on treatment, and 32% had achieved glycaemic control. Among 210 participants with diabetes in the longitudinal population, 50 (24%) participants' diabetes management worsened, while 40 (19%) participants improved. Specifically, the proportion of those treated decreased (60% in 2014-2017 to 51% in 2018-2020), while the proportion of participants achieving glycaemic control did not change. Although treatment rates have declined substantially among people with diabetes in Venezuela, management changed less than expected during the crisis.

13.
J Neuroinflammation ; 21(1): 24, 2024 Jan 17.
Artículo en Inglés | MEDLINE | ID: mdl-38233868

RESUMEN

BACKGROUND: Venezuelan Equine Encephalitis virus (VEEV) may enter the central nervous system (CNS) within olfactory sensory neurons (OSN) that originate in the nasal cavity after intranasal exposure. While it is known that VEEV has evolved several mechanisms to inhibit type I interferon (IFN) signaling within infected cells, whether this inhibits virologic control during neuroinvasion along OSN has not been studied. METHODS: We utilized an established murine model of intranasal infection with VEEV and a repository of scRNAseq data from IFN-treated OSN to assess the cellular targets and IFN signaling responses after VEEV exposure. RESULTS: We found that immature OSN, which express higher levels of the VEEV receptor LDLRAD3 than mature OSN, are the first cells infected by VEEV. Despite rapid VEEV neuroinvasion after intranasal exposure, olfactory neuroepithelium (ONE) and olfactory bulb (OB) IFN responses, as assessed by evaluation of expression of interferon signaling genes (ISG), are delayed for up to 48 h during VEEV neuroinvasion, representing a potential therapeutic window. Indeed, a single intranasal dose of recombinant IFNα triggers early ISG expression in both the nasal cavity and OB. When administered at the time of or early after infection, IFNα treatment delayed onset of sequelae associated with encephalitis and extended survival by several days. VEEV replication after IFN treatment was also transiently suppressed in the ONE, which inhibited subsequent invasion into the CNS. CONCLUSIONS: Our results demonstrate a critical and promising first evaluation of intranasal IFNα for the treatment of human encephalitic alphavirus exposures.


Asunto(s)
Virus de la Encefalitis Equina Venezolana , Neuronas Receptoras Olfatorias , Humanos , Ratones , Animales , Virus de la Encefalitis Equina Venezolana/genética , Sistema Nervioso Central , Replicación Viral
14.
BMC Public Health ; 24(1): 210, 2024 01 17.
Artículo en Inglés | MEDLINE | ID: mdl-38233806

RESUMEN

BACKGROUND: Human immunodeficiency virus (HIV) infection and sexually transmitted infections (STIs) are major global public health issues. Migrants represent a vulnerable group that faces multiple barriers to access to healthcare services, including HIV/STI testing. This study aimed to assess the factors associated with access to HIV/STI testing in male and female Venezuelan migrants in Peru. METHODS: This was a cross-sectional study involving secondary data analysis of the 2022 Venezuelan Population Residing in Peru Survey. The study was conducted in the eight most populated cities inhabited by Venezuelan migrants and refugees. For each city, the sampling design was probabilistic, stratified, and independent. The outcome variable was whether participants had access to HIV or other STI testing during their stay in Peru. Statistical analysis was stratified by sex owing to potential effect modification. Crude and adjusted prevalence ratios were calculated using generalized linear models Poisson family with log link function. Confidence intervals were calculated to 95%. RESULTS: A total of 3,723 male and 3,984 female migrants were included. Access to HIV/STI testing among male and female migrants was 19.85% and 25.16%, respectively. Among male migrants, being LGBTI, health insured, and married or cohabiting were associated with increased access to HIV/STI testing. Among females, those aged 18-44 years, those who were married or cohabiting and were health insured, and those residing for more than 1 year in Peru were significantly more likely to have access to HIV/STI testing. Moreover, physical/mental disability and unemployed status were associated with a lower probability of HIV/STI testing in females. CONCLUSIONS: Only two in ten Venezuelan migrants and refugees in Peru were screened for HIV/STI, with fewer males than females. Sex-specific sociodemographic, health-related, and migration-related variables were independently associated with access to HIV/STI testing.


