Excess weight and thinness over two decades (1996-2015) and spatial distribution in children from Jujuy, Argentina.

BACKGROUND: The increase of excess weight around the world is progressive and sustained in children. This is the most prevalent form of malnutrition in this population and they represent the major public health problem in developed and developing countries. The aim of this study was to analyze the magnitude of change in thinness and excess weight prevalence in 4-7 years-old schoolchildren from Jujuy (Argentina), between 1996 and 2015 and to examine the association according to sex and school location. METHODS: Cross-sectional study. Data was obtained from databases of School Health programs and it is representative of the city school population. For the analysis, 31,014 schoolchildren between 4 and 7 years old were evaluated, 20,224 from the first period (1996-2001) and 10,790 from the second (2010-2015). The city was partitioned in three different areas determined by the rivers that cross it. Nutritional status was determined by BMI for age with the criteria suggested by the International Obesity Task Force. The percentage of malnutrition change between periods was calculated and a binomial regression model was adjusted. RESULTS: Between periods, a significant (p-value< 0.0001) increase in the prevalence of overweight from 15.1% (CI 14.6-15.6%) to 18.1% (CI 17.4-18.8%) and obesity from 5% (CI 4.7-5.3) to 10.7% (CI 10.1-11.3%), and a decrease of thinness prevalence from 6.3% (CI 6.0-6.7%) to 4.7% (CI 4.3-5.1%) were observed. The percentage of change in the prevalence of obesity was very high in all areas and in both sexes (103.5% girls; 125.6% in boys), being higher in the south for girls (122.4%) and in the north for boys (158.8%). Besides, being a boy was inversely associated with the presence of excess weight and, as the age increases, the presence of obesity does it too. By analyzing the effect of the school location, the south and north zones had an inverse association with the presence of obesity. The period has a direct association with the presence of excess weight. CONCLUSION: The study contributes with valuable information on the magnitude of the increase in obesity in schoolchildren and suggests a possible correlation with sex and spatial distribution in the capital city of Jujuy.

Absorption of arsenic from soil and water by two chard (Beta vulgaris L.) varieties: A potential risk to human health.

The accumulation of arsenic (As) in vegetables poses a risk of contamination to humans via the food chain. Two chard (var. cicla and var. d'ampuis) crops were grown for 60 days in greenhouses on Aridisol soil, and irrigated with water from Pastos Chicos, Jujuy (Argentina). The soil and water used in the trial presented 49 and 1.44 mg/L As concentration levels, respectively. Total dry biomass (TDB) and total As were determined in soils, roots and leaves. The latter was quantified by atomic absorption spectrometry with hydride generation, and bioconcentration and translocation factors were determined. TDB in var. cicla showed statistically significant differences when the plant was cultivated in control soil and watered with the toxicant (2.04 g), as compared with the treatment without exposure (2.8 g). TDB in var. d'ampuis presented statistically significant differences with respect to that of the control when the plants were grown in soils with As and watered with the toxicant (3.3 g). This variety increased its biomass in the presence of As. In the two Swiss chard varieties evaluated, the largest As accumulation in root and leaves was found when they were cultivated in contaminated soil and watered with distilled water. The presence of the toxicant in the leaves exceeded the limits established by Código Alimentario Argentino, i.e. 0.30 mg/kg. Total target hazard quotient (THQ) values for As were higher than 1, suggesting that consumers would run significant risks when consuming these chard varieties. Furthermore, it was determined that the carcinogenic risk (CR) posed by this type of exposure to As exceeded the acceptable risk level of 1 × 10-6. Based on this evidence, we may conclude that consuming chard cultivated on the evaluated site brings about considerable risks to local residents' health.

STR Markers Unveil Microgeographic Differentiation over the Steep Mountainous Landscape of Jujuy Province, Northwest Argentina.

This study explores potential signals of microdifferentiation in the gene pool of three high-altitude populations from Jujuy province in northwest Argentina using highly polymorphic markers. These human communities are characterized by extreme living conditions and very low population densities owing to considerable height above sea level and steep orography. A set of autosomal short tandem repeats (STRs) located at chromosome 6 (6p21.3) was typed in samples from Quebrada Baja (∼2,500 m), Quebrada Alta (∼3,300 m), and Puna (> 3,500 m). Genetic diversity was estimated through the observed and expected heterozygosities and the haplotype diversity. Analyses of the molecular variance (AMOVAs) and population differentiation tests based on allele and haplotype frequencies were performed to assess genetic heterogeneity among subgroups. No deviation from Hardy-Weinberg equilibrium was detected in any subpopulation, yet significant departures were detected in the analysis considering the whole area (D6S2792 and D6S105 loci). Overall, genetic diversity showed a decreasing trend as the altitude increased. Thus, allele and haplotype frequencies showed the most significant differences between Puna and Quebrada Baja, the populations sited at the edges of the altitude range. The trend toward reduction of heterozygosity with altitude is compatible with historical patterns of colonization, interregional migration trends, population density, and genetic admixture. The main consequence of the complex mountainous landscape of Jujuy would be an imbalance in the interplay of gene flow and genetic drift, favoring the latter. The combined effect of restricted gene flow and intense genetic drift would have promoted local genetic differentiation between the Jujuy highland subpopulations, leading to spatial patterning of the allele frequencies not entirely attributable to geographic distance. Our findings corroborate the effectiveness of STRs to identify microevolutionary changes.

Geographical altitude, size, mass and body surface area in children (1-4 years) in the Province of Jujuy (Argentina).

