38 results on '"Camila González"'
Search Results
2. Diagnosis and treatment of benign adipocytic tumors in children
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Laura Daniela Pérez Daza, Laura Camila González Villarreal, Laura Camila Sánchez Rodríguez, Iván Darío Molina Ramírez, and Edna Margarita Quintero Canasto
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Male ,Diagnosis, Differential ,Hospitalization ,Pediatrics, Perinatology and Child Health ,Humans ,Surgery ,Female ,General Medicine ,Child ,Hospitals, Teaching ,Retrospective Studies ,Lipoblastoma - Abstract
Purpose To describe demographic, clinical, diagnostic and therapeutic aspects of pediatric patients with benign adipocytic tumors admitted to a high complexity teaching hospital from 2007 to 2021. Methods Retrospective observational descriptive study. Patient information was retrieved from clinical records. A descriptive analysis was carried out for qualitative data and frequencies were calculated for quantitative data. Results 76 patients were included with a mean age of 7.5 years old where 60.5% were boys. The main symptom was a mass (73.7%) mostly found in the lower limbs (23.6%). Congenital birth defects were identified in 48.6% of the cases. Preoperative imaging was available in 78.9% of the patients allowing characterization of lesions or differential diagnosis. The therapeutic goal was resection with negative margins, which was feasible in all cases except for one case. The histopathological diagnosis was lipoma in 68.4% of the cases followed by lipoblastoma in 13.1%. The mean follow-up period was 17.9 months. 79.7% of the patients were asymptomatic at their last out-patient visit. Conclusion Benign adipocytic tumors constitute a wide spectrum of lesions, which involve diverse anatomic segments from the neural axis to the inguinoscrotal region. The present work contributes to the general understanding of the clinical presentation and differential diagnosis for these infrequent neoplasms.
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- 2022
3. Sequencing of hsp70 for discernment of species from the Leishmania (Viannia) guyanensis complex from endemic areas in Colombia
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Juliana Hoyos, Mariana Rosales-Chilama, Cielo León, Camila González, and María Adelaida Gómez
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Leishmania ,Mammals ,Infectious Diseases ,Animals ,Humans ,Parasitology ,HSP70 Heat-Shock Proteins ,Bayes Theorem ,Colombia ,Psychodidae ,Leishmania guyanensis ,Phylogeny - Abstract
Background Colombia is ranked very high among countries with the highest numbers of endemic Leishmania species (n = 9) causing human disease. Although much effort has been devoted to generating simple and specific tools for Leishmania species identification, challenges remain in the discrimination of species belonging to the Leishmania (Viannia) guyanensis complex: L. (V.) guyanensis and L. (V.) panamensis. Methods A set of seven reference strains of species belonging to the L. (Leishmania) and L. (Viannia) subgenera, clinical strains from human cases of cutaneous leishmaniasis (CL; n = 26) and samples collected from sylvatic mammals and sand flies (n = 7) from endemic areas in Colombia were analyzed in this study. The heat-shock protein 70 gene (hsp70) was amplified by PCR from DNA extracted from logarithmic-phase promastigotes or tissue samples, and the PCR products were sequenced. Sequence alignment was performed against a set of previously published and curated sequences, and phylogenetic analysis based on the maximum-likelihood and Bayesian inference approaches was conducted. Haplotype diversity among strains and species of the L. (V.) guyanensis complex was explored using a median-joining network. Results Sequencing of the hsp70 gene for L. (Viannia) spp. typing was comparable to species identification using isoenzyme electrophoresis or monoclonal antibodies. Complete species matching was found, except for one sylvatic sample with an identity yet unsolved. Among the L. (V.) panamensis clinical strains, two distinctive phylogenetic clusters were found to correlate with two different zymodemes: L. (V.) panamensis Z2.2 and Z2.3. Analysis of samples from sylvatic environments identified novel records of naturally infected wild mammal and sand fly species. Conclusions Our results support the adequacy of hsp70 gene sequencing as a single-locus approach for discrimination of L. (Viannia) spp., as well as for exploring the genetic diversity within the L. (V.) guyanensis complex. Graphical Abstract
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- 2022
4. LAMP4yaws
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Becca Louise, Handley, Camila, González-Beiras, Serges, Tchatchouang, Laud Antony, Basing, Kouadio Aboh, Hugues, Mohammed, Bakheit, Lisa, Becherer, Christina, Ries, Earnest, Njih Tabah, Tania, Crucitti, Nadine, Borst, Simone, Lüert, Sieghard, Frischmann, Tamara, Haerpfer, Emelie, Landmann, Ivy, Amanor, Aboubacar, Sylla, Mireille S, Kouamé-Sina, Jean P, Ndzomo-Ngono, Adingra, Tano, Daniel, Arhinful, Patrick, Awondo, Solange, Ngazoa Kakou, Sara, Eyangoh, Kennedy Kwasi, Addo, Emma Michele, Harding-Esch, Sascha, Knauf, Oriol, Mitjà, and Michael, Marks
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Haemophilus ducreyi ,Observational Studies as Topic ,Cross-Sectional Studies ,Molecular Diagnostic Techniques ,Skin Ulcer ,Yaws ,Humans ,Treponema ,Treponema pallidum ,Real-Time Polymerase Chain Reaction ,Ghana ,Nucleic Acid Amplification Techniques - Abstract
Yaws, caused by the bacteriumThe LAMP4yaws project is a cross-sectional, observational, diagnostic accuracy study of a combinedWe have received ethical approval from all relevant institutional and national ethical committees. All participants, or their parents or guardians, must provide written informed consent prior to study enrolment. Study results will be published in an open access journal and disseminated with partners and the World Health Organization.NCT04753788.
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- 2022
5. Multicenter international assessment of a SARS-CoV-2 RT-LAMP test for point of care clinical application
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Suying Lu, David Duplat, Paula Benitez-Bolivar, Cielo León, Stephany D. Villota, Eliana Veloz-Villavicencio, Valentina Arévalo, Katariina Jaenes, Yuxiu Guo, Seray Cicek, Lucas Robinson, Philippos Peidis, Joel D. Pearson, Jim Woodgett, Tony Mazzulli, Patricio Ponce, Silvia Restrepo, John M. González, Adriana Bernal, Marcela Guevara-Suarez, Keith Pardee, Varsovia E. Cevallos, Camila González, and Rod Bremner
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Canada ,Multidisciplinary ,Molecular Diagnostic Techniques ,SARS-CoV-2 ,Point-of-Care Systems ,COVID-19 ,Humans ,RNA, Viral ,Nucleic Acid Amplification Techniques ,Sensitivity and Specificity - Abstract
Continued waves, new variants, and limited vaccine deployment mean that SARS-CoV-2 tests remain vital to constrain the COVID-19 pandemic. Affordable, point-of-care (PoC) tests allow rapid screening in non-medical settings. Reverse-transcription loop-mediated isothermal amplification (RT-LAMP) is an appealing approach. A crucial step is to optimize testing in low/medium resource settings. Here, we optimized RT-LAMP for SARS-CoV-2 and human β-actin, and tested clinical samples in multiple countries. “TTTT” linker primers did not improve performance, and while guanidine hydrochloride, betaine and/or Igepal-CA-630 enhanced detection of synthetic RNA, only the latter two improved direct assays on nasopharygeal samples. With extracted clinical RNA, a 20 min RT-LAMP assay was essentially as sensitive as RT-PCR. With raw Canadian nasopharygeal samples, sensitivity was 100% (95% CI: 67.6% - 100%) for those with RT-qPCR Ct values ≤ 25, and 80% (95% CI: 58.4% - 91.9%) for those with 25 < Ct ≤ 27.2. Highly infectious, high titer cases were also detected in Colombian and Ecuadorian labs. We further demonstrate the utility of replacing thermocyclers with a portable PoC device (FluoroPLUM). These combined PoC molecular and hardware tools may help to limit community transmission of SARS-CoV-2.
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- 2022
6. Distance-based detection of out-of-distribution silent failures for Covid-19 lung lesion segmentation
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Camila González, Karol Gotkowski, Moritz Fuchs, Andreas Bucher, Armin Dadras, Ricarda Fischbach, Isabel Jasmin Kaltenborn, and Anirban Mukhopadhyay
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FOS: Computer and information sciences ,Male ,Lung Diseases ,Computer Science - Machine Learning ,Radiological and Ultrasound Technology ,Computer Vision and Pattern Recognition (cs.CV) ,Image and Video Processing (eess.IV) ,Computer Science - Computer Vision and Pattern Recognition ,COVID-19 ,Health Informatics ,Electrical Engineering and Systems Science - Image and Video Processing ,Magnetic Resonance Imaging ,Computer Graphics and Computer-Aided Design ,Machine Learning (cs.LG) ,FOS: Electrical engineering, electronic engineering, information engineering ,Humans ,Radiology, Nuclear Medicine and imaging ,Computer Vision and Pattern Recognition ,Tomography, X-Ray Computed ,Lung - Abstract
Automatic segmentation of ground glass opacities and consolidations in chest computer tomography (CT) scans can potentially ease the burden of radiologists during times of high resource utilisation. However, deep learning models are not trusted in the clinical routine due to failing silently on out-of-distribution (OOD) data. We propose a lightweight OOD detection method that leverages the Mahalanobis distance in the feature space and seamlessly integrates into state-of-the-art segmentation pipelines. The simple approach can even augment pre-trained models with clinically relevant uncertainty quantification. We validate our method across four chest CT distribution shifts and two magnetic resonance imaging applications, namely segmentation of the hippocampus and the prostate. Our results show that the proposed method effectively detects far- and near-OOD samples across all explored scenarios.