Asunto(s)
Infecciones por VIH , Enfermedades de Transmisión Sexual , Migrantes , Masculino , Humanos , Femenino , Enfermedades de Transmisión Sexual/diagnóstico , Enfermedades de Transmisión Sexual/epidemiología , Infecciones por VIH/diagnóstico , Infecciones por VIH/epidemiología , Estudios Transversales , Perú/epidemiología
15.
MAbs ; 16(1): 2297451, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38170638

RESUMEN

The development of specific, safe, and potent monoclonal antibodies (Abs) has led to novel therapeutic options for infectious disease. In addition to preventing viral infection through neutralization, Abs can clear infected cells and induce immunomodulatory functions through engagement of their crystallizable fragment (Fc) with complement proteins and Fc receptors on immune cells. Little is known about the role of Fc effector functions of neutralizing Abs in the context of encephalitic alphavirus infection. To determine the role of Fc effector function in therapeutic efficacy against Venezuelan equine encephalitis virus (VEEV), we compared the potently neutralizing anti-VEEV human IgG F5 (hF5) Ab with intact Fc function (hF5-WT) or containing the loss of function Fc mutations L234A and L235A (hF5-LALA) in the context of VEEV infection. We observed significantly reduced binding to complement and Fc receptors, as well as differential in vitro kinetics of Fc-mediated cytotoxicity for hF5-LALA compared to hF5-WT. The in vivo efficacy of hF5-LALA was comparable to hF5-WT at -24 and + 24 h post infection, with both Abs providing high levels of protection. However, when hF5-WT and hF5-LALA were administered + 48 h post infection, there was a significant decrease in the therapeutic efficacy of hF5-LALA. Together these results demonstrate that optimal therapeutic Ab treatment of VEEV, and possibly other encephalitic alphaviruses, requires neutralization paired with engagement of immune effectors via the Fc region.


Asunto(s)
Anticuerpos Antivirales , Virus de la Encefalitis Equina Venezolana , Animales , Caballos , Humanos , Virus de la Encefalitis Equina Venezolana/genética , Anticuerpos Neutralizantes/farmacología , Receptores Fc , Inmunoglobulina G
16.
Artículo en Inglés | MEDLINE | ID: mdl-38193824

RESUMEN

The migration of health workforces tends to be economically based benefiting high-income countries, while draining lower-income countries of workers and skills However, national instability or civil conflict may also have the effect of forcing out health workers. However, few articles focus on the experiences of these types of migrants. Peru has become the second largest Latin American destination for Venezuelan forced displaced migrants, a number of which are health workers. While the exact numbers of these workers is unknown, it is estimated that 4000 and 3000 doctors and about 2500 nurses and health technicians from Venezuela reside in Peru. These workers find entry into the heath system difficult due to bureaucratic and costly registration and qualification validation procedures. However, during Covid-19 these conditions were relaxed, and a large number of these heath workers entered the heath workforce. These workers were primarily doctors and worked in urban medical facilities, though there was some distribution across the country's departments. This avenue to the health workforce allowed the mobilisation of dormant health skills and lifted workforce density numbers. Nonetheless, it is too early to see if there have been sustainable improvements, and it remains uncertain how these policies have contributed to the country's UHC goals. Peru's experiences raise the issue of how to mobilise dormant displaced health worker migrants.