BACKGROUND: Highland child populations show low growth rates. AIM: To evaluate the variation of size, mass and body surface area of Jujenean infants (1-4 years) as a function of geographic altitude. SUBJECTS AND METHODS: Nutritional status of 8059 healthy infants was determined based on weight and height data; body mass index, ponderal index, body surface area, body surface area/mass and ectomorphy were calculated. Variables were standardized with a provincial mean and WHO references. Data were grouped by age, sex and geographic altitude: Highlands (≥2500 masl) and Lowlands (<2500 masl). Chi-square, correlation and t-tests were applied. RESULTS: Highlands infants had higher prevalence of stunting, reduced height, weight, body surface area and ectomorphy; also higher body mass index, ponderal index and body surface area/mass. The population average z-score for height, weight and body surface area was positive in Lowlands and negative in Highlands. The opposite happened with body mass index, ponderal index and body surface area/mass. In Highlands and Lowlands the average z-score reference was negative for weight and height and positive for body mass index. Correlations between indices were high and significant, higher in Highlands. CONCLUSION: Jujenean children differ in size, mass and body surface area based on the geographical altitude and adverse nutritional and socioeconomic factors.

Birth weight in the Northwest region of Argentina. Comparison with a national reference and an international standard. / Peso al nacer en el noroeste argentino. Comparación conuna referencia nacional y un estándar internacional.

Introduction. Size at birth is subject to genetic and environmental influences; altitude is highly influential. Birth weight (BW) is the most widely used indicator to assess size at birth; different standards and references are available. Due to the variability in BW distribution in relation to altitude in the province of Jujuy (Argentina), the purpose of this study is to analyze the percentile distribution of BW in the highlands (HL) and the lowlands (LL) of Jujuy based on gestational age (GA) and sex and compare it with a national reference and the INTERGROWTH-21st (IG-21) international standard. Population and methods. The records of 78 524 live births in Jujuy in the 2009-2014 period were analyzed. Using the LMS method, the 3rd, 10th, 50th, 90th, and 97th percentiles of BW/GA by sex were estimated for the HL (≥ 2000 MASL), the LL (< 2000 MASL), and the total for Jujuy, and compared with the Argentine population reference by Urquía and the IG-21 standard using growth charts. The statistical significance was established using the Wilcoxon test. Results. BW in Jujuy showed a heterogeneous distribution, with statistically significant differences (p < 0.05) between the LL and the HL. When compared with the national reference and the IG-21 standard, differences in terms of altitude were observed, mainly in the 90th and 97th percentiles for both regions and the 3rd and 10th percentiles in the HL compared with the international standard. Conclusions. BW distribution varied in association with altitude; therefore, to assess intrauterine growth, it is critical to include GA and the environment in which the pregnancy takes place.

Introducción. El tamaño al nacer se encuentra sujeto a influencias genéticas y ambientales; la altura geográfica es muy influyente. El peso al nacer (PN) es el indicador más utilizado para evaluarlo; existen diferentes estándares y referencias. Debido a la variabilidad de la distribución del PN en relación con la altura en la provincia de Jujuy (Argentina), este trabajo analiza la distribución percentilar del PN para tierras altas (TA) y tierras bajas (TB) jujeñas según edad gestacional (EG) y sexo, y su comparación con una referencia nacional y el estándar internacional INTERGROWTH-21st (IG-21). Población y métodos. Se analizaron los registros de 78 524 nacidos vivos en Jujuy en el período 2009-2014. Utilizando el método LMS, se estimaron los percentiles 3, 10, 50, 90 y 97 de PN/EG por sexo, para TA (≥2000 msnm), TB (<2000 msnm) y el total provincial, y se compararon gráficamente con la referencia poblacional argentina de Urquía y el estándar IG-21. La significación estadística se determinó mediante la prueba de Wilcoxon. Resultados. El PN en Jujuy presentó distribución heterogénea, con diferencias estadísticamente significativas (p <0,05) entre TB y TA. Al comparar con la referencia nacional y el estándar IG-21, se observaron diferencias por altitud, principalmente en los percentiles 90 y 97 para ambas regiones, y en los percentiles 3 y 10 en TA comparados con el estándar. Conclusiones. Se observó variabilidad de la distribución del PN asociada a la altura geográfica, por lo que, para evaluar el crecimiento intrauterino, resulta fundamental incluir la EG y el contexto donde transcurre la gestación.

Spatial distribution and secular trend (1991-2014) of small for gestational age infants born in Jujuy. / Distribución espacial y tendencia secular (1991-2014) de nacidos pequeños para la edad gestacional en Jujuy.

Introduction. A fetus that does not reach the expected growth potential in utero is considered small for gestational age (SGA). Such restriction depends on genetic and/or environmental factors, being altitude a very relevant factor. This study analyzes the spatial distribution of the prevalence of SGA and its secular trend in Jujuy (1991-2014). Materials and methods. The records of 308 469 live births in Jujuy (Health Statistics and Information Department) were analyzed. The prevalence of SGA (weight/gestational age < P10 and < P3) was estimated for sex according to the INTERGROWTH-21st standard in the ecoregions of Jujuy (Valle and Ramal -less than 2000 MASL-, Puna, and Quebrada) across 3 periods (1991-2000, 2001-2009, 2010-2014) and proportions were compared. The secular trend was assessed using the Joinpoint regression analysis. Results. The overall prevalence of SGA was 2.3% (< P3) and 7% (< P10). Significantly higher values were observed in Puna and Quebrada in both SGA categories and across all periods. Only in Valle, significant differences were observed between sexes across all periods. The prevalence of SGA showed a significant downward secular trend at a provincial and regional level, and this was greater in Quebrada (5.2% < P3 and 3.5% < P10). Conclusions. A consistent and significant decrease in the prevalence of SGA has been observed since the 1990s in Jujuy, where altitude is itself a determining factor of size at birth, since the Puna and Quebrada regions showed the highest prevalence of SGA during the entire period.