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- 2022
7. Determinants of Aedes mosquito density as an indicator of arbovirus transmission risk in three sites affected by co-circulation of globally spreading arboviruses in Colombia, Ecuador and Argentina
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Patricio Ponce, Benoit Talbot, Manisha A. Kulkarni, Beate Sander, Sergio Litwiñiuk, Varsovia Cevallos, Denisse Benítez, Fabian Zelaya, Claudio Carissimo, Camila González, Neris Gauto, Stephany D. Villota, Mario Iván Ortiz, Mauricio Espinel, María C. Carrasquilla Ferro, Jianhong Wu, Marcos Mateo Miretti, and Karen Lopez
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Disease risk ,Infectious and parasitic diseases ,RC109-216 ,medicine.disease_cause ,Dengue fever ,Zika virus ,Dengue ,0302 clinical medicine ,Aedes ,Risk Factors ,030212 general & internal medicine ,Chikungunya ,2. Zero hunger ,Mosquito vector ,Zika Virus Infection ,Wealth Index ,3. Good health ,Infectious Diseases ,symbols ,Female ,Ecuador ,Aedes albopictus ,education ,Socio-economic status ,030231 tropical medicine ,Argentina ,Global health ,Mosquito Vectors ,Aedes aegypti ,Arbovirus Infections ,Colombia ,Biology ,Arbovirus ,03 medical and health sciences ,symbols.namesake ,parasitic diseases ,medicine ,Animals ,Humans ,Poisson regression ,Cities ,Research ,medicine.disease ,biology.organism_classification ,Chikungunya Fever ,Parasitology ,Animal Distribution ,Arboviruses ,Demography - Abstract
Background The global impact of Zika virus in Latin America has drawn renewed attention to circulating mosquito-borne viruses in this region, such as dengue and chikungunya. Our objective was to assess socio-ecological factors associated with Aedes mosquito vector density as a measure of arbovirus transmission risk in three cities of potentially recent Zika virus introduction: Ibagué, Colombia; Manta, Ecuador; and Posadas, Argentina, in order to inform disease mitigation strategies. Methods We sampled Aedes mosquito populations in a total of 1086 households, using indoor and peridomestic mosquito collection methods, including light traps, resting traps, traps equipped with chemical attractant and aspirators. For each sampled household, we collected socio-economic data using structured questionnaires and data on microenvironmental conditions using iButton data loggers. Results A total of 3230 female Aedes mosquitoes were collected, of which 99.8% were Aedes aegypti and 0.2% were Aedes albopictus. Mean female Aedes mosquito density per household was 1.71 (standard deviation: 2.84). We used mixed-effects generalized linear Poisson regression analyses to identify predictors of Aedes density, using month, neighborhood and country as random-effects variables. Across study sites, the number of household occupants [incidence rate ratio (IRR): 1.08, 95% confidence interval (CI): 1.01–1.14], presence of entry points for mosquitoes into the household (IRR: 1.51, 95% CI: 1.30–1.76) and presence of decorative vegetation (IRR: 1.52, 95% CI: 1.22–1.88) were associated with higher Aedes density; while being in the highest wealth tertile of household wealth (IRR: 0.78, 95% CI: 0.66–0.92), knowledge of how arboviruses are transmitted (IRR: 0.94, 95% CI: 0.89–1.00) and regular emptying of water containers by occupants (IRR: 0.79, 95% CI: 0.67–0.92) were associated with lower Aedes density. Conclusions Our study addresses the complexities of arbovirus vectors of global significance at the interface between human and mosquito populations. Our results point to several predictors of Aedes mosquito vector density in countries with co-circulation of multiple Aedes-borne viruses, and point to modifiable risk factors that may be useful for disease prevention and control. Graphical Abstract
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- 2021
8. High-titre methylene blue-treated convalescent plasma as an early treatment for outpatients with COVID-19: a randomised, placebo-controlled trial
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Andrea Alemany, Pere Millat-Martinez, Marc Corbacho-Monné, Pierre Malchair, Dan Ouchi, Anna Ruiz-Comellas, Anna Ramírez-Morros, Joana Rodríguez Codina, Rosa Amado Simon, Sebastian Videla, Gèlia Costes, Mar Capdevila-Jáuregui, Pamela Torrano-Soler, Alba San José, Glòria Bonet Papell, Jordi Puig, Aurema Otero, Jose Carlos Ruibal Suarez, Alvaro Zarauza Pellejero, Ferran Llopis Roca, Orlando Rodriguez Cortez, Vanesa Garcia Garcia, Josep Vidal-Alaball, Anna Millan, Enric Contreras, Joan-Ramon Grifols, Àgueda Ancochea, Ivan Galvan-Femenia, Francini Piccolo Ferreira, Mireia Bonet, Jordi Cantoni, Núria Prat, Jordi Ara, Anna Forcada Arcarons, Magí Farré, Edwards Pradenas, Julià Blanco, Miquel Àngel Rodriguez-Arias, Gema Fernández Rivas, Michael Marks, Quique Bassat, Ignacio Blanco, Bàrbara Baro, Bonaventura Clotet, Oriol Mitjà, Susana Ferrer, Mireia Gallardo, Maria Ubals, Camila González-Beiras, Martí Vall-Mayans, Clara Suñer, Clàudia Laporte-Villar, Aroa Nieto, Xavier Comas-Leon, Zahida Jiménez, Ferran Ramírez-Viaplana, Maria Delgado-Capel, Beatriz Díez Sánchez, Maria Pons Barber, Cristian Gonzalez Ruiz, Laura Navarrete Gonzalez, David González García, Ainhoa Vivero Larraza, Victor Carceles Peiró, Clàudia Roquer López, Neus Robert, Carles Palet, Carlota Gudiol, Pablo Casares Gonzalez, Gemma Arcos Vila, Begoña Flores Aguilera, Graciela Rodríguez-Sevilla, Macarena Dastis Arias, Judit Roca Font, Katherine M. Carrasco Matos, Glòria Saüch Valmaña, Carla Vidal Obradors, Silvia Tarres García, Margarida Curriu Sabatès, Raquel Nieto Rodríguez, Rosa Línio, Míriam Fornos, Natàlia Casamitjana, Eva Alonso, Núria Martínez, Laura Analía Maglio, Laura Comellas Fernandez, Nadia Garcia, Luis Hernández, Maria Isabel González, Anna Bravo, Yolanda García, Silvia Sauleda Oliveras, Tatiana Vertiz, Sergio Benavent, Andrea Sofia Bianco, Joaquim Verdaguer, Ney Nicanor Briones Zambrano, Maria Viozquez Meya, Águeda Hernández, Cristina Casaña Lopez, Antoni E. Bordoy, Victoria González Soler, Montserrat Giménez, Alexa París, Silvia Marfil, Benjamin Trinité, and Eulàlia Grau
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Pulmonary and Respiratory Medicine ,Adult ,Methylene Blue ,COVID-19 Vaccines ,Treatment Outcome ,Double-Blind Method ,SARS-CoV-2 ,Outpatients ,Immunization, Passive ,COVID-19 ,Humans ,Middle Aged ,COVID-19 Serotherapy - Abstract
BACKGROUND: Convalescent plasma has been proposed as an early treatment to interrupt the progression of early COVID-19 to severe disease, but there is little definitive evidence. We aimed to assess whether early treatment with convalescent plasma reduces the risk of hospitalisation and reduces SARS-CoV-2 viral load among outpatients with COVID-19. METHODS: We did a multicentre, double-blind, randomised, placebo-controlled trial in four health-care centres in Catalonia, Spain. Adult outpatients aged 50 years or older with the onset of mild COVID-19 symptoms 7 days or less before randomisation were eligible for enrolment. Participants were randomly assigned (1:1) to receive one intravenous infusion of either 250-300 mL of ABO-compatible high anti-SARS-CoV-2 IgG titres (EUROIMMUN ratio =6) methylene blue-treated convalescent plasma (experimental group) or 250 mL of sterile 0·9% saline solution (control). Randomisation was done with the use of a central web-based system with concealment of the trial group assignment and no stratification. To preserve masking, we used opaque tubular bags that covered the investigational product and the infusion catheter. The coprimary endpoints were the incidence of hospitalisation within 28 days from baseline and the mean change in viral load (in log(10) copies per mL) in nasopharyngeal swabs from baseline to day 7. The trial was stopped early following a data safety monitoring board recommendation because more than 85% of the target population had received a COVID-19 vaccine. Primary efficacy analyses were done in the intention-to-treat population, safety was assessed in all patients who received the investigational product. This study is registered with ClinicalTrials.gov, NCT04621123. FINDINGS: Between Nov 10, 2020, and July 28, 2021, we assessed 909 patients with confirmed COVID-19 for inclusion in the trial, 376 of whom were eligible and were randomly assigned to treatment (convalescent plasma n=188 [serum antibody-negative n=160]; placebo n=188 [serum antibody-negative n=166]). Median age was 56 years (IQR 52-62) and the mean symptom duration was 4·4 days (SD 1·4) before random assignment. In the intention-to-treat population, hospitalisation within 28 days from baseline occurred in 22 (12%) participants who received convalescent plasma versus 21 (11%) who received placebo (relative risk 1·05 [95% CI 0·78 to 1·41]). The mean change in viral load from baseline to day 7 was -2·41 log(10) copies per mL (SD 1·32) with convalescent plasma and -2·32 log(10) copies per mL (1·43) with placebo (crude difference -0·10 log(10) copies per mL [95% CI -0·35 to 0·15]). One participant with mild COVID-19 developed a thromboembolic event 7 days after convalescent plasma infusion, which was reported as a serious adverse event possibly related to COVID-19 or to the experimental intervention. INTERPRETATION: Methylene blue-treated convalescent plasma did not prevent progression from mild to severe illness and did not reduce viral load in outpatients with COVID-19. Therefore, formal recommendations to support the use of convalescent plasma in outpatients with COVID-19 cannot be concluded. FUNDING: Grifols, Crowdfunding campaign YoMeCorono.
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- 2021
9. A cluster-randomized trial of hydroxychloroquine for prevention of Covid-19
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Oriol, Mitjà, Marc, Corbacho-Monné, Maria, Ubals, Andrea, Alemany, Clara, Suñer, Cristian, Tebé, Aurelio, Tobias, Judith, Peñafiel, Ester, Ballana, Carla A, Pérez, Pol, Admella, Núria, Riera-Martí, Pep, Laporte, Jordi, Mitjà, Mireia, Clua, Laia, Bertran, Maria, Sarquella, Sergi, Gavilán, Jordi, Ara, Josep M, Argimon, Gabriel, Cuatrecasas, Paz, Cañadas, Aleix, Elizalde-Torrent, Robert, Fabregat, Magí, Farré, Anna, Forcada, Gemma, Flores-Mateo, Cristina, López, Esteve, Muntada, Núria, Nadal, Silvia, Narejos, Aroa, Nieto, Nuria, Prat, Jordi, Puig, Carles, Quiñones, Ferran, Ramírez-Viaplana, Juliana, Reyes-Urueña, Eva, Riveira-Muñoz, Lidia, Ruiz, Sergi, Sanz, Alexis, Sentís, Alba, Sierra, César, Velasco, Rosa M, Vivanco-Hidalgo, Juani, Zamora, Jordi, Casabona, Martí, Vall-Mayans, Camila, González-Beiras, Bonaventura, Clotet, and Esther, Diaz Soler
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Adult ,Male ,medicine.medical_specialty ,Agents antiinfecciosos ,030204 cardiovascular system & hematology ,Asymptomatic ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Anti-Infective Agents ,Double-Blind Method ,Randomized controlled trial ,law ,Internal medicine ,Ús terapèutic ,Disease Transmission, Infectious ,medicine ,Humans ,Treatment Failure ,030212 general & internal medicine ,Adverse effect ,Index case ,SARS-CoV-2 ,business.industry ,Incidence (epidemiology) ,Therapeutic use ,COVID-19 ,Hydroxychloroquine ,General Medicine ,Middle Aged ,Viral Load ,Confidence interval ,Relative risk ,Patient Compliance ,Anti-infective agents ,Female ,Original Article ,medicine.symptom ,business ,medicine.drug - Abstract
BackgroundCurrent strategies for preventing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are limited to nonpharmacologic interventions. Hydroxychloroquine has been proposed as a postexposure therapy to prevent coronavirus disease 2019 (Covid-19), but definitive evidence is lacking. MethodsWe conducted an open-label, cluster-randomized trial involving asymptomatic contacts of patients with polymerase-chain-reaction (PCR)-confirmed Covid-19 in Catalonia, Spain. We randomly assigned clusters of contacts to the hydroxychloroquine group (which received the drug at a dose of 800 mg once, followed by 400 mg daily for 6 days) or to the usual-care group (which received no specific therapy). The primary outcome was PCR-confirmed, symptomatic Covid-19 within 14 days. The secondary outcome was SARS-CoV-2 infection, defined by symptoms compatible with Covid-19 or a positive PCR test regardless of symptoms. Adverse events were assessed for up to 28 days. ResultsThe analysis included 2314 healthy contacts of 672 index case patients with Covid-19 who were identified between March 17 and April 28, 2020. A total of 1116 contacts were randomly assigned to receive hydroxychloroquine and 1198 to receive usual care. Results were similar in the hydroxychloroquine and usual-care groups with respect to the incidence of PCR-confirmed, symptomatic Covid-19 (5.7% and 6.2%, respectively; risk ratio, 0.86 [95% confidence interval, 0.52 to 1.42]). In addition, hydroxychloroquine was not associated with a lower incidence of SARS-CoV-2 transmission than usual care (18.7% and 17.8%, respectively). The incidence of adverse events was higher in the hydroxychloroquine group than in the usual-care group (56.1% vs. 5.9%), but no treatment-related serious adverse events were reported. ConclusionsPostexposure therapy with hydroxychloroquine did not prevent SARS-CoV-2 infection or symptomatic Covid-19 in healthy persons exposed to a PCR-positive case patient. (Funded by the crowdfunding campaign YoMeCorono and others; BCN-PEP-CoV2 ClinicalTrials.gov number, NCT04304053.) In a trial involving asymptomatic contacts of patients with PCR-confirmed Covid-19 in Spain, the authors compared the use of hydroxychloroquine with usual care. Postexposure therapy with hydroxychloroquine did not prevent SARS-CoV-2 infection or symptomatic Covid-19 in healthy persons.
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- 2021
10. Streptococcus pyogenes Is Associated with Idiopathic Cutaneous Ulcers in Children on a Yaws-Endemic Island
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Camila González-Beiras, Charmie Godornes, Qunfeng Dong, Barry P. Katz, Brad Griesenauer, David E. Nelson, Katherine R. Fortney, Stanley M. Spinola, Oriol Mitjà, Xiang Gao, Sheila A. Lukehart, and Huaiying Lin
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Impetigo ,microbiome ,Azithromycin ,medicine.disease_cause ,urologic and male genital diseases ,Polymerase Chain Reaction ,Clinical Science and Epidemiology ,Haemophilus ducreyi ,RNA, Ribosomal, 16S ,Prospective Studies ,Child ,pertenue ,0303 health sciences ,Clostridiales ,Treponema ,biology ,Microbiota ,female genital diseases and pregnancy complications ,QR1-502 ,Anti-Bacterial Agents ,Cellulitis ,medicine.symptom ,medicine.drug ,Research Article ,cutaneous ulcers ,Streptococcus pyogenes ,Asymptomatic ,Microbiology ,03 medical and health sciences ,Papua New Guinea ,Virology ,Skin Ulcer ,medicine ,Treponema pallidum subsp ,Humans ,Ulcer ,030304 developmental biology ,030306 microbiology ,business.industry ,medicine.disease ,biology.organism_classification ,bacterial infections and mycoses ,Penicillin ,Yaws ,Metagenomics ,Treponema pallidum subsp. pertenue ,business - Abstract
Cutaneous ulcers (CU) affect approximately 100,000 children in the tropics each year. While two-thirds of CU are caused by Treponema pallidum subspecies pertenue and Haemophilus ducreyi, the cause(s) of the remaining one-third is unknown., Exudative cutaneous ulcers (CU) in yaws-endemic areas are associated with Treponema pallidum subsp. pertenue (TP) and Haemophilus ducreyi (HD), but one-third of CU cases are idiopathic (IU). Using mass drug administration (MDA) of azithromycin, a yaws eradication campaign on Lihir Island in Papua New Guinea reduced but failed to eradicate yaws; IU rates remained constant throughout the campaign. To identify potential etiologies of IU, we obtained swabs of CU lesions (n = 279) and of the skin of asymptomatic controls (AC; n = 233) from the Lihir Island cohort and characterized their microbiomes using a metagenomics approach. CU bacterial communities were less diverse than those of the AC. Using real-time multiplex PCR with pathogen-specific primers, we separated CU specimens into HD-positive (HD+), TP+, HD+TP+, and IU groups. Each CU subgroup formed a distinct bacterial community, defined by the species detected and/or the relative abundances of species within each group. Streptococcus pyogenes was the most abundant organism in IU (22.65%) and was enriched in IU compared to other ulcer groups. Follow-up samples (n = 31) were obtained from nonhealed ulcers; the average relative abundance of S. pyogenes was 30.11% in not improved ulcers and 0.88% in improved ulcers, suggesting that S. pyogenes in the not improved ulcers may be azithromycin resistant. Catonella morbi was enriched in IU that lacked S. pyogenes. As some S. pyogenes and TP strains are macrolide resistant, penicillin may be the drug of choice for CU azithromycin treatment failures. Our study will aid in the design of diagnostic tests and selective therapies for CU.