17.
BMC Infect Dis ; 24(1): 87, 2024 Jan 15.
Artículo en Inglés | MEDLINE | ID: mdl-38225550

RESUMEN

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has disrupted multiple health services, including human immunodeficiency virus (HIV) testing, care, and treatment services, jeopardizing the achievement of the Joint United Nations Programme on HIV/AIDS 90-90-90 global target. While there are limited studies assessing the impact of the COVID-19 pandemic on people living with HIV (PLHIV) in Latin America, there are none, to our knowledge, in Venezuela. This study aims to assess the impact of the COVID-19 pandemic among PLHIV seen at the outpatient clinic of a reference hospital in Venezuela. METHODS: We conducted a cross-sectional study among PLHIV aged 18 years and over seen at the Infectious Diseases Department of the University Hospital of Caracas, Venezuela between March 2021 and February 2022. RESULTS: A total of 238 PLHIV were included in the study. The median age was 43 (IQR 31-55) years, and the majority were male (68.9%). Most patients (88.2%, n = 210) came for routine check-ups, while 28 (11.3%) were newly diagnosed. The majority of patients (96.1%) were on antiretroviral therapy (ART), but only 67.8% had a viral load test, with almost all (95.6%) being undetectable. Among those who attended regular appointments, 11.9% reported missing at least one medical consultation, and 3.3% reported an interruption in their ART refill. More than half of the patients (55.5%) had received at least one dose of the COVID-19 vaccine, while the rest expressed hesitancy to get vaccinated. Most patients with COVID-19 vaccine hesitancy were male (65.1%), younger than 44 years (57.5%), employed (47.2%), and had been diagnosed with HIV for less than one year (33%). However, no statistically significant differences were found between vaccinated patients and those with COVID-19 vaccine hesitancy. Older age was a risk factor for missing consultations, while not having an alcoholic habit was identified as a protective factor against missing consultations. CONCLUSION: This study found that the COVID-19 pandemic had a limited impact on adherence to medical consultations and interruptions in ART among PLHIV seen at the University Hospital of Caracas, Venezuela.


Asunto(s)
COVID-19 , Infecciones por VIH , Humanos , Masculino , Femenino , Adolescente , Adulto , VIH , COVID-19/epidemiología , Pandemias , Estudios Transversales , Vacunas contra la COVID-19/uso terapéutico , Venezuela/epidemiología , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/epidemiología
18.
Sci Rep ; 14(1): 1673, 2024 01 19.
Artículo en Inglés | MEDLINE | ID: mdl-38242939

RESUMEN

Efficient monitoring of biodiversity-rich areas in conflict-affected areas with poor rule of law requires a combination of different analytical approaches to account for data biases and incompleteness. In the upland Amazon region of Venezuela, in Canaima National Park, we initiated biodiversity monitoring in 2015, but it was interrupted by the establishment of a large-scale mining development plan in 2016, compromising the temporal and geographical extent of monitoring and the security of researchers. We used a resource selection function model framework that considers imperfect detectability and supplemented detections from camera trap surveys with opportunistic off-camera records (including animal tracks and direct sighting) to (1) gain insight into the value of additional occurrence records to accurately predict wildlife resource use in the perturbated area (deforestation, fire, swidden agriculture, and human settlements vicinity), (2) when faced with security and budget constraints. Our approach maximized the use of available data and accounted for biases and data gaps. Adding data from poorly sampled areas had mixed results on estimates of resource use for restricted species, but improved predictions for widespread species. If budget or resources are limited, we recommend focusing on one location with both on-camera and off-camera records over two with cameras. Combining camera trap records with other field observations (28 mammals and 16 birds) allowed us to understand responses of 17 species to deforestation, 15 to fire, and 13 to swidden agriculture. Our study encourages the use of combinations of methods to support conservation in high-biodiversity sites, where access is restricted, researchers are vulnerable, and unequal sampling efforts exist.


Asunto(s)
Animales Salvajes , Conservación de los Recursos Naturales , Animales , Humanos , Venezuela , Conservación de los Recursos Naturales/métodos , Biodiversidad , Mamíferos/fisiología
19.
J Am Coll Surg ; 2024 Jan 22.
Artículo en Inglés | MEDLINE | ID: mdl-38251675
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