Introducción. El feto que no alcanza el potencial de crecimiento esperado en el útero se considera pequeño para la edad gestacional (PEG). Esta restricción depende de factores genéticos y/o ambientales; la altura geográfica es uno muy relevante. Este trabajo analiza la distribución espacial de las prevalencias de PEG y su tendencia secular en Jujuy (1991-2014). Materiales y métodos. Se analizaron los registros de 308 469 nacidos vivos de Jujuy (Dirección de Estadísticas e Información de Salud). Se estimaron prevalencias de PEG (peso/edad gestacional

Birth Size and Maternal, Social, and Environmental Factors in the Province of Jujuy, Argentina.

INTRODUCTION: birth size is affected by diverse maternal, environmental, social, and economic factors. AIM: analyze the relationships between birth size-shown by the indicators small for gestational age (SGA) and large for gestational age (LGA)-and maternal, social, and environmental factors in the Argentine province of Jujuy, located in the Andean foothills. METHODS: data was obtained from 49,185 mother-newborn pairs recorded in the Jujuy Perinatal Information System (SIP) between 2009 and 2014, including the following: newborn and maternal weight, length/height, and body mass index (BMI); gestational age and maternal age; mother's educational level, nutritional status, marital status and birth interval; planned pregnancy; geographic-linguistic origin of surnames; altitudinal place of birth; and unsatisfied basic needs (UBN). The dataset was split into two groups, SGA and LGA, and compared with adequate for gestational age (AGA). Bivariate analysis (ANOVA) and general lineal modeling (GLM) with multinomial distribution were employed. RESULTS: for SGA newborns, risk factors were altitude (1.43 [1.12-1.82]), preterm birth (5.33 [4.17-6.82]), older maternal age (1.59 [1.24-2.05]), and primiparous mothers (1.88 [1.06-3.34]). For LGA newborns, the risk factors were female sex (2.72 [5.51-2.95]), overweight (1.33 [1.22-2.46]) and obesity (1.85 [1.66-2.07]). CONCLUSIONS: the distribution of birth size and the factors related to its variability in Jujuy are found to be strongly conditioned by provincial terrain and the clinal variation due to its Andean location.

New Records of Mosquito Species in Northwestern Argentina.

Four mosquito species-Anopheles (Nyssorhynchus) galvaoi, An. (Anopheles) mediopunctatus, Culex (Culex) lahillei, and Uranotaenia (Uranotaenia) geométrica-were recorded for the first time in northwestern Argentina. In addition, Psorophora (Grabhamia) confinnis and Cx. (Melanoconion) pedroi are reported for the first time in Jujuy Province, while Aedes (Ochlerotatus) hastatus, Coquillettidia (Rhynchotaenia) hermanoi, An. (Ano.) fluminensis, and An. (Ano.) punctimacula were reported for the first time in Tucumán Province.

Urbanization Affects Composition but Not Richness of Flower Visitors in the Yungas of Argentina.

Urban areas represent a spatially small impact in relation to other land-uses such as livestock and agriculture, but they undergo rapid changes. Such changes involve their size, shape, interconnectivity, and composition of natural patches. Habitat loss generated by urbanization affects the diversity and abundance of bees and other flower visitors in many sites. In general, the presence of urban areas represents a strict boundary to flower visitors and restricts their movement between natural and suburban habitat patches. The aim of this work is to evaluate how the flower visitor assemblage change along an urban-natural gradient in northwest Argentina. We established five areas in the Yungas ecoregion and sampled three sites with different degrees of urbanization (urban, suburban, and natural), at each area, reaching 15 sites. At each site, we sampled flower visitors during 5-min observation periods done over flowering plants. We found 197 morphospecies of flower-visiting insects along the gradient and an invariant richness, abundance, and Shannon diversity. The assemblage presented the same taxonomic group distributions in the three categories established. However, in urban sites, solitary bees and bees with soil borrowing nesting type predominate, while eusocial and cavity nesting bees were the main flower visitors in suburban sites. Our results suggest that the cities of northwestern Argentina are not a strict boundary for flower visitors; however, urbanization seems to be selecting and favoring certain flower-visitor species traits.

Peso al nacer en el noroeste argentino. Comparación con una referencia nacional y un estándar internacional / Birth weight in the Northwest region of Argentina. Comparison with a national reference and an international standard

Introducción. El tamaño al nacer se encuentra sujeto a influencias genéticas y ambientales; la altura geográfica es muy influyente. El peso al nacer (PN) es el indicador más utilizado para evaluarlo; existen diferentes estándares y referencias. Debido a la variabilidad de la distribución del PN en relación con la altura en la provincia de Jujuy (Argentina), este trabajo analiza la distribución percentilar del PN para tierras altas (TA) y tierras bajas (TB) jujeñas según edad gestacional (EG) y sexo, y su comparación con una referencia nacional y el estándar internacional INTERGROWTH-21st (IG-21). Población y métodos. Se analizaron los registros de 78 524 nacidos vivos en Jujuy en el período 20092014. Utilizando el método LMS, se estimaron los percentiles 3, 10, 50, 90 y 97 de PN/EG por sexo, para TA (≥2000 msnm), TB (<2000 msnm) y el total provincial, y se compararon gráficamente con la referencia poblacional argentina de Urquía y el estándar IG-21. La significación estadística se determinó mediante la prueba de Wilcoxon. Resultados. El PN en Jujuy presentó distribución heterogénea, con diferencias estadísticamente significativas (p <0,05) entre TB y TA. Al comparar con la referencia nacional y el estándar IG-21, se observaron diferencias por altitud, principalmente en los percentiles 90 y 97 para ambas regiones, y en los percentiles 3 y 10 en TA comparados con el estándar. Conclusiones. Se observó variabilidad de la distribución del PN asociada a la altura geográfica, por lo que, para evaluar el crecimiento intrauterino, resulta fundamental incluir la EG y el contexto donde transcurre la gestación.