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- 2021
11. Entomological characterization of Aedes mosquitoes and arbovirus detection in Ibagué, a Colombian city with co-circulation of Zika, dengue and chikungunya viruses
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Carrasquilla, María C., Ortiz, Mario I., Cielo, León, Silvia, Rondón, Kulkarni, Manisha A., Benoit, Talbot, Beate, Sander, Heriberto, Vásquez, Cordovez, Juan M., Camila, González, and RADAM-LAC Research Team
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Male ,Veterinary medicine ,viruses ,Infectious and parasitic diseases ,RC109-216 ,Dengue virus ,medicine.disease_cause ,Dengue fever ,Zika virus ,Dengue ,0302 clinical medicine ,Aedes aegypti ,Aedes ,Chikungunya ,0303 health sciences ,Family Characteristics ,Zika Virus Infection ,dengue ,zika ,chikungunya ,aedes aegypti ,aedes albopictus ,colombia ,virus diseases ,Aedes albopictus ,3. Good health ,Infectious Diseases ,Female ,Public Health ,Chikungunya virus ,030231 tropical medicine ,Mosquito Vectors ,Biology ,Colombia ,Arbovirus ,03 medical and health sciences ,Zika ,parasitic diseases ,medicine ,Animals ,Humans ,Cities ,030304 developmental biology ,Research ,fungi ,Zika Virus ,Dengue Virus ,medicine.disease ,biology.organism_classification ,Chikungunya Fever ,Parasitology ,Arboviruses - Abstract
Background Dengue, Zika and chikungunya are arboviruses of significant public health importance that are transmitted by Aedes aegypti and Aedes albopictus mosquitoes. In Colombia, where dengue is hyperendemic, and where chikungunya and Zika were introduced in the last decade, more than half of the population lives in areas at risk. The objective of this study was to characterize Aedes spp. vectors and study their natural infection with dengue, Zika and chikungunya in Ibagué, a Colombian city and capital of the department of Tolima, with case reports of simultaneous circulation of these three arboviruses. Methods Mosquito collections were carried out monthly between June 2018 and May 2019 in neighborhoods with different levels of socioeconomic status. We used the non-parametric Friedman, Mann–Whitney and Kruskal–Wallis tests to compare mosquito density distributions. We applied logistic regression analyses to identify associations between mosquito density and absence/presence of breeding sites, and the Spearman correlation coefficient to analyze the possible relationship between climatic variables and mosquito density. Results We collected Ae. aegypti in all sampled neighborhoods and found for the first time Ae. albopictus in the city of Ibagué. A greater abundance of mosquitoes was collected in neighborhoods displaying low compared to high socioeconomic status as well as in the intradomicile compared to the peridomestic space. Female mosquitoes predominated over males, and most of the test females had fed on human blood. In total, four Ae. aegypti pools (3%) were positive for dengue virus (serotype 1) and one pool for chikungunya virus (0.8%). Interestingly, infected females were only collected in neighborhoods of low socioeconomic status, and mostly in the intradomicile space. Conclusions We confirmed the co-circulation of dengue (serotype 1) and chikungunya viruses in the Ae. aegypti population in Ibagué. However, Zika virus was not detected in any mosquito sample, 3 years after its introduction into the country. The positivity for dengue and chikungunya viruses, predominance of mosquitoes in the intradomicile space and the high proportion of females fed on humans highlight the high risk for arbovirus transmission in Ibagué, but may also provide an opportunity for establishing effective control strategies. Graphical abstract
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- 2021
12. Sertraline and Citalopram Actions on Gut Barrier Function
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Javier A. Bravo, Camila González-Arancibia, María Paz González-Toro, Jorge Escobar-Luna, Marcela Julio-Pieper, Johana Eyzaguirre-Velásquez, and Caroll J. Beltrán
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Male ,Barrier ,Low protein ,Physiology ,Ileum ,Citalopram ,Pharmacology ,Permeability ,Rats, Sprague-Dawley ,03 medical and health sciences ,0302 clinical medicine ,In vivo ,Stress, Physiological ,Sertraline ,TLR ,medicine ,Animals ,Humans ,SSRI ,Gut ,Intestinal Mucosa ,Barrier function ,business.industry ,Gastroenterology ,Animal Feed ,Diet ,Rats ,Intestines ,medicine.anatomical_structure ,Gene Expression Regulation ,030220 oncology & carcinogenesis ,Zonula Occludens-1 Protein ,030211 gastroenterology & hepatology ,Original Article ,Serotonin ,Dietary Proteins ,business ,Ex vivo ,Selective Serotonin Reuptake Inhibitors ,medicine.drug - Abstract
Introduction Disruption of intestinal barrier is a key component to various diseases. Whether barrier dysfunction is the cause or effect in these situations is still unknown, although it is believed that translocation of luminal content may initiate gastrointestinal or systemic inflammatory disorders. Since trauma- or infection-driven epithelial permeability depends on Toll-like receptor (TLR) activity, inhibition of TLR signaling has been proposed as a strategy to protect intestinal barrier integrity after infection or other pathological conditions. Recently, selective serotonin recapture inhibitors including sertraline and citalopram were shown to inhibit TLR-3 activity, but the direct effects of these antidepressant drugs on the gut mucosa barrier remain largely unexplored. Materials and methods To investigate this, two approaches were used: first, ex vivo studies were performed to evaluate sertraline and citalopram-driven changes in permeability in isolated intestinal tissue. Second, both compounds were tested for their preventive effects in a rat model of disrupted gut barrier, induced by a low protein (LP) diet. Results Only sertraline was able to increase transepithelial electrical resistance in the rat colon both when used in an ex vivo (0.8 μg/mL, 180 min) or in vivo (30 mg/kg p.o., 20 days) fashion. However, citalopram (20 mg/kg p.o., 20 days), but not sertraline, prevented the increase in phospho–IRF3 protein, a marker of TLR-3 activation, in LP-rat ileum. Neither antidepressant affected locomotion, anxiety-like behaviours or stress-induced defecation. Conclusion Our data provides evidence to support the investigation of sertraline as therapeutic strategy to protect intestinal barrier function under life-threatening situations or chronic conditions associated with gut epithelial disruption.
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- 2020
13. Immune Profile of the Nasal Mucosa in Patients with Cutaneous Leishmaniasis
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Camila González, María J. Gómez-Zafra, Adriana Navas, Julieth Murillo, Jimena Jojoa, and Maria Adelaida Gomez
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Adult ,Male ,0301 basic medicine ,Conjunctiva ,CD14 ,CD3 ,Immunology ,Population ,Leishmaniasis, Cutaneous ,Mucous membrane of nose ,Microbiology ,03 medical and health sciences ,0302 clinical medicine ,Immune system ,Cutaneous leishmaniasis ,Antigens, CD ,Interleukin-5 Receptor alpha Subunit ,medicine ,Humans ,030212 general & internal medicine ,education ,Skin ,Leishmania ,education.field_of_study ,biology ,Interleukin-4 Receptor alpha Subunit ,Matrix Attachment Region Binding Proteins ,biology.organism_classification ,medicine.disease ,3. Good health ,Nasal Mucosa ,030104 developmental biology ,Infectious Diseases ,medicine.anatomical_structure ,biology.protein ,Female ,Parasitology ,Fungal and Parasitic Infections ,Transcriptome ,Cell Adhesion Molecules - Abstract
Localized skin lesions are characteristic of cutaneous leishmaniasis (CL); however, Leishmania (Viannia) species, which are responsible for most CL cases in the Americas, can spread systemically, sometimes resulting in mucosal disease. Detection of Leishmania has been documented in healthy mucosal tissues (conjunctiva, tonsils, and nasal mucosa) and healthy skin of CL patients and in individuals with asymptomatic infection in areas of endemicity of L. (V.) panamensis and L. (V.) braziliensis transmission. However, the conditions and mechanisms that favor parasite persistence in healthy mucosal tissues are unknown. In this descriptive study, we compared the cell populations of the nasal mucosa (NM) of healthy donors and patients with active CL and explored the immune gene expression signatures related to molecular detection of Leishmania in this tissue in the absence of clinical signs or symptoms of mucosal disease. The cellular composition and gene expression profiles of NM samples from active CL patients were similar to those of healthy volunteers, with a predominance of epithelial over immune cells, and within the CD45(+) cell population, a higher frequency of CD66b(+) followed by CD14(+) and CD3(+) cells. In CL patients with molecular evidence of Leishmania persistence in the NM, genes characteristic of an anti-inflammatory and tissue repair responses (IL4R, IL5RA, POSTN, and SATB1) were overexpressed relative to NM samples from CL patients in which Leishmania was not detected. Here, we report the first immunological description of subclinically infected NM tissues of CL patients and provide evidence of a local anti-inflammatory environment favoring parasite persistence in the NM.
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- 2020
14. Maternal Smoking: A Life Course Blood Pressure Determinant?
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Liane Correia-Costa, Henrique Barros, Maria João Fonseca, Ana Cristina Santos, Camila González-Beiras, Maria Cabral, and Instituto de Saúde Pública
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Adult ,Male ,medicine.medical_specialty ,Pregnancy Trimester, Third ,Blood Pressure ,030204 cardiovascular system & hematology ,Body Mass Index ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Pregnancy ,medicine ,Humans ,Longitudinal Studies ,030212 general & internal medicine ,Maternal Behavior ,2. Zero hunger ,Obstetrics ,business.industry ,Public health ,Smoking ,Public Health, Environmental and Occupational Health ,medicine.disease ,Confidence interval ,3. Good health ,Smoking - Pregnancy ,Blood pressure ,Child, Preschool ,Prenatal Exposure Delayed Effects ,Hypertension ,Gestation ,Life course approach ,Female ,Tobacco Smoke Pollution ,business ,Body mass index ,Follow-Up Studies ,Cohort study - Abstract
Introduction: Exposure to maternal smoking early in life may affect blood pressure (BP) control mechanisms. We examined the association between maternal smoking (before conception, during pregnancy, and 4 years after delivery) and BP in preschool children. Methods: We evaluated 4295 of Generation XXI children, recruited at birth in 2005–2006 and reevaluated at the age of 4. At birth, information was collected by face-to-face interview and additionally abstracted from clinical records. At 4-year follow-up, interviews were performed and children’s BP measured. Linear regression models were fitted to estimate the association between maternal smoking and children’s BP. Results: Children of smoking mothers presented significantly higher BP levels. After adjustment for maternal education, gestational hypertensive disorders, and child’s body mass index, children exposed during pregnancy to maternal smoking presented a higher systolic BP (SBP) z-score (β = 0.08, 95% confidence interval [CI] 0.04 to 0.14). In crude models, maternal smoking was associated with higher SBP z-score at every assessed period. However, after adjustment, an attenuation of the association estimates occurred (β = 0.08, 95% CI 0.03 to 0.13 before conception; β = 0.07, 95%CI 0.02 to 0.12; β = 0.04, 95%CI −0.02 to 0.10; and β = 0.06, 95%CI 0.00 to 0.13 for the first, second, and third pregnancy trimesters, respectively; and β = 0.07, 95%CI 0.02 to 0.12 for current maternal smoking). No significant association was observed for diastolic BP z-score levels. Conclusion: Maternal smoking before, during, and after pregnancy was independently associated with systolic BP z-score in preschool children. This study provides additional evidence to the public health relevance of maternal smoking cessation programs if early cardiovascular health of children is envisaged. Implications: Using observational longitudinal data from the birth cohort Generation XXI, this study showed that exposure to maternal smoking—before pregnancy, during pregnancy, and 4 years after delivery—was associated with a systolic BP-raising effect in children at the age of 4. The findings of this study add an important insight into the need to support maternal smoke-free environments in order to provide long-term cardiovascular benefit, starting as early as possible in life. Generation XXI has been funded by the Operational Health Programme XXI Health, Community support framework III (co-funded by Feder), Administração Regional de Saúde do Norte, Fundação Calouste Gulbenkian and Fundação para a Ciência e Tecnologia (SFRH/BSAB/113778/2015; PD/BD/105824/2014; PD/BD/105827/2014; F-COMP-01-0124-FEDER-011008; FCT—PTDC/SAU-ESA/105033/2008). Also, the Portuguese Foundation for Science and Technology funds the Epidemiology Research Unit of the Institute of Public Health of the University of Porto (UID/DTP/04750/2013). This article is a result of the project DOCnet (NORTE-01-0145-FEDER-000003), supported by Norte Portugal Regional Operational Programme (NORTE 2020), under the PORTUGAL 2020 Partnership Agreement, through the European Regional Development Fund (ERDF).
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- 2017
15. Baseline in vivo, ex vivo and molecular responses of Plasmodium falciparum to artemether and lumefantrine in three endemic zones for malaria in Colombia
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María Fernanda Yasnot, César Restrepo, Ángela Patricia Guerra, Sindy Durley Bernal, Angélica Knudson-Ospina, Camila González, Samanda Aponte, and Catalina Álvarez-Larrotta
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Artemisinin-based combination therapies (ACT), Colombia, Plasmodium falciparum, Polymorphisms, Resistance surveillance, Therapeutic efficacy studies (TES) ,Male ,0301 basic medicine ,medicine.medical_treatment ,Drug Resistance ,Protozoan Proteins ,Parasitemia ,chemistry.chemical_compound ,0302 clinical medicine ,Chloroquine ,Artemether ,Artemisinin ,Child ,biology ,General Medicine ,Middle Aged ,Artemisinins ,Drug Combinations ,Infectious Diseases ,Ethanolamines ,Drug Therapy, Combination ,Female ,medicine.drug ,Adult ,medicine.medical_specialty ,Adolescent ,DNA Copy Number Variations ,Plasmodium falciparum ,030106 microbiology ,030231 tropical medicine ,Dihydroartemisinin ,Colombia ,Lumefantrine ,Antimalarials ,Young Adult ,03 medical and health sciences ,Internal medicine ,parasitic diseases ,medicine ,Humans ,Aged ,Fluorenes ,Polymorphism, Genetic ,business.industry ,Artemether, Lumefantrine Drug Combination ,Public Health, Environmental and Occupational Health ,medicine.disease ,biology.organism_classification ,Malaria ,chemistry ,Parasitology ,business - Abstract
Background Colombia began using artemisinin-based combination therapies for the treatment of uncomplicated Plasmodium falciparum malaria in 2006. It is necessary to implement resistance surveillance to antimalarial drugs in order to promptly detect changes in parasite susceptibility. The aim of this study was to establish a susceptibility baseline of P. falciparum to artemether-lumefantrine using three monitoring tools. Methods Patients with uncomplicated malaria treated with artemether-lumefantrine underwent clinical and parasitological follow-up over 28 days. Ex vivo test was performed using the microtest technique for chloroquine, arthemeter, dihydroartemisinin and lumefantrine. Pfmdr1 copy number and polymorphisms in Pfk13, Pfatp6, Pfcrt and Pfmdr1 genes were analyzed. Results From a total of 150 screened patients, 49 completed follow-up for 28 days. All treated patients had adequate clinical and parasitological responses. Parasitic clearance showed a drastic reduction of parasite biomass at 24 hours and complete elimination at 48 hours. One hundred eleven isolates were processed, all exhibited high susceptibility to artemisinins and a slight decrease in susceptibility to lumefantrine. No genetic polymorphisms associated with resistance to artemisinin were found. Conclusion This study generated a susceptibility baseline in response to therapy with Coartem (artemether-lumefantrine) with numerical reference values, which will allow data comparison with future studies to systematically monitor changes in the parasite and to provide an early alert to the health authorities.
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- 2017
16. Detección y caracterización molecular de cepas de Trypanosoma cruzi aisladas de triatominos recolectados por la comunidad en el departamento de Córdoba, Colombia
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Catalina Tovar, Cielo León, Camila González, Ernesto Arroyo, Jorge Negrete, and Mario Iván Ortiz
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0301 basic medicine ,Chagas disease ,lcsh:Arctic medicine. Tropical medicine ,Genotype ,lcsh:RC955-962 ,Trypanosoma cruzi ,030231 tropical medicine ,030106 microbiology ,Rhodnius ,lcsh:Medicine ,Zoology ,Colombia ,General Biochemistry, Genetics and Molecular Biology ,Birds ,03 medical and health sciences ,0302 clinical medicine ,parasitic diseases ,medicine ,Animals ,Humans ,Chagas Disease ,Cities ,Reduviidae ,Genotyping ,Triatominae ,Mammals ,Panstrongylus ,Rhodnius, Panstrongylus ,biology ,enfermedad de Chagas ,lcsh:R ,Feeding Behavior ,biology.organism_classification ,medicine.disease ,Insect Vectors ,Panstrongylus geniculatus ,Blood ,Housing - Abstract
Introduction: From 2011 to 2016, 24 cases of Chagas disease were reported in Córdoba according to the national public health surveillance system (Sistema Nacional de Vigilancia en Salud Pública, Sivigila), but the information regarding Trypanosoma cruzi circulating strains and infection rates are unknown. Objectives: To establish the triatomine species with which people come in contact and recognize as Chagas disease vectors, as well as to assess the infection with trypanosomes and make an exploratory approach to host feeding preferences with the participation of the local community. Materials and methods: Triatomines sampling was conducted in 12 municipalities between 2011 and 2016; T. cruzi infection was established by k-PCR, SAT-PCR, while strain genotyping was done by mini-exon and SL-IR (spliced-leader intergenic region) sequence characterization. We also screened for blood sources. Results: Local community members collected the majority of triatomines and we identified three species: Rhodnius pallescens, Panstrongylus geniculatus, and Eratyrus cuspidatus. The overall T. cruzi infection rate in collected triatomines was 66.6% and we detected the TcIDOM and TcI sylvatic strains. Community-based insect collection allowed reporting the presence of P. geniculatus in two new disperse rural settlements, T. cruzi infection of P. geniculatus in Córdoba, and the first report of triatomines infected with T. cruzi in Montería municipality. Conclusions: These results revealed the presence of triatomines infected with T. cruzi inside dwellings in five municipalities of Córdoba. The dominant circulating T. cruzi strain was TcIDOM, a genotype associated with human Chagas disease and cardiomyopathies in Colombia. Our results highlight the importance of local community participation in entomological surveillance tasks. Resumen Introducción. Entre el 2011 y el 2016, se reportaron 24 casos de enfermedad de Chagas en Córdoba, según el Sistema Nacional de Vigilancia en Salud Pública (Sivigila), pero la información sobre las unidades discretas de tipificación de Trypanosoma cruzi circulantes y las tasas de infección se desconoce. Objetivos. Identificar las especies de triatominos con las cuales las personas entran en contacto y que reconocen como vectores de la enfermedad de Chagas, así como establecer la infección por tripanosomas y explorar posibles fuentes de alimentación de los triatominos con la participación de la comunidad. Materiales y métodos. El muestreo de triatominos se hizo en 12 municipios entre el 2011 y el 2016. T. cruzi se detectó mediante las técnicas de kinetic-polymerase chain reaction (k-PCR) y serial amplification of targets-polymerase chain reaction (SAT-PCR), en tanto que la genotipificación de las cepas se logró mediante la caracterización de secuencias de genes miniexon y de la región intergénica SL-IR (Spliced-Leader Intergenic Region). Se evaluaron, asimismo, las fuentes de alimento. Resultados. La mayoría de los triatominos fue recolectada por miembros de la comunidad y se identificaron tres especies: Rhodnius pallescens, Panstrongylus geniculatus y Eratyrus cuspidatus. La tasa de infección general por T. cruzi fue de 66,6 % y se detectaron las cepas TcIDOM y TcI sylvatic. La participación de la comunidad permitió reportar la presencia de P. geniculatus en dos nuevas localidades, la infección con T. cruzi de P. geniculatus en Córdoba y reportar por primera vez triatominos infectados con T. cruzi en Montería. Conclusiones. Se demostró la presencia de triatominos infectados con T. cruzi dentro de las viviendas en cinco municipalidades. La cepa circulante dominante fue T. cruzi TcIDOM, asociada con la enfermedad de Chagas y con cardiomiopatías en Colombia. Los resultados resaltan la importancia de vincular a miembros de la comunidad en la vigilancia entomológica.
- Published
- 2019
17. Evaluating the spatial distribution of Leishmania parasites in Colombia from clinical samples and human isolates (1999 to 2016)
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Diana Londoño-Barbosa, Jussep Salgado-Almario, Clemencia Ovalle-Bracho, and Camila González
- Subjects
0301 basic medicine ,Leishmaniasis, Mucocutaneous ,Distribution (economics) ,Disease Vectors ,Geographical locations ,law.invention ,0302 clinical medicine ,Mathematical and Statistical Techniques ,law ,Zoonoses ,Medicine and Health Sciences ,Leishmaniasis ,Leishmania ,Protozoans ,education.field_of_study ,Principal Component Analysis ,Multidisciplinary ,biology ,Amazon rainforest ,Ecology ,Statistics ,Eukaryota ,Transmission (mechanics) ,Geography ,Infectious Diseases ,Physical Sciences ,Medicine ,Brazil ,Research Article ,Neglected Tropical Diseases ,Science ,030231 tropical medicine ,Population ,Colombia ,Spatial distribution ,Research and Analysis Methods ,Models, Biological ,03 medical and health sciences ,parasitic diseases ,medicine ,Parasitic Diseases ,Animals ,Humans ,Statistical Methods ,education ,Ecosystem ,Ecological niche ,Protozoan Infections ,business.industry ,Organisms ,Biology and Life Sciences ,South America ,biology.organism_classification ,medicine.disease ,Tropical Diseases ,Parasitic Protozoans ,Insect Vectors ,Sand Flies ,Species Interactions ,030104 developmental biology ,Phlebotomus ,Multivariate Analysis ,People and places ,business ,Mathematics - Abstract
In Colombia, nine species of parasites of the genus Leishmania circulate in more than 20 sand fly species, putting at risk of contracting the disease approximately 60% of the population. The Federico Lleras Acosta Dermatological Center, a reference center in Colombia, has been treating patients with cutaneous and mucosal leishmaniasis for more than 15 years, identifying the infecting Leishmania species from different clinical samples, and recording systematically all the epidemiological and geographic information related to each diagnosed patient. With this valuable information, the objective of this work was to perform a long term and large-scale study, aiming to identify the Leishmania species circulating in Colombia from clinical samples from 1999 to 2016, and to assess their current and potential spatial distribution. In all, four Leishmania species were identified in 688 samples from 183 municipalities distributed in 28 of the 32 departments of the country, and 387 records were georeferenced, from 20 departments. The most widespread species was L. (V.) braziliensis, showing new collection records, and the species related to areas with highest leishmaniasis transmission was L. (V.) panamensis. Ecological niche models were built for the three species that had more than 20 georeferenced records, showing a potential distribution for L. (V.) braziliensis on 42% of the national territory mainly in the interandean valleys, and the Orinoquia and Amazon regions. Leishmania (V.) guyanensis potential distribution covers 36% of Colombia continental territory with a spatial distribution similar to that of L. (V.) braziliensis. There was a marked tendency of L. (V.) panamensis to be distributed in the northwest of the country occupying 35% of the national area and mainly in areas of transformed ecosystems. Species were identified in patients from areas where the occurrence of cases was unprecedented, which suggests that the distribution of Leishmania may be greater than currently known. To improve the predictive capacity of the models, we suggest incorporating, in future studies, Leishmania samples from vectors and reservoirs that have a greater dependence on environmental variables. Our results are an important tool for health systems because they allow potential areas of transmission and information gaps to be identified.
- Published
- 2019
18. Do your gut microbes affect your brain dopamine?
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Camila, González-Arancibia, Jocelyn, Urrutia-Piñones, Javiera, Illanes-González, Jonathan, Martinez-Pinto, Ramón, Sotomayor-Zárate, Marcela, Julio-Pieper, and Javier A, Bravo
- Subjects
Dopamine ,Mental Disorders ,Animals ,Brain ,Humans ,Anti-Bacterial Agents ,Gastrointestinal Microbiome - Abstract
Increasing evidence shows changes in gut microbiota composition in association with psychiatric disorders, including anxiety and depression. Moreover, it has been reported that perturbations in gut microbe diversity and richness influence serotonergic, GABAergic, noradrenergic, and dopaminergic neurotransmission. Among these, dopamine is regarded as a main regulator of cognitive functions such as decision making, attention, memory, motivation, and reward. In this work, we will highlight findings that link alterations in intestinal microbiota and dopaminergic neurotransmission, with a particular emphasis on the mesocorticolimbic circuit, which is involved in reward to natural reinforcers, as well as abuse substances. For this, we reviewed evidence from studies carried out on germ-free animals, or in rodents subjected to intestinal dysbiosis using antibiotics, and also through the use of probiotics. All this evidence strongly supports that the microbiota-gut-brain axis is key to the physiopathology of several neuropsychiatric disorders involving those where dopaminergic neurotransmission is compromised. In addition, the gut microbiota appears as a key player when it comes to proposing novel strategies to the treatment of these psychiatric conditions.
- Published
- 2018
19. How microclimatic variables and blood meal sources influence Rhodnius prolixus abundance and Trypanosoma cruzi infection in Attalea butyracea and Elaeis guineensis palms?