Introduction. Size at birth is subject to genetic and environmental influences; altitude is highly influential. Birth weight (BW) is the most widely used indicator to assess size at birth; different standards and references are available. Due to the variability in BW distribution in relation to altitude in the province of Jujuy (Argentina), the purpose of this study is to analyze the percentile distribution of BW in the highlands (HL) and the lowlands (LL) of Jujuy based on gestational age (GA) and sex and compare it with a national reference and the INTERGROWTH-21 st (IG-21) international standard. Population and methods. The records of 78 524 live births in Jujuy in the 2009­2014 period were analyzed. Using the LMS method, the 3 rd, 10 th, 50 th, 90 th, and 97 th percentiles of BW/GA by sex were estimated for the HL (≥ 2000 MASL), the LL (< 2000 MASL), and the total for Jujuy, and compared with the Argentine population reference by Urquía and the IG-21 standard using growth charts. The statistical significance was established using the Wilcoxon test. Results. BW in Jujuy showed a heterogeneous distribution, with statistically significant differences (p < 0.05) between the LL and the HL. When compared with the national reference and the IG-21 standard, differences in terms of altitude were observed, mainly in the 90 th and 97 th percentiles for both regions and the 3 rd and 10 th percentiles in the HL compared with the international standard. Conclusions. BW distribution varied in association with altitude; therefore, to assess intrauterine growth, it is critical to include GA and the environment in which the pregnancy takes place.

Distribución espacial y tendencia secular (1991-2014) de nacidos pequeños para la edad gestacional en Jujuy / Spatial distribution and secular trend (1991­2014) of small for gestational age infants born in Jujuy

Introducción. El feto que no alcanza el potencial de crecimiento esperado en el útero se considera pequeño para la edad gestacional (PEG). Esta restricción depende de factores genéticos y/o ambientales; la altura geográfica es uno muy relevante. Este trabajo analiza la distribución espacial de las prevalencias de PEG y su tendencia secular en Jujuy (1991-2014). Materiales y métodos. Se analizaron los registros de 308 469 nacidos vivos de Jujuy (Dirección de Estadísticas e Información de Salud). Se estimaron prevalencias de PEG (peso/edad gestacional

Introduction. A fetus that does not reach the expected growth potential in utero is considered small for gestational age (SGA). Such restriction depends on genetic and/or environmental factors, being altitude a very relevant factor. This study analyzes the spatial distribution of the prevalence of SGA and its secular trend in Jujuy (1991­2014). Materials and methods. The records of 308 469 live births in Jujuy (Health Statistics and Information Department) were analyzed. The prevalence of SGA (weight/gestational age < P10 and < P3) was estimated for sex according to the INTERGROWTH-21 st standard in the ecoregions of Jujuy (Valle and Ramal ­less than 2000 MASL­, Puna, and Quebrada) across 3 periods (1991­2000, 2001­2009, 2010­2014) and proportions were compared. The secular trend was assessed using the Joinpoint regression analysis. Results. The overall prevalence of SGA was 2.3% (< P3) and 7% (< P10). Significantly higher values were observed in Puna and Quebrada in both SGA categories and across all periods. Only in Valle, significant differences were observed between sexes across all periods. The prevalence of SGA showed a significant downward secular trend at a provincial and regional level, and this was greater in Quebrada (5.2% < P3 and 3.5% < P10). Conclusions. A consistent and significant decrease in the prevalence of SGA has been observed since the 1990s in Jujuy, where altitude is itself a determining factor of size at birth, since the Puna and Quebrada regions showed the highest prevalence of SGA during the entire period.

Differential diagnosis of a neoplastic condition in a prehistoric juvenile individual from La Falda site, Northwest Argentina.

Bone neoplasms or tumors are of great interest for paleopathological studies due to their close relationship with health and survivorship as well as for their epidemiologic and demographic relevance. However, the identification of these lesions in archaeological specimens is very uncommon. The aim of this paper is to report the case of skeleton R5 E#1 from the prehistoric cemetery La Falda, in the Northwest region of Argentina. During the osteopathological analysis of the skeletal series, proliferative lesions in several bones of the skeleton of a 7-10-year-old juvenile were observed (i.e., both scapulae; left clavicle, humerus, and ulna, both os coxae, femora, and fibulae, and right foot bones). Age-at-death estimation, location and distribution pattern, and morphological appearances of the lesions indicated that this juvenile suffered from a neoplastic condition. A comprehensive differential diagnosis was carried out, suggesting that these lesions were compatible with hereditary multiple osteochondromas. However, Ewing's sarcoma was not definitively ruled out as a probable diagnosis. Thus, this work adds new evidence to the existence of neoplastic conditions in the prehistoric populations of the Americas, and it contributes original data to perform a differential diagnosis for multiple proliferative lesions.