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Troy J. Kieran, Johan M. Calderón, Diana Erazo, Camila González, Felipe Guhl, Cielo León, Travis C. Glenn, Nicole L. Gottdenker, and Juan M. Cordovez
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Chagas disease ,congenital, hereditary, and neonatal diseases and abnormalities ,Veterinary (miscellaneous) ,education ,Rhodnius ,Zoology ,Arecaceae ,Elaeis guineensis ,Abundance (ecology) ,Zoonoses ,parasitic diseases ,medicine ,Animals ,Humans ,Chagas Disease ,Rhodnius prolixus ,Trypanosoma cruzi ,biology ,food and beverages ,Microclimate ,biology.organism_classification ,medicine.disease ,Blood meal ,Insect Vectors ,body regions ,Infectious Diseases ,Insect Science ,Parasitology ,Palm - Abstract
Chagas disease is a zoonosis that affects several million people and is caused by the parasite Trypanosoma cruzi, which is mainly transmitted through the feces of triatomine bugs. Within triatomines, several Rhodnius species have been found inhabiting palms, and certain factors such as palm species and location have been related to the abundance and T. cruzi infection of those insects in palms. In this study, the main goal was to determine if R. prolixus abundances and infection rates in Attalea butyracea and Elaeis guineensis palms are related to ecological factors such as palm species, crown microclimate, and available blood meal sources. Triatomine sampling was performed in two municipalities of Casanare, Colombia, specifically in the intersection of riparian forests and oil palm plantations. For R. prolixus abundance per palm, the predictors showing more relationship were palm species and blood meal species identified in the palm, and for T. cruzi infection per triatomine, they were palm species and nymphal stage. Palm microclimate was very similar in both palm species and did not show a relationship with triatomine abundance. Comparing palm species, A. butyracea showed more blood meal species, including more refractory host species, than E. guineensis, but lower T. cruzi infection rate and parasitaemia. Interestingly, non-arboreal blood meal species were frequently found in the analyzed nymphs, indicating that the blood source for R. prolixus in palms corresponded to all the fauna located in the surrounded landscape and not only in the palm. These results could expose a new ecological scenario to interpret the T. cruzi transmission in sylvatic environments.
- Published
- 2020
20. Epidemiology ofHaemophilus ducreyiInfections
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Camila González-Beiras, Cheng Y. Chen, Michael Marks, Oriol Mitjà, and Sally Roberts
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Male ,0301 basic medicine ,Epidemiology ,lcsh:Medicine ,Disease ,nongenital cutaneous infections ,urologic and male genital diseases ,Bacteris ,Úlceres ,Haemophilus ducreyi ,skin ulcers ,0302 clinical medicine ,genital ulcers ,030212 general & internal medicine ,bacteria ,Child ,Ulcers ,integumentary system ,biology ,Chancroid ,female genital diseases and pregnancy complications ,3. Good health ,Genital ulcer ,Infectious Diseases ,Synopsis ,Female ,medicine.symptom ,Adult ,Microbiology (medical) ,medicine.medical_specialty ,Epidemiology of Haemophilus ducreyi Infections ,030106 microbiology ,genital ulcer disease ,lcsh:Infectious and parasitic diseases ,03 medical and health sciences ,Skin Ulcer ,medicine ,Humans ,lcsh:RC109-216 ,Sex organ ,Epidemiologia ,sexually transmitted infections ,Bacteria ,business.industry ,lcsh:R ,Skin ulcer ,biology.organism_classification ,medicine.disease ,Virology ,Dermatology ,Cutaneous ulcers ,business - Abstract
Infections are at their lowest level worldwide, but nongenital cutaneous infections have increased., The global epidemiology of Haemophilus ducreyi infections is poorly documented because of difficulties in confirming microbiological diagnoses. We evaluated published data on the proportion of genital and nongenital skin ulcers caused by H. ducreyi before and after introduction of syndromic management for genital ulcer disease (GUD). Before 2000, the proportion of GUD caused by H. ducreyi ranged from 0.0% to 69.0% (35 studies in 25 countries). After 2000, the proportion ranged from 0.0% to 15.0% (14 studies in 13 countries). In contrast, H. ducreyi has been recently identified as a causative agent of skin ulcers in children in the tropical regions; proportions ranged from 9.0% to 60.0% (6 studies in 4 countries). We conclude that, although there has been a sustained reduction in the proportion of GUD caused by H. ducreyi, this bacterium is increasingly recognized as a major cause of nongenital cutaneous ulcers.
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- 2016
21. Multiple Class I and Class II Haemophilus ducreyi Strains Cause Cutaneous Ulcers in Children on an Endemic Island
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Ana B. Abecasis, Stanley M. Spinola, Oriol Mitjà, Kristen M. Amick, Tricia L. Humphreys, Kate R. Fortney, Jacob C. Grant, Camila González-Beiras, and Dharanesh Gangaiah
- Subjects
DNA, Bacterial ,0301 basic medicine ,Microbiology (medical) ,Endemic Diseases ,medicine.drug_class ,Antibiotics ,Subspecies ,urologic and male genital diseases ,Polymerase Chain Reaction ,Microbiology ,Chancroid ,Haemophilus ducreyi ,Papua New Guinea ,03 medical and health sciences ,Skin Ulcer ,Humans ,Medicine ,Colonization ,Typing ,Child ,Articles and Commentaries ,Phylogeny ,Islands ,Polymorphism, Genetic ,Treponema ,Whole Genome Sequencing ,biology ,Molecular epidemiology ,business.industry ,High-Throughput Nucleotide Sequencing ,medicine.disease ,biology.organism_classification ,Bacterial Typing Techniques ,030104 developmental biology ,Infectious Diseases ,Coinfection ,Mass Drug Administration ,business ,Multilocus Sequence Typing - Abstract
BACKGROUND: Together with Treponema pallidum subspecies pertenue, Haemophilus ducreyi is a major cause of exudative cutaneous ulcers (CUs) in children. For H. ducreyi, both class I and class II strains, asymptomatic colonization, and environmental reservoirs have been found in endemic regions, but the epidemiology of this infection is unknown. METHODS: Based on published whole-genome sequences of H. ducreyi CU strains, a single-locus typing system was developed and applied to H. ducreyi–positive CU samples obtained prior to, 1 year after, and 2 years after the initiation of a mass drug administration campaign to eradicate CU on Lihir Island in Papua New Guinea. DNA from the CU samples was amplified with class I and class II dsrA-specific primers and sequenced; the samples were classified into dsrA types, which were geospatially mapped. Selection pressure analysis was performed on the dsrA sequences. RESULTS: Thirty-seven samples contained class I sequences, 27 contained class II sequences, and 13 contained both. There were 5 class I and 4 class II types circulating on the island; 3 types accounted for approximately 87% of the strains. The composition and geospatial distribution of the types varied little over time and there was no evidence of selection pressure. CONCLUSIONS: Multiple strains of H. ducreyi cause CU on an endemic island and coinfections are common. In contrast to recent findings with T. pallidum pertenue, strain composition is not affected by antibiotic pressure, consistent with environmental reservoirs of H. ducreyi. Such reservoirs must be addressed to achieve eradication of H. ducreyi.
- Published
- 2018
22. Etiological Characterization of the Cutaneous Ulcer Syndrome in Papua New Guinea Using Shotgun Metagenomics
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Oriol Mitjà, August Kapa, Mariona Parera, Maria Ubals, Camila González-Beiras, Marc Noguera-Julian, and Roger Paredes
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0301 basic medicine ,Microbiology (medical) ,Male ,Adolescent ,030106 microbiology ,Population ,Arcanobacterium haemolyticum ,Microbiology ,law.invention ,03 medical and health sciences ,Papua New Guinea ,0302 clinical medicine ,law ,Medicine ,Humans ,030212 general & internal medicine ,Prospective Studies ,education ,Child ,Polymerase chain reaction ,Ulcer ,education.field_of_study ,biology ,Bacteria ,Shotgun sequencing ,business.industry ,Coinfection ,Sequence Analysis, DNA ,Skin Diseases, Bacterial ,Skin ulcer ,biology.organism_classification ,Infectious Diseases ,Metagenomics ,Female ,medicine.symptom ,Haemophilus ducreyi ,Streptococcus dysgalactiae ,business - Abstract
Background Treponema pallidum subsp pertenue and Haemophilus ducreyi are causative agents of cutaneous ulcer (CU) in yaws-endemic regions in the tropics. However, a significant proportion of CU patients remain polymerase chain reaction (PCR) negative for both bacterial agents. We aimed to identify potential additional etiological agents of CU in a yaws-endemic region. Methods This population-based cohort study included children in Lihir Island (Papua New Guinea) examined during a yaws eradication campaign in October 2013-October 2014. All consenting patients with atraumatic exudative ulcers of >1 cm diameter were enrolled. Lesional swabs were collected for real-time PCR testing for T. pallidum subsp pertenue and H. ducreyi. We then performed shotgun whole DNA metagenomics sequencing on extracted DNA and taxonomically assigned shotgun sequences using a human microbiome reference. Results Sequence data were available for 122 samples. Shotgun sequencing showed high classification agreement relative to PCR testing (area under the curve for T. pallidum/H. ducreyi was 0.92/0.85, respectively). Clustering analysis of shotgun data revealed compositional clusters where the dominant species (median relative abundance ranged from 32% to 66%) was H. ducreyi (23% of specimens), T. pallidum subsp pertenue (16%), Streptococcus dysgalactiae (12%), Arcanobacterium haemolyticum (8%), and Corynebacterium diphtheriae (8%). Sample clustering derived from ulcer microbial composition did not show geographical patterns. Conclusions These data suggest a diverse etiology of skin ulcers in yaws-endemic areas, which may help design more accurate diagnostic tools and more effective antimicrobial treatment approaches to the cutaneous ulcer syndrome.
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- 2017
23. Re-emergence of yaws after single mass azithromycin treatment followed by targeted treatment: a longitudinal study
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Wendy Houinei, Camila González-Beiras, Alyssa E. Barry, Charmie Godornes, James Wangi, August Kapa, Sergi Sanz, Sheila A. Lukehart, Oriol Mitjà, Sibauk Bieb, Raymond Paru, Haina Abel, and Quique Bassat
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Male ,Pediatrics ,Longitudinal study ,genetic structures ,Prevalence ,Azithromycin ,Úlceres ,Communicable Diseases, Emerging ,Polymerase Chain Reaction ,Serology ,0302 clinical medicine ,Epidemiology ,030212 general & internal medicine ,Longitudinal Studies ,Child ,Children ,Ulcers ,education.field_of_study ,Treponema ,biology ,General Medicine ,3. Good health ,Anti-Bacterial Agents ,RNA, Ribosomal, 23S ,Treatment Outcome ,Child, Preschool ,Mass Drug Administration ,Female ,Macrolides ,Infants ,medicine.drug ,medicine.medical_specialty ,Adolescent ,030231 tropical medicine ,Population ,Article ,03 medical and health sciences ,Papua New Guinea ,Drug Resistance, Bacterial ,medicine ,Humans ,Treponema pallidum ,Disease Eradication ,education ,business.industry ,Genetic Variation ,Infant ,Single mass ,biology.organism_classification ,Yaws ,business - Abstract
Yaws is a substantial cause of chronic disfiguring ulcers in children in at least 14 countries in the tropics. WHO's newly adopted strategy for yaws eradication uses a single round of mass azithromycin treatment followed by targeted treatment programmes, and data from pilot studies have shown a short-term significant reduction of yaws. We assessed the long-term efficacy of the WHO strategy for yaws eradication.Between April 15, 2013, and Oct 24, 2016, we did a longitudinal study on a Papua New Guinea island (Lihir; 16 092 population) in which yaws was endemic. In the initial study, the participants were followed for 12 months; in this extended follow-up study, clinical, serological, and PCR surveys were continued every 6 months for 42 months. We used genotyping and travel history to identify importation events. Active yaws confirmed by PCR specific for Treponema pallidum was the primary outcome indicator. The study is registered with ClinicalTrials.gov, number NCT01955252.Mass azithromycin treatment (coverage rate of 84%) followed by targeted treatment programmes reduced the prevalence of active yaws from 1·8% to a minimum of 0·1% at 18 months (difference from baseline -1·7%, 95% CI, -1·9 to -1·4; p0·0001), but the infection began to re-emerge after 24 months with a significant increase to 0·4% at 42 months (difference from 18 months 0·3%, 95% CI 0·1 to 0·4; p0·0001). At each timepoint after baseline, more than 70% of the total community burden of yaws was found in individuals who had not had the mass treatment or as new infections in non-travelling residents. At months 36 and 42, five cases of active yaws, all from the same village, showed clinical failure following azithromycin treatment, with PCR-detected mutations in the 23S ribosomal RNA genes conferring resistance to azithromycin. A sustained decrease in the prevalence of high-titre latent yaws from 13·7% to1·5% in asymptomatic children aged 1-5 years old and of genetic diversity of yaws strains from 0·139 to less than 0·046 between months 24 and 42 indicated a reduction in transmission of infection.The implementation of the WHO strategy did not, in the long-term, achieve elimination in a high-endemic community mainly due to the individuals who were absent at the time of mass treatment in whom yaws reactivated; repeated mass treatment might be necessary to eliminate yaws. To our knowledge, this is the first report of the emergence of azithromycin-resistant T p pertenue and spread within one village. Communities' surveillance should be strengthened to detect any possible treatment failure and biological markers of resistance.ISDIN laboratories, Newcrest Mining Limited, and US Public Health Service National Institutes of Health.