Escorpiones y escorpionismo en la provincia de Jujuy / Scorpions and scorpionism in the province of Jujuy

En Sudamérica los escorpiones que revisten importancia sanitaria pertenecen a la familia Buthidae y al género Tityus. En Argentina existen seis especies: T. trivittatus Kraepelin, T. confluens Borelli, T. bahiensis (Perty), T. argentinus Borelli, T. paragua­yensis Kraepelin y T. uruguayensis Borelli, de las cuales sólo las tres primeras demostraron poseer venenos tóxicos capaces de ocasionar accidentes fatales. En Jujuy la especie más importante fue T. confluens y recientemente se registró T. trivittatus. También está presente T. argentinus, que hasta el momento, no reviste riesgo sanitario. Los objetivos del presente trabajo fueron identificar los escorpiones del género Tityus (Buthidae), obtenidos en cinco instituciones de referencia de la provincia de Jujuy, conocer su distribución, abundancia, estacionalidad y relación con variables climáticas en dos eco-regiones (Valles y Yungas); ámbito de ocurrencia de hallazgos y accidentes, horario de los mismos y características epidemiológicas de los accidentados (edad, sexo, óbitos). El periodo considerado fue octubre 2013 a septiembre 2014. Se registraron los accidentes y hallazgos de escorpiones de las instituciones de la ciudad capital con área de influencia en la región Valles y aquellas del interior provincial con área de influencia en la región Yungas. Se analizaron 422 ejemplares de escorpiones. Las especies presentes fueron Tityus argentinus, T. trivittatus y T. confluens; esta última dominó en Yungas. El mayor número de registros de T. trivittatus se obtuvo en la ciudad de San Pedro de Jujuy. En la región Valles, T. argentinus fue la especie dominante. La mayor cantidad de accidentes y hallazgos de escorpiones se registró por la mañana y en los meses cálidos con valores máximos de abundancia en diciembre. Si se considera el ámbito de ocurrencia predominaron los accidentes y hallazgos intradomiciliarios (92%); el dormitorio fue el lugar más mencionado (46%). Entre los accidentados predominó el sexo femenino (66%). La franja etaria más afectada fue la de los adultos (75%), en particular el rango 26-35 años; en la franja pediátrica el mayor número de accidentes se produjo en niños mayores de 7 años. No se registraron óbitos. El conocimiento de la distribución espacial y temporal de T. confluens sumada al ingreso y colonización de T. trivittatus convierten a la provincia de Jujuy en un área de mayor riesgo, siendo necesaria una estricta vigilancia epidemiológica de los casos de escorpionismo. Este es el primer estudio que integra aspectos taxonómicos y epidemiológicos en esta provincia.

In South America the scorpions that are of health care importance belong to the Buthidae family and to the Tityus genus. There are six species in Argentina: T. trivittatus Kraepelin, T. confluens Borelli, T. bahiensis (Perty), T. argentinus Borelli, T. paraguay­ensis Kraepelin and T. uruguayensis Borelli, of which only the first three demostrated to possess toxic poisons capable of causing fatal accidents. T. confluens is the most important species in Jujuy and T. trivittatus has been recently recorded. Also present is T. argentinus, which has not posed a health risk to date. The objectives of the present work were to identify scorpions of the Tityus (Buthidae) genus received at five reference institutions in the province of Jujuy, to identify their distribution, abundance, seasonality and relation with climatic variables in two eco-regions (Valles and Yungas), area of occurrence of findings and accidents, their sched­ule and epidemiological characteristics of the victims (age, sex, deaths). The period considered was from October 2013 to Septem­ber 2014. Accidents and findings of scorpions from the institutions of the capital city with area of influence in the valleys region and those of the provincial interior with area of influence in the Yungas region were recorded. 422 specimens of scorpions were analyzed. The species present were Tityus argentinus, T. trivittatus and T. confluens; the latter dominated in Yungas. The highest number of T. trivittatus records was obtained in the city of San Pedro de Jujuy. In the Valles region, T. argentinus was the dominant species. The largest number of accidents and scorpion finds were recorded in the morning and in warm months with maximum abundance values in december. Considering the scope of occurrence, 92% of scorpion findings and accidents predominated intradomiciliarly. The bedroom was the most mentioned place (46%). Among the victims, the female sex predominated (66%). The most affected age group was that of adults (75%), in particular the range 26-35 years. In the pediatric group, the greatest number of accidents occurred in children older than 7 years. No deaths were recorded. The knowledge of the spatial and temporal distribution of T. confluens plus the entrance and colonization of T. trivittatus make the province of Jujuy an area of greater risk, requiring a strict epidemiological surveillance of scorpionism cases. This is the first study that integrates taxonomic and epidemiological aspects in this province.

Caracterización de la enfermedad de la artritis y encefalitis caprina en las provincias de Salta y Jujuy

La artritis y encefalitis Caprina (CAEV) puede presentar diferentes síntomas clínicos, siendo la artritis la más común. A fin de caracterizar la presencia de enfermedades en las majadas caprinas del noroeste argentino, se llevó a cabo una encuesta sanitaria a productores, con toma de muestras biológicas para el diagnóstico de enfermedades en la que fue incluida CAEV. Se efectuó un análisis serológico con un ELISA indirecto y se completó con un examen clínico general de los animales y toma de muestra de necropsia de algunos de los casos. En la Provincia de Salta, tres establecimientos fueron positivos, con un 6,25% de prevalencia. La seroprevalencia del hato con seguimiento de caso fue del 55% mientras que el 48% presentó signos clínicos donde la artritis de la articulación carpal fue la más frecuentemente afectada. El virus CAEV está distribuido en la provincia de Salta y la severidad de las lesiones observadas sugiere la presencia de nuevas cepas que deben ser investigadas conjuntamente al desarrollo de capacidades locales para el diagnóstico, clave de cualquier plan de erradicación.