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- 2017
24. Single-Dose Azithromycin for the Treatment of Haemophilus ducreyi Skin Ulcers in Papua New Guinea
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Rosario Martins, August Kapa, Sibauk Bieb, Sergi Sanz, Raymond Paru, Sergi Gavilán, Martí Vall-Mayans, Camila González-Beiras, Oriol Mitjà, and Wendy Houinei
- Subjects
Microbiology (medical) ,Male ,medicine.medical_specialty ,Adolescent ,medicine.drug_class ,030231 tropical medicine ,Antibiotics ,Administration, Oral ,Azithromycin ,Gastroenterology ,Polymerase Chain Reaction ,Chancroid ,Cohort Studies ,Haemophilus ducreyi ,03 medical and health sciences ,Papua New Guinea ,0302 clinical medicine ,Pharmacotherapy ,Internal medicine ,Skin Ulcer ,Clinical endpoint ,Medicine ,Humans ,030212 general & internal medicine ,Treponema pallidum ,Child ,Retrospective Studies ,biology ,business.industry ,Skin ulcer ,biology.organism_classification ,medicine.disease ,Anti-Bacterial Agents ,Infectious Diseases ,Treatment Outcome ,Female ,Public Health ,medicine.symptom ,business ,medicine.drug ,Cohort study - Abstract
Background Haemophilus ducreyi (HD) and Treponema pallidum subspecies pertenue (TP) are major causative agents of cutaneous ulcer (CU) in the tropics. Azithromycin is recommended to treat sexually transmitted HD infections and has good in vitro activity against HD strains from both genital and skin ulcers. We investigated the efficacy of oral single-dose azithromycin on HD-CU. Methods We conducted a community-based cohort study in Lihir Island, Papua New Guinea, from October 2014 through May 2016. Consenting patients with skin ulcers >1 cm in diameter were eligible for this study and had collected a lesional swab for polymerase chain reaction (PCR). All participants were treated with single-dose azithromycin (30 mg/kg) and were followed up for assessment of clinical resolution. We retrospectively classified patients according to PCR results into HD, TP, and PCR-negative groups. The primary endpoint was healing rates of HD-CU at 14 days after treatment. Results We obtained full outcome data from 246 patients; 131 (53.3%) were HD PCR positive, 37 (15.0%) were TP positive, and 78 (31.7%) were negative for all tests. Healing rates were 88.5% (95% confidence interval [CI], .82-.93) in the HD group, 78.4% [95% CI, .63-.89] in the TP group, and 74.4% (95% CI, .64-.83) in the PCR-negative group. If we included the participants with improved ulcers, the healing rates increased to 94.7%, 97.3%, and 89.7% respectively. HD cases classified as not healed all converted to HD-negative PCR. Conclusions Based upon clinical resolution and PCR conversion to HD negative, a single oral dose of azithromycin is efficacious for the treatment of HD-CU. These results have implications for the treatment of individual patients and for the use of antibiotics in public health strategies to control CU in the tropics.
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- 2017
25. Yaws Osteoperiostitis Treated with Single-Dose Azithromycin
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Kelly McClymont, Ángel González-Escalante, Oriol Mitjà, Martí Vall-Mayans, Li Ma, and Camila González-Beiras
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Benzathine benzylpenicillin ,DNA, Bacterial ,Male ,medicine.medical_specialty ,genetic structures ,030231 tropical medicine ,Azithromycin ,Single oral dose ,03 medical and health sciences ,chemistry.chemical_compound ,Periostitis ,0302 clinical medicine ,Virology ,Periosteum ,medicine ,Humans ,030212 general & internal medicine ,Treponema pallidum ,skin and connective tissue diseases ,Leg ,Treponema ,biology ,business.industry ,Central africa ,Articles ,Wrist ,medicine.disease ,biology.organism_classification ,Dermatology ,Anti-Bacterial Agents ,Infectious Diseases ,Treatment Outcome ,chemistry ,Child, Preschool ,Yaws ,Parasitology ,Syphilis ,Yaws periostitis ,business ,Tomography, X-Ray Computed ,medicine.drug - Abstract
The etiologic agent of yaws, Treponema pallidum subsp. pertenue, causes a multistage infection transmitted by nonsexual contact with the exudates from active lesions. Bone lesions in the form of osteoperiostitis are common and occur in numerous bones simultaneously in early stages. Although a multinational eradication campaign with mass administration of intramuscular benzathine benzylpenicillin in the 1950s greatly reduced its global incidence, a resurgence of yaws has occurred since around 2000 in western and central Africa and the Pacific Islands. The finding that a single oral dose of azithromycin (30 mg/kg) was as effective as benzathine benzylpenicillin prompted renewed interest by World Health Organization in 2012 toward eradication of this infection by 2020. We previously reported the excellent response to benzathine benzylpenicillin therapy for yaws osteoperiostitis. Herein, we document a confirmed case of yaws with osteoperiostitis successfully treated with single-dose azithromycin and discuss the pathology of yaws periostitis and comment on the implications of this in light of the new campaign toward yaws eradication.
- Published
- 2017
26. Taxonomy, diversity, temporal and geographical distribution of Cutaneous Leishmaniasis in Colombia: A retrospective study
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Camila González, Carolina Flórez, Juan David Ramírez, Cielo León, Carolina Hernández, and Martha S. Ayala
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0301 basic medicine ,Veterinary medicine ,030231 tropical medicine ,Colombia ,Article ,Genus: Leishmania ,03 medical and health sciences ,Molecular typing ,0302 clinical medicine ,Cutaneous leishmaniasis ,Leishmaniasis cutánea ,parasitic diseases ,medicine ,Animals ,Humans ,Psychodidae ,Leishmaniasis ,Enfermedades zoonóticas tropicales ,Leishmania ,Multidisciplinary ,biology ,Retrospective cohort study ,medicine.disease ,biology.organism_classification ,Enfermedades ,Enfermedades zoonóticas ,030104 developmental biology ,South american ,Taxonomy (biology) - Abstract
Leishmaniases are tropical zoonotic diseases, caused by kinetoplastid parasites from the genus Leishmania. New World (NW) species are related to sylvatic cycles although urbanization processes have been reported in some South American Countries such as Colombia. Currently, few studies show the relative distribution of Leishmania species related to cutaneous Leishmaniasis (CL) in South America due to the lack of accurate surveillance and public health systems. Herein, we conducted a systematic estimation of the Leishmania species causing CL in Colombia from 1980 to 2001 via molecular typing and isoenzymes. A total of 327 Leishmania isolates from humans, sandflies and reservoirs were typed as L. panamensis 61.3% (201), L. braziliensis 27.1% (88), L. lainsoni 0.6% (2), L. guyanensis 0.9% (3), L. infantum chagasi 4% (12), L. equatoriensis 0.6% (2), L. mexicana 2.1% (8), L. amazonensis 2.8% (9) and L. colombiensis 0.6% (2). This is the first report of two new Leishmania species circulating in Colombia and suggests the need to convince the Colombian government about the need to deploy and standardize tools for the species identification to provide adequate management to individuals suffering this pathology.
- Published
- 2016
27. Identification of Six New World Leishmania species through the implementation of a High-Resolution Melting (HRM) genotyping assay
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Catalina Alvarez, Camila González, Cielo León, Martha S. Ayala, Juan David Ramírez, and Carolina Hernández
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Genetic procedures ,Veterinary medicine ,Leishmania mexicana ,Limit of detection ,High-resolution Melting ,Evaluation study ,Transition temperature ,Insect vectors ,Transition Temperature ,Heat shock protein 70 ,Leishmania infantum ,Leishmania guyanensis ,Leishmaniasis ,Accuracy ,Leishmania ,Mammals ,Genetics ,Leishmania panamensis ,Protozoal dna ,biology ,Reliability ,Classification ,Polymerase chain reaction ,Algorithm ,Parasite identification ,Chemistry ,Infectious Diseases ,Genetic Techniques ,Restriction fragment length polymorphism ,Genetic techniques ,Human ,Monoclonal antibody ,Genotyping ,High resolution melting analysis ,Genotype ,Short Report ,Colombia ,Parasite isolation ,Article ,Leishmania braziliensis ,Mammal ,High Resolution Melt ,High-resolution melting ,parasitic diseases ,Animals ,Humans ,Real-time pcr ,Molecular epidemiology ,Animal ,protozoan ,Dna ,DNA, Protozoan ,Nonhuman ,biology.organism_classification ,Insect Vectors ,Multilocus enzyme electrophoresis ,Disease carrier ,Isolation and purification ,Parasitology ,Real-Time PCR ,Controlled study ,Internal transcribed spacer 1 ,Leishmania amazonensis - Abstract
Background: Leishmaniases are tropical zoonotic diseases, caused by parasites from the genus Leishmania. New World (NW) species are related to sylvatic cycles although urbanization processes have been reported in some South American Countries such as Colombia. This eco-epidemiological complexity imposes a challenge to the detection of circulating parasite species, not only related to human cases but also infecting vectors and reservoirs. Currently, no harmonized methods have been deployed to discriminate the NW Leishmania species. Findings: Herein, we conducted a systematic and mechanistic High-Resolution Melting (HRM) assay targeted to HSP70 and ITS1. Specific primers were designed that coupled with a HRM analyses permitted to discriminate six NW Leishmania species. In order to validate the herein described algorithm, we included 35 natural isolates obtained from human cases, insect vectors and mammals. Our genotyping assay allowed the correct assignment of the six NW Leishmania species (L. mexicana, L. infantum (chagasi), L. amazonensis, L. panamensis, L. guyanensis and L. braziliensis) based on reference strains. When the algorithm was applied to a set of well-characterized strains by means of PCR-RFLP, MLEE and monoclonal antibodies (MA) we observed a tailored concordance between the HRM and PCR-RFLP/MLEE/MA (KI = 1.0). Additionally, we tested the limit of detection for the HRM method showing that this is able to detect at least 10 equivalent-parasites per mL. Conclusions: This is a rapid and reliable method to conduct molecular epidemiology and host-parasite association studies in endemic areas. © 2014 Baleela et al.
- Published
- 2014
28. Using the basic reproduction number to assess the effects of climate change in the risk of Chagas disease transmission in Colombia
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Juan M. Cordovez, Camila González, Lina María Rendón, and Felipe Guhl
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Chagas disease ,Veterinary (miscellaneous) ,Climate Change ,Trypanosoma cruzi ,Basic Reproduction Number ,Climate change ,Biology ,Colombia ,Risk Assessment ,Next-generation matrix ,Effects of global warming ,Statistics ,medicine ,Animals ,Humans ,Parasite transmission ,Chagas Disease ,Models, Statistical ,Ecology ,Temperature ,medicine.disease ,Complex dynamics ,Infectious Diseases ,Insect Science ,Parasitology ,Disease transmission ,Basic reproduction number - Abstract
The dynamics of vector-borne diseases has often been linked to climate change. However the commonly complex dynamics of vector-borne diseases make it very difficult to predict risk based on vector or host distributions. The basic reproduction number ( R 0 ) integrates all factors that determine whether a pathogen can establish or not. To obtain R 0 for complex vector-borne diseases one can use the next-generation matrix (NGM) approach. We used the NGM to compute R 0 for Chagas disease in Colombia incorporating the effect of temperature in some of the transmission routes of Trypanosoma cruzi . We used R 0 to generate a risk map of present conditions and a forecast risk map at 20 years from now based on mean annual temperature (data obtained from Worldclim). In addition we used the model to compute elasticity and sensitivity indexes on all model parameters and routes of transmission. We present this work as an approach to indicate which transmission pathways are more critical for disease transmission but acknowledge the fact that results and projections strongly depend on better knowledge of entomological parameters and transmission routes. We concluded that the highest contribution to R 0 comes from transmission of the parasites from humans to vectors, which is a surprising result. In addition, parameters related to contacts between human and vectors and the efficiency of parasite transmission between them also show a prominent effect on R 0 .