Caprine arthritis and encephalitis virus (CAEV) may present different clinical symptoms, with arthritis being the most common. In order to characterize the presence of diseases in goats from the Argentinean northwest, a sanitary survey was carried out to producers, with biological sampling for the diagnosis of diseases in which CAEV was included. A serological analysis was performed with an indirect ELISA and was completed with a general clinical examination of the animals and a necropsy sample collection of some of the cases. In the Province of Salta, three establishments were positive, with a prevalence of 6.25%. The serum prevalence of the herd with case follow-up was 55%, while 48% presented clinical signs where arthritis of the carpal joint was most frequently affected. The CAEV virus is spread in the province of Salta and the severity of the observed lesions suggests the presence of new strains that should be investigated in combination with the development of local capacities for diagnosis, this is the key to any eradication plan.

Latrodectismo en la provincia de Jujuy: Aspectos epidemiológicos y clínicos / Latrodectism in the province of Jujuy: Epidemiological and clinical aspects

En Argentina, las especies de arañas de importancia sanitaria pertenecen a los géneros Loxosceles, Phoneutria y Latrodectus. El objetivo del presente trabajo fue relevar los accidentes producidos por el género Latrodectus atendidos en el centro de referencia y derivación provincial de animales venenosos de Jujuy (Hospital San Roque) en el período: 1 de enero de 1998 al 31 de diciembre de 2014. En los diecisiete años analizados se registraron 30 historias clínicas con diagnóstico de latrodectismo, el 83 % de los casos procede de zonas semiáridas y áridas de la provincia de Jujuy. Se registró un valor medio de 1.8 casos/año; la mayoría de los accidentados (63 %) fueron de sexo masculino y la franja etaria más afectada se ubicó entre 16-25 años (50 %). La visualización del arácnido fue confirmada por 18 pacientes, de los cuales el 67 % (n=12) lo identificó como "huayruro" o "viuda negra". Entre las manifestaciones clínicas predominaron: dolor local, dolor generalizado, dolor abdominal, diaforesis e hipertensión arterial. El periodo de internación fue corto (2,7 días) y no hubo complicaciones ni óbitos. Este es el primer estudio clínico-epidemiológico de latrodectismo en el noroeste argentino.

In Argentina, the species of spiders of sanitary importance belong to the Loxosceles, Latrodectus and Phoneutria genera. The objective of this study was to survey accidents caused by the spiders of Latrodectus genus treated at the Jujuy provincial venomous animal reference and referral center (San Roque Hospital) between January 1, 1998 and December 31, 2014. In the seventeen years analyzed, 30 medical records with a diagnosis of latrodectism were analyzed, 83% of the cases came from semi-arid and arid areas of the province of Jujuy. An average of 1.8 cases/year was established. Most of the injured (63%) were male and the most affected age group was between 16-25 years (50%). The arachnid depiction was confirmed by 18 patients, of which 67% (n=12) identified it as "huayruro" or "black widow". Predominant clinical manifestations were local pain, generalized pain, abdominal pain, diaphoresis and hypertension. The length of hospitalization was short (2,7 days) and there were no complications or deaths. This is the first clinical-epidemiological study of latrodectism in northwestern Argentina

Indice compuesto de fracaso antropométrico y altura geográfica en infantes jujeños (1-5 años) / Composite index of anthropometric failure and geographic altitude in children from Jujuy (1 to 5 years old)

Introducción. El índice compuesto de fracaso antropométrico (ICFA), integrado por los índices antropométricos habituales y sus combinaciones en 7 categorías, propone una medida agregada para ponderar la desnutrición como alternativa a la evaluación independiente del acortamiento, emaciación y bajo peso. Objetivo. Evaluar el ICFA en la población infantil jujeña asentada a distintos niveles altitudinales. Materiales y métodos. El peso y la talla se tomaron de los controles de niños sanos, de 1-5 años, realizados en los Centros de Atención Primaria (CAP) jujeños entre 2005 y 2007. El estado nutricional (bajo peso, acortamiento y emaciado) se caracterizó con el estándar OMS-2007. El ICFA y sus 7 grupos se calcularon agrupando los datos por sexo, edad y nivel altitudinal (tierras altas: > 2500 msnm; tierras bajas: < 2500msnm). Las diferencias porcentuales del ICFA por altura y sexo y edad se verificaron con la prueba chi-cuadrado. Resultados. Se incluyeron 8059 niños. El ICFA de tierras altas (6,1%) duplicó al de tierras bajas (3,4%) (p < 0,05) y la prevalencia de bajo peso (grupo Y) fue significativamente superior en tierras altas (p < 0,05). El ICFA y el acortamiento (grupo F) aumentaron con la edad, pero el aumento fue significativamente mayor en tierras altas. Conclusiones. Las tierras altas presentaron un IFCA significativamente mayor a expensas del acortamiento. No obstante, el índice de fracaso antropométrico no superó el 10% en los dos niveles, lo que da cuenta de un estado sanitario por desnutrición de escasa magnitud en la población infantil jujeña estudiada.(AU)