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- 2014
29. Predicted altitudinal shifts and reduced spatial distribution of Leishmania infantum vector species under climate change scenarios in Colombia
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Andrea Paz, Camila González, and Cristina Ferro
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Veterinary (miscellaneous) ,Climate Change ,Climate change ,Colombia ,Spatial distribution ,Cutaneous leishmaniasis ,medicine ,Animals ,Humans ,Computer Simulation ,Leishmania infantum ,Ecological niche ,biology ,Geography ,Ecology ,Leishmaniasis ,Leishmania chagasi ,biology.organism_classification ,medicine.disease ,Insect Vectors ,Infectious Diseases ,Insect Science ,Vector (epidemiology) ,Leishmaniasis, Visceral ,Parasitology ,Topography, Medical ,Psychodidae - Abstract
Visceral leishmaniasis (VL) is caused by the trypanosomatid parasite Leishmania infantum (=Leishmania chagasi), and is epidemiologically relevant due to its wide geographic distribution, the number of annual cases reported and the increase in its co-infection with HIV. Two vector species have been incriminated in the Americas: Lutzomyia longipalpis and Lutzomyia evansi. In Colombia, L. longipalpis is distributed along the Magdalena River Valley while L. evansi is only found in the northern part of the Country. Regarding the epidemiology of the disease, in Colombia the incidence of VL has decreased over the last few years without any intervention being implemented. Additionally, changes in transmission cycles have been reported with urban transmission occurring in the Caribbean Coast. In Europe and North America climate change seems to be driving a latitudinal shift of leishmaniasis transmission. Here, we explored the spatial distribution of the two known vector species of L. infantum in Colombia and projected its future distribution into climate change scenarios to establish the expansion potential of the disease. An updated database including L. longipalpis and L. evansi collection records from Colombia was compiled. Ecological niche models were performed for each species using the Maxent software and 13 Worldclim bioclimatic coverages. Projections were made for the pessimistic CSIRO A2 scenario, which predicts the higher increase in temperature due to non-emission reduction, and the optimistic Hadley B2 Scenario predicting the minimum increase in temperature. The database contained 23 records for L. evansi and 39 records for L. longipalpis, distributed along the Magdalena River Valley and the Caribbean Coast, where the potential distribution areas of both species were also predicted by Maxent. Climate change projections showed a general overall reduction in the spatial distribution of the two vector species, promoting a shift in altitudinal distribution for L. longipalpis and confining L. evansi to certain regions in the Caribbean Coast. Altitudinal shifts have been reported for cutaneous leishmaniasis vectors in Colombia and Peru. Here, we predict the same outcome for VL vectors in Colombia. Changes in spatial distribution patterns could be affecting local abundances due to climatic pressures on vector populations thus reducing the incidence of human cases.
- Published
- 2013
30. Current and future niche of North and Central American sand flies (Diptera: psychodidae) in climate change scenarios
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Sergio Ibáñez-Bernal, Camila González, Carlos N. Ibarra-Cerdeña, Eduardo A. Rebollar-Téllez, David A. Moo-Llanes, and Janine M. Ramsey
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Range (biology) ,Climate Change ,RC955-962 ,Niche ,Climate change ,Arctic medicine. Tropical medicine ,parasitic diseases ,Animals ,Humans ,Computer Simulation ,Psychodidae ,Ecological niche ,biology ,Ecology ,Public Health, Environmental and Occupational Health ,Species diversity ,Central America ,biology.organism_classification ,Insect Vectors ,Phylogeography ,Infectious Diseases ,Geography ,Habitat ,Vector (epidemiology) ,North America ,Public aspects of medicine ,RA1-1270 ,Research Article - Abstract
Ecological niche models are useful tools to infer potential spatial and temporal distributions in vector species and to measure epidemiological risk for infectious diseases such as the Leishmaniases. The ecological niche of 28 North and Central American sand fly species, including those with epidemiological relevance, can be used to analyze the vector's ecology and its association with transmission risk, and plan integrated regional vector surveillance and control programs. In this study, we model the environmental requirements of the principal North and Central American phlebotomine species and analyze three niche characteristics over future climate change scenarios: i) potential change in niche breadth, ii) direction and magnitude of niche centroid shifts, iii) shifts in elevation range. Niche identity between confirmed or incriminated Leishmania vector sand flies in Mexico, and human cases were analyzed. Niche models were constructed using sand fly occurrence datapoints from Canada, USA, Mexico, Guatemala and Belize. Nine non-correlated bioclimatic and four topographic data layers were used as niche components using GARP in OpenModeller. Both B2 and A2 climate change scenarios were used with two general circulation models for each scenario (CSIRO and HadCM3), for 2020, 2050 and 2080. There was an increase in niche breadth to 2080 in both scenarios for all species with the exception of Lutzomyia vexator. The principal direction of niche centroid displacement was to the northwest (64%), while the elevation range decreased greatest for tropical, and least for broad-range species. Lutzomyia cruciata is the only epidemiologically important species with high niche identity with that of Leishmania spp. in Mexico. Continued landscape modification in future climate change will provide an increased opportunity for the geographic expansion of NCA sand flys' ENM and human exposure to vectors of Leishmaniases., Author Summary The present study models the niche of the most abundant sand fly species in North and Central America, including all proven and incriminated vectors of Leishmaniases, an important neglected tropical disease of the region. The expansion and elevation or centroid shifts of the species' niche are modeled for extreme (A2) and conservative (B2) climate change scenarios to 2020, 2050 and 2080. In climate change scenarios, models predict significant niche breadth changes in geographic space, principally in temperate sand fly species, while elevation shifts occur principally in tropical, and greatest, in vector species. Niche centroid shifts for individual species were predominately to the northwest, and secondarily to the northeast. The highest proportion of human population at-risk for contact with a vector species was with Lutzomyia diabolica and Lutzomyia shannoni. Despite the fact that Lutzomyia olmeca olmeca is the only confirmed vector species in Mexico, the present study demonstrates a significant niche identity between Leishmania spp. and Lutzomyia cruciata.
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- 2013
31. Intradiaphragmatic bronchopulmonary sequestration: a case report and review
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Marisol Chávez Gatica, Jorge Morales Sepúlveda, David Schnettler Rodríguez, Camila Cuevas Vergara, and Camila González Parra
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Male ,medicine.medical_specialty ,Diaphragm ,Adrenal Gland Neoplasms ,Computed tomography ,Ultrasonography, Prenatal ,Neuroblastoma ,Pregnancy ,Prenatal Diagnosis ,International literature ,Humans ,Medicine ,Bronchopulmonary Sequestration ,Laparoscopy ,Bronchopulmonary sequestration ,medicine.diagnostic_test ,business.industry ,Thoracoscopy ,Ultrasound ,Infant, Newborn ,Magnetic resonance imaging ,General Medicine ,Magnetic Resonance Imaging ,Abdominal mass ,Female ,Radiology ,medicine.symptom ,Tomography, X-Ray Computed ,business ,Lung tissue - Abstract
Bronchopulmonary sequestration is a rare congenital malformation, consisting in a mass of nonfunctioning lung tissue with no connection to the tracheobronchial tree. It can be classified into intra- and extra-lobar. Extra-lobar bronchopulmonary sequestration accounts for 25% of them; of these, only 1% are intra-diaphragmatic. There is little international literature about intra-diaphragmatic bronchopulmonary sequestration and its diagnosis and treatment remain a challenge for the surgeon. Our case is a newborn with antenatal diagnosis of an abdominal mass by ultrasound and magnetic resonance imaging (MRI) showing a left adrenal tumor that appeared to be a neuroblastoma. Postnatal computed tomography (CT) revealed the likelihood of an intra-diaphragmatic bronchopulmonary sequestration, although neuroblastoma could not be ruled out. Abdominal laparoscopy was performed in the bulging left hemidiaphragmatic area. A combined thoracoscopic approach was decided which showed that the defect was located in between both cavities. This is the first case of intra-diaphragmatic bronchopulmonary sequestration reported in Chile.El secuestro broncopulmonar es una malformación congénita rara, consistente en una masa de tejido pulmonar no funcionante sin conexión al árbol traqueobronquial. Esta puede clasificarse en intra y extralobar. El extralobar corresponde al 25% de los secuestros broncopulmonares y sólo el 1% es intradiafragmático. Existe escasa literatura internacional sobre secuestro broncopulmonar intradiafragmático, por lo que su diagnóstico y tratamiento es un desafío para el cirujano. Nuestro caso es un recién nacido con diagnóstico antenatal de una masa abdominal por ecografía y resonancia magnética nuclear, las cuales mostraron un tumor adrenal que impresiona ser un neuroblastoma. Se realizó tomografía axial computarizada postnatal donde el secuestro broncopulmonar intradiafragmático apareció como más probable. No se pudo excluir el neuroblastoma. Se realizó laparoscopía abdominal en la que se observó un bulto en el hemidiafragma izquierdo. Se decidió un abordaje toracoscópico combinado, el cual mostró que el defecto se encontraba entre ambas cavidades. Este es el primer caso reportado de secuestro broncopulmonar intradiafragmático en Chile.
- Published
- 2015
32. Spatial Distribution of Sand Fly Vectors and Eco-Epidemiology of Cutaneous Leishmaniasis Transmission in Colombia
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Cristina Ferro, Juan M. Cordovez, Ligia Lugo, Camila González, Marla López, and Patricia Fuya
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Phlebotominae ,Species distribution ,lcsh:Medicine ,Leishmaniasis, Cutaneous ,Colombia ,Prevalence ,Animals ,Humans ,Psychodidae ,lcsh:Science ,Leishmania ,Multidisciplinary ,biology ,Ecology ,lcsh:R ,Species diversity ,biology.organism_classification ,Insect Vectors ,Environmental niche modelling ,Animals, Domestic ,Vector (epidemiology) ,Enzootic ,lcsh:Q ,Seasons ,Species richness ,Research Article - Abstract
Background Leishmania is transmitted by Phlebotominae insects that maintain the enzootic cycle by circulating between sylvatic and domestic mammals; humans enter the cycles as accidental hosts due to the vector’s search for blood source. In Colombia, leishmaniasis is an endemic disease and 95% of all cases are cutaneous (CL), these cases have been reported in several regions of the country where the intervention of sylvatic areas by the introduction of agriculture seem to have an impact on the rearrangement of new transmission cycles. Our study aimed to update vector species distribution in the country and to analyze the relationship between vectors’ distribution, climate, land use and CL prevalence. Methods A database with geographic information was assembled, and ecological niche modeling was performed to explore the potential distribution of each of the 21 species of medical importance in Colombia, using thirteen bioclimatic variables, three topographic and three principal components derived from NDVI. Binary models for each species were obtained and related to both land use coverage, and a CL prevalence map with available epidemiological data. Finally, maps of species potential distribution were summed to define potential species richness in the country. Results In total, 673 single records were obtained with Lutzomyia gomezi, Lutzomyia longipalpis, Psychodopygus panamensis, Psathyromyia shannoni and Pintomyia evansi the species with the highest number of records. Eighteen species had significant models, considering the area under the curve and the jackknife results: L. gomezi and P. panamensis had the widest potential distribution. All sand fly species except for Nyssomyia antunesi are mainly distributed in regions with rates of prevalence between 0.33 to 101.35 cases per 100,000 inhabitants and 76% of collection data points fall into transformed ecosystems. Discussion Distribution ranges of sand flies with medical importance in Colombia correspond predominantly to disturbed areas, where the original land coverage is missing therefore increasing the domiciliation potential. We highlight the importance of the use of distribution maps as a tool for the development of strategies for prevention and control of diseases.
- Published
- 2015
33. Current Knowledge of Leishmania Vectors in Mexico: How Geographic Distributions of Species Relate to Transmission Areas
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Sergio Ibáñez-Bernal, Enrique Martínez-Meyer, Camila González, Víctor Sánchez-Cordero, Eduardo A. Rebollar-Téllez, Ingeborg Becker-Fauser, and A. Townsend Peterson
- Subjects
Leishmania mexicana ,law.invention ,Cutaneous leishmaniasis ,Species Specificity ,law ,Virology ,parasitic diseases ,medicine ,Animals ,Humans ,Leishmaniasis ,Mexico ,Demography ,Ecological niche ,Leishmania ,biology ,Ecology ,Articles ,medicine.disease ,biology.organism_classification ,Insect Vectors ,Infectious Diseases ,Transmission (mechanics) ,Vector (epidemiology) ,Olmeca ,Parasitology ,Psychodidae - Abstract
Leishmaniases are a group of vector-borne diseases with different clinical manifestations caused by parasites transmitted by sand fly vectors. In Mexico, the sand fly Lutzomyia olmeca olmeca is the only vector proven to transmit the parasite Leishmania mexicana to humans, which causes leishmaniasis. Other vector species with potential medical importance have been obtained, but their geographic distributions and relation to transmission areas have never been assessed. We modeled the ecological niches of nine sand fly species and projected niches to estimate potential distributions by using known occurrences, environmental coverages, and the algorithms GARP and Maxent. All vector species were distributed in areas with known recurrent transmission, except for Lu. diabolica, which appeared to be related only to areas of occasional transmission in northern Mexico. The distribution of Lu. o. olmeca does not overlap with all reported cutaneous leishmaniasis cases, suggesting that Lu. cruciata and Lu. shannoni are likely also involved as primary vectors in those areas. Our study provides useful information of potential risk areas of leishmaniasis transmission in Mexico.