Introduction. The Composite Index of Anthropometric Failure (CIAF) is made up of typical anthropometric indicators and their combination into seven categories, and proposes an additional measure to study malnutrition as an alternative to the evaluation of stunting, wasting and underweight as separate measures. Objective. To assess the CIAF in the child population settled at different altitudinal zones in Jujuy. Population and Methods. Weight and height were obtained from healthy 1 to 5 year-old control children, measured at primary healthcare centers (PHCCs) in Jujuy between 2005 and 2007. Nutritional status indicators such as underweight, stunting and wasting were determined as per the World Health Organization 2007 child growth standards. The CIAF and its seven categories were estimated by grouping data by gender, age and altitudinal zone (highlands: >2500 MASL; lowlands: <2500 MASL). The CIAF percentage differences for height, gender and age were verified using a chi-square test. Results. A total of 8059 children were included. The CIAF for highland children (6.1%) doubled that for lowland children (3.4%) (p < 0.05), and underweight prevalence (group Y) was significantly higher in the highlands (p < 0.05). The CIAF value and stunting (group F) increased with age, but such increase was more significant in the highlands. Conclusions. A significantly higher CIAF was observed in highland children, at the expense of stunting. However, the index of anthropometric failure was not more than 10% at both the highlands and the lowlands, and this accounts for a scarcely significant malnutrition health status in the studied child population of Jujuy.(AU)

Índice compuesto de fracaso antropométrico y altura geográfica en infantes jujeños (1-5 años) / Composite index of anthropometric failure and geographic altitude in children from Jujuy (1 to 5 years old)

Introducción. El índice compuesto de fracaso antropométrico (ICFA), integrado por los índices antropométricos habituales y sus combinaciones en 7 categorías, propone una medida agregada para ponderar la desnutrición como alternativa a la evaluación independiente del acortamiento, emaciación y bajo peso. Objetivo. Evaluar el ICFA en la población infantil jujeña asentada a distintos niveles altitudinales. Materiales y métodos. El peso y la talla se tomaron de los controles de niños sanos, de 1-5 años, realizados en los Centros de Atención Primaria (CAP) jujeños entre 2005 y 2007. El estado nutricional (bajo peso, acortamiento y emaciado) se caracterizó con el estándar OMS-2007. El ICFA y sus 7 grupos se calcularon agrupando los datos por sexo, edad y nivel altitudinal (tierras altas: > 2500 msnm; tierras bajas: < 2500msnm). Las diferencias porcentuales del ICFA por altura y sexo y edad se verificaron con la prueba chi-cuadrado. Resultados. Se incluyeron 8059 niños. El ICFA de tierras altas (6,1%) duplicó al de tierras bajas (3,4%) (p < 0,05) y la prevalencia de bajo peso (grupo Y) fue significativamente superior en tierras altas (p < 0,05). El ICFA y el acortamiento (grupo F) aumentaron con la edad, pero el aumento fue significativamente mayor en tierras altas. Conclusiones. Las tierras altas presentaron un IFCA significativamente mayor a expensas del acortamiento. No obstante, el índice de fracaso antropométrico no superó el 10% en los dos niveles, lo que da cuenta de un estado sanitario por desnutrición de escasa magnitud en la población infantil jujeña estudiada.

Introduction. The Composite Index of Anthropometric Failure (CIAF) is made up of typical anthropometric indicators and their combination into seven categories, and proposes an additional measure to study malnutrition as an alternative to the evaluation of stunting, wasting and underweight as separate measures. Objective. To assess the CIAF in the child population settled at different altitudinal zones in Jujuy. Population and Methods. Weight and height were obtained from healthy 1 to 5 year-old control children, measured at primary healthcare centers (PHCCs) in Jujuy between 2005 and 2007. Nutritional status indicators such as underweight, stunting and wasting were determined as per the World Health Organization 2007 child growth standards. The CIAF and its seven categories were estimated by grouping data by gender, age and altitudinal zone (highlands: >2500 MASL; lowlands: <2500 MASL). The CIAF percentage differences for height, gender and age were verified using a chi-square test. Results. A total of 8059 children were included. The CIAF for highland children (6.1%) doubled that for lowland children (3.4%) (p < 0.05), and underweight prevalence (group Y) was significantly higher in the highlands (p < 0.05). The CIAF value and stunting (group F) increased with age, but such increase was more significant in the highlands. Conclusions. A significantly higher CIAF was observed in highland children, at the expense of stunting. However, the index of anthropometric failure was not more than 10% at both the highlands and the lowlands, and this accounts for a scarcely significant malnutrition health status in the studied child population of Jujuy.

Prevalencia de sobrepeso y obesidad en escolares jujeños de diferente nivel altitudinal según las referencias IOTF, CDC y OMS / Prevalence of overweight and obesity in students from different altitudinal zones of Jujuy according to three intvernational references (IOTF, CDC and WHO)

Introducción. Se comparan las prevalencias de sobrepeso (SP) y obesidad (OB) en escolares jujeños de distintos niveles altitudinales utilizando las referencias de la International Obesity Task Force (IOTF), de los Centers for Disease Control (CDC) y de la Organización Mundial de la Salud (OMS), y la concordancia entre ellas. Materiales y métodos. Los datos de peso y talla de 15 541 escolares (PROSANE) se agruparon en tierras altas (TA) (= 2500 msnm) y bajas (TB) (< 2500 msnm), y en dos grupos de edad (5 a 6,99 y 11 a 12,99 años). Se calcularon las prevalencias de SP, OB y SP+OB según las referencias. Las diferencias entre variables y prevalencias se establecieron con la prueba de la ?² y la prueba de la t, y la concordancia entre criterios, con el índice kappa. Resultados. Los escolares de las TA presentaron menor peso, talla e índice de masa corporal (IMC) (p< 0,05). Las prevalencias de SP, OB y SP+OB con OMS fueron superiores, excepto para SP en ambos sexos de 11 a 12,99 años de TB y TA. Independientemente de las referencias, el sexo y la edad, las prevalencias de SP, OB y SP+OB fueron, en general, mayores en las TB. La concordancia entre las referencias IOTF/CDC fue buena-muy buena, y entre estas y las de la OMS, regular-moderada. Conclusiones. Los escolares de TA presentaron menor prevalencia de SB y OB. La mejor concordancia se dio entre las referencias IOTF y CDC.

Introduction. Prevalences of overweight and obesity in students from different altitudinal zones of Jujuy are compared using the International Obesity Task Force (IOTF), the Centers for Disease Control (CDC) and the World Health Organization (WHO) references, and the agreement among them. Material and Methods. Weight and height data from 15 541 students were grouped in highlands (HL) (=2500 MASL) and lowlands (LL) (<2500 MASL) and in two age groups (5-6.99 years old and 11-12.99 years old). Overweight and obesity prevalences were calculated according to the different references. The differences in outcome measures and prevalences were established using the ?2 test and the t test, and agreement among the criteria was calculated using the kappa index. Results. Students from the HL had lower weight, height and body mass index (BMI) values (p< 0.05). Overweight and obesity prevalences compared to the WHO reference were higher, except for overweight in students of both sexes, from 11 to 12.99 years old, from the HL and the LL. Regardless of the references, gender and age, overweight and obesity prevalences were generally higher in the LL. Agreement between the IOTF and the CDC was good-very good, and agreement among them and the WHO was fair-moderate. Conclusions. Students from the HL had a lower overweight and obesity prevalence. The greatest agreement was observed between the IOTF and the CDC references.

Prevalencia de sobrepeso y obesidad en escolares jujeños de diferente nivel altitudinal según las referencias IOTF, CDC y OMS / Prevalence of overweight and obesity in students from different altitudinal zones of Jujuy according to three intvernational references (IOTF, CDC and WHO)

Introducción. Se comparan las prevalencias de sobrepeso (SP) y obesidad (OB) en escolares jujeños de distintos niveles altitudinales utilizando las referencias de la International Obesity Task Force (IOTF), de los Centers for Disease Control (CDC) y de la Organización Mundial de la Salud (OMS), y la concordancia entre ellas. Materiales y métodos. Los datos de peso y talla de 15 541 escolares (PROSANE) se agruparon en tierras altas (TA) (= 2500 msnm) y bajas (TB) (< 2500 msnm), y en dos grupos de edad (5 a 6,99 y 11 a 12,99 años). Se calcularon las prevalencias de SP, OB y SP+OB según las referencias. Las diferencias entre variables y prevalencias se establecieron con la prueba de la ?² y la prueba de la t, y la concordancia entre criterios, con el índice kappa. Resultados. Los escolares de las TA presentaron menor peso, talla e índice de masa corporal (IMC) (p< 0,05). Las prevalencias de SP, OB y SP+OB con OMS fueron superiores, excepto para SP en ambos sexos de 11 a 12,99 años de TB y TA. Independientemente de las referencias, el sexo y la edad, las prevalencias de SP, OB y SP+OB fueron, en general, mayores en las TB. La concordancia entre las referencias IOTF/CDC fue buena-muy buena, y entre estas y las de la OMS, regular-moderada. Conclusiones. Los escolares de TA presentaron menor prevalencia de SB y OB. La mejor concordancia se dio entre las referencias IOTF y CDC.(AU)

Introduction. Prevalences of overweight and obesity in students from different altitudinal zones of Jujuy are compared using the International Obesity Task Force (IOTF), the Centers for Disease Control (CDC) and the World Health Organization (WHO) references, and the agreement among them. Material and Methods. Weight and height data from 15 541 students were grouped in highlands (HL) (=2500 MASL) and lowlands (LL) (<2500 MASL) and in two age groups (5-6.99 years old and 11-12.99 years old). Overweight and obesity prevalences were calculated according to the different references. The differences in outcome measures and prevalences were established using the ?2 test and the t test, and agreement among the criteria was calculated using the kappa index. Results. Students from the HL had lower weight, height and body mass index (BMI) values (p< 0.05). Overweight and obesity prevalences compared to the WHO reference were higher, except for overweight in students of both sexes, from 11 to 12.99 years old, from the HL and the LL. Regardless of the references, gender and age, overweight and obesity prevalences were generally higher in the LL. Agreement between the IOTF and the CDC was good-very good, and agreement among them and the WHO was fair-moderate. Conclusions. Students from the HL had a lower overweight and obesity prevalence. The greatest agreement was observed between the IOTF and the CDC references.(AU)

Diagnóstico de un caso de rabia humana en Jujuy, 2008 / Diagnosis of a human rabies case in Jujuy, 2008

El 22 de Julio de 2008, un niño de 8 años de edad, residente en la provincia de Jujuy, Argentina, falleció por una encefalitis producida por el virus de la rabia. El diagnóstico se realizó mediante la detección de anticuerpos en suero y se confirmó por inmunofluorescencia en el cerebro. La tipificación antigénica correspondió a la variante 1 trasmitida por perros. El análisis molecular estableció que el virus detectado es de la misma variante genética que circula en Jujuy desde 2003. Este trabajo resume la evolución clínica del paciente y la posterior investigación epidemiológica que reveló el antecedente de mordedura por un perro 60 días antes de la iniciación de la enfermedad y la ausencia de un tratamiento antirrábico post-exposición.

On July 22, 2008, a previously healthy 8 years old boy from Jujuy, Argentina, died of encephalitis later confirmed as rabies. Diagnosis was made on the basis rabies-specific antibodies presence in a serum sample and it was confirmed by detection of the viral antigens in brain necropsy using the inmunofluorescent test. Antigenic characterization identified dog as source of infection. Molecular analysis recognized the same genetic variant circulating in Jujuy since 2003. This report presents the patient's clinical course and the epidemiologic investigation that revealed a dog bite 60 days before the illness onset and the lack of rabies treatment.