- Published
- 2011
34. Evaluation of community-based strategies for Aedes aegypti control inside houses
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Clara B, Ocampo, Camila, González, Carlos A, Morales, Mauricio, Pérez, Dawn, Wesson, and Charles S, Apperson
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Adult ,Health Knowledge, Attitudes, Practice ,Insecticides ,Mosquito Control ,Endemic Diseases ,Bacillus thuringiensis ,Community Participation ,Pupa ,Urban Health ,Dengue Virus ,Sampling Studies ,Insect Vectors ,Dengue ,Insecticide Resistance ,Random Allocation ,Aedes ,Larva ,Surveys and Questionnaires ,Housing ,Animals ,Humans ,Female ,Pest Control, Biological ,Program Evaluation - Abstract
Dengue viruses transmitted principally by the urban mosquito Aedes aegypti, cause one of the major public health problems confronting tropical cities. Insecticide spraying has been the mainstay of mosquito control; however, its continuous use has selected for resistance. Other important methods of control involve community participation.This study evaluated two control methods for Ae. aegypti that can be used by the community: Lethal ovitraps (LOs) and Bacillus thuringiensis var israeliensis (Bti) briquettes.The project study was carried out in four similar neighborhoods within a representative district in the city of Cali, Colombia. Three interventions (LO, Bti, LO+Bti plus education and one control (education only) area were evaluated for efficacy in post-intervention entomological surveys. Additionally, entomological indices were also compared to results from a pre-intervention survey carried out on a sample of city blocks in the same neighborhoods. Relative vector abundance in relation to weather conditions using the same entomological sampling methods was compared.The interventions did not achieve significant differences in vector abundance among the treatments. However, the interventions achieved a significant reduction in entomological indices compared with those observed during the pre-intervention survey: House index 15.1% vs. 8.5%, mean pupae per house 1.15 vs. 0.073, and Adult index 56.3% vs. 34.8% (p0.05).The lack of significant differences among the interventions, and between treated and control blocks suggested that educational activities together with periodic visits to the houses produced similar reductions of immature and adult Aedes aegypti.
- Published
- 2010
35. A global public database of disease vector and reservoir distributions
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Sahotra Sarkar, Alexander Moffett, Stavana E. Strutz, Nelson Guda, María C. Carrasquilla Ferro, Víctor Sánchez-Cordero, and Camila González
- Subjects
Infectious Diseases/Epidemiology and Control of Infectious Diseases ,Disease reservoir ,lcsh:Arctic medicine. Tropical medicine ,Databases, Factual ,lcsh:RC955-962 ,Public Health and Epidemiology/Infectious Diseases ,Disease Vectors ,Biology ,From Innovation to Application ,Infectious Diseases/Viral Infections ,Animals ,Humans ,Disease Reservoirs ,Malarial parasites ,Internet ,lcsh:Public aspects of medicine ,Infectious Diseases/Protozoal Infections ,Public Health, Environmental and Occupational Health ,lcsh:RA1-1270 ,Public Health and Epidemiology/Global Health ,Disease control ,Geographic distribution ,Infectious Diseases ,Infectious Diseases/Neglected Tropical Diseases ,Ecology/Spatial and Landscape Ecology ,Humanities - Abstract
Alexander Moffett is with UT Austin, Stavana Strutz is with UT Austin, Nelson Guda is with UT Austin, Camila Gonzalez is with National Autonomous University of Mexico, Maria Cristina Ferro is with the National Institute of Health Bogota, Victor Sanchez-Cordero is with National Autonomous University of Mexico, Sahotra Sarkar is with UT Austin.
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- 2009
36. Climate Change and Risk of Leishmaniasis in North America: Predictions from Ecological Niche Models of Vector and Reservoir Species
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Sahotra Sarkar, Stavana E. Strutz, Víctor Sánchez-Cordero, Constantino González-Salazar, Ophelia Wang, and Camila González
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Ecology/Global Change Ecology ,lcsh:Arctic medicine. Tropical medicine ,lcsh:RC955-962 ,Range (biology) ,Climate Change ,Population ,Public Health and Epidemiology ,Public Health and Epidemiology/Infectious Diseases ,Climate change ,Animals ,Humans ,education ,Leishmaniasis ,Ecological niche ,education.field_of_study ,Ecology ,biology ,lcsh:Public aspects of medicine ,Public Health, Environmental and Occupational Health ,Computational Biology ,lcsh:RA1-1270 ,Public Health and Epidemiology/Global Health ,Models, Theoretical ,biology.organism_classification ,Insect Vectors ,Infectious Diseases ,Infectious Diseases/Neglected Tropical Diseases ,Habitat ,Vector (epidemiology) ,North America ,Biological dispersal ,Psychodidae ,Lutzomyia ,Research Article - Abstract
Background Climate change is increasingly being implicated in species' range shifts throughout the world, including those of important vector and reservoir species for infectious diseases. In North America (México, United States, and Canada), leishmaniasis is a vector-borne disease that is autochthonous in México and Texas and has begun to expand its range northward. Further expansion to the north may be facilitated by climate change as more habitat becomes suitable for vector and reservoir species for leishmaniasis. Methods and Findings The analysis began with the construction of ecological niche models using a maximum entropy algorithm for the distribution of two sand fly vector species (Lutzomyia anthophora and L. diabolica), three confirmed rodent reservoir species (Neotoma albigula, N. floridana, and N. micropus), and one potential rodent reservoir species (N. mexicana) for leishmaniasis in northern México and the United States. As input, these models used species' occurrence records with topographic and climatic parameters as explanatory variables. Models were tested for their ability to predict correctly both a specified fraction of occurrence points set aside for this purpose and occurrence points from an independently derived data set. These models were refined to obtain predicted species' geographical distributions under increasingly strict assumptions about the ability of a species to disperse to suitable habitat and to persist in it, as modulated by its ecological suitability. Models successful at predictions were fitted to the extreme A2 and relatively conservative B2 projected climate scenarios for 2020, 2050, and 2080 using publicly available interpolated climate data from the Third Intergovernmental Panel on Climate Change Assessment Report. Further analyses included estimation of the projected human population that could potentially be exposed to leishmaniasis in 2020, 2050, and 2080 under the A2 and B2 scenarios. All confirmed vector and reservoir species will see an expansion of their potential range towards the north. Thus, leishmaniasis has the potential to expand northwards from México and the southern United States. In the eastern United States its spread is predicted to be limited by the range of L. diabolica; further west, L. anthophora may play the same role. In the east it may even reach the southern boundary of Canada. The risk of spread is greater for the A2 scenario than for the B2 scenario. Even in the latter case, with restrictive (contiguous) models for dispersal of vector and reservoir species, and limiting vector and reservoir species occupancy to only the top 10% of their potential suitable habitat, the expected number of human individuals exposed to leishmaniasis by 2080 will at least double its present value. Conclusions These models predict that climate change will exacerbate the ecological risk of human exposure to leishmaniasis in areas outside its present range in the United States and, possibly, in parts of southern Canada. This prediction suggests the adoption of measures such as surveillance for leishmaniasis north of Texas as disease cases spread northwards. Potential vector and reservoir control strategies—besides direct intervention in disease cases—should also be further investigated., Author Summary We explored the consequences of climate change for the spread of leishmaniasis in North America. We modeled the distribution of two sand fly vector and four rodent reservoir species found in northern México and the southern United States. Models were based on occurrence data and environmental and topographic layers. Successful models were projected to 2020, 2050, and 2080 using an extreme (A2) and a conservative (B2) future climate scenario. We predicted potential range shifts of vector and reservoir species varying assumptions about dispersal ability and capacity to persist in habitats with different degrees of ecological suitability. Even with the most conservative assumptions the distributions of both vector and reservoir species expand northwards, potentially reaching as far as southern Canada in the east. Assuming that at least one vector and one reservoir species must be present for a parasite cycle, the extent of this shift is predicted to be controlled by the availability of suitable habitat for sand fly vector species. Finally, we computed the human population potentially exposed to leishmaniasis because of these range shifts. Even in the most optimistic scenario we found that twice as many individuals could be exposed to leishmaniasis in North America in 2080 compared to today.
- Published
- 2010
37. Effectiveness of single-dose azithromycin to treat latent yaws: a longitudinal comparative cohort study
- Author
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Sibauk Bieb, Reman Kolmau, August Kapa, Wendy Houinei, Oriol Mitjà, Charmie Godornes, Camila González-Beiras, James Wangi, Sergi Sanz, Sheila A. Lukehart, Raymond Paru, Quique Bassat, Haina Abel, and Kingsley Asiedu
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Male ,medicine.medical_specialty ,Adolescent ,genetic structures ,030231 tropical medicine ,Population ,Azithromycin ,Polymerase Chain Reaction ,Rapid plasma reagin ,Serology ,Cohort Studies ,Papua New Guinea ,03 medical and health sciences ,0302 clinical medicine ,Clinical trials ,Radiation victims ,Internal medicine ,medicine ,Clinical endpoint ,Humans ,Longitudinal Studies ,Treponema pallidum ,030212 general & internal medicine ,Child ,education ,skin and connective tissue diseases ,education.field_of_study ,medicine.diagnostic_test ,Transmission (medicine) ,business.industry ,lcsh:Public aspects of medicine ,Absolute risk reduction ,lcsh:RA1-1270 ,General Medicine ,Anti-Bacterial Agents ,Surgery ,body regions ,Víctimes de radiacions ,Child, Preschool ,Yaws ,Female ,business ,medicine.drug ,Cohort study ,Assaigs clínics - Abstract
BACKGROUND: Treatment of latent yaws is a crucial component of the WHO yaws eradication strategy to prevent relapse and the resulting transmission to uninfected children. We assessed the effectiveness of single-dose azithromycin to treat patients with latent yaws. METHODS: This population-based cohort study included children (age /=1:8) latent or active yaws, between April, 2013, and May, 2015. Latent yaws was defined as lack of suspicious skin lesions or presence of ulcers negative for Treponema pallidum subsp pertenue on PCR, and active yaws was defined as ulcers positive for T pertenue on PCR. All children received one oral dose of 30 mg/kg azithromycin. The primary endpoint was serological cure, defined as a two-dilution decrease in rapid plasma reagin titre by 24 months after treatment. Treatment of latent yaws was taken to be non-inferior to that of active yaws if the lower limit of the two-sided 95% CI for the difference in rates was higher than or equal to -10%. This study is registered with ClinicalTrials.gov, number NCT01955252. FINDINGS: Of 311 participants enrolled, 273 (88%; 165 with latent yaws and 108 with active yaws) completed follow-up. The primary endpoint was achieved in 151 (92%) participants with latent yaws and 101 (94%) with active yaws (risk difference -2.0%, 95% CI -8.3 to 4.3), meeting the prespecified criteria for non-inferiority. INTERPRETATION: On the basis of decline in serological titre, oral single-dose azithromycin was effective in participants with latent yaws. This finding supports the WHO strategy for the eradication of yaws based on mass administration of the entire endemic community irrespective of clinical status. FUNDING: Newcrest Mining Limited and ISDIN laboratories.
38. Haemophilus ducreyi DNA is detectable on the skin of asymptomatic children, flies and fomites in villages of Papua New Guinea
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Quique Bassat, Raymond Paru, Sergi Sanz, Paul Advent, Eric Q. Mooring, Sheila A. Lukehart, Wendy Houinei, August Kapa, Sivauk Bieb, Ronald Watup, Charmie Godornes, Camila González-Beiras, Stanley M. Spinola, Oriol Mitjà, and Sascha Knauf
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Bacterial Diseases ,Male ,0301 basic medicine ,Medicina tropical ,Artificial Gene Amplification and Extension ,Azithromycin ,Skin infection ,Pathology and Laboratory Medicine ,urologic and male genital diseases ,Polymerase Chain Reaction ,Treponematoses ,law.invention ,Haemophilus ducreyi ,0302 clinical medicine ,Medical microbiology ,Tropical medicine ,law ,Bacterial genetics ,Medicine and Health Sciences ,Child ,Treponema Pallidum ,DNA extraction ,Children ,Polymerase chain reaction ,Skin ,Ulcers ,Treponema ,biology ,integumentary system ,lcsh:Public aspects of medicine ,Leg Ulcer ,female genital diseases and pregnancy complications ,Bacterial Pathogens ,Anti-Bacterial Agents ,3. Good health ,Infectious Diseases ,Medical Microbiology ,Child, Preschool ,Fomites ,Female ,Pathogens ,medicine.symptom ,Infants ,Research Article ,Neglected Tropical Diseases ,Skin Infections ,DNA, Bacterial ,medicine.medical_specialty ,lcsh:Arctic medicine. Tropical medicine ,Adolescent ,lcsh:RC955-962 ,030231 tropical medicine ,Haemophilus ,Dermatology ,Research and Analysis Methods ,Microbiology ,Asymptomatic ,Chancroid ,03 medical and health sciences ,Papua Nova Guinea ,Papua New Guinea ,Signs and Symptoms ,Extraction techniques ,Diagnostic Medicine ,medicine ,Animals ,Humans ,Molecular Biology Techniques ,Molecular Biology ,Microbial Pathogens ,Gram Negative Bacteria ,Genètica bacteriana ,Bacteria ,Diptera ,Organisms ,Public Health, Environmental and Occupational Health ,Biology and Life Sciences ,Bacteriology ,lcsh:RA1-1270 ,Tropical Diseases ,biology.organism_classification ,medicine.disease ,Cross-Sectional Studies ,Logistic Models ,030104 developmental biology ,Yaws ,Asymptomatic Diseases - Abstract
Background Haemophilus ducreyi and Treponema pallidum subsp. pertenue are major causes of leg ulcers in children in Africa and the Pacific Region. We investigated the presence of DNA (PCR positivity) from these bacteria on asymptomatic people, flies, and household linens in an endemic setting. Methodology/Principal findings We performed a cross-sectional study in rural villages of Lihir Island, Papua New Guinea during a yaws elimination campaign. Participants were asymptomatic subjects recruited from households with cases of leg ulcers, and from households without cases of leg ulcers. We rubbed swabs on the intact skin of the leg of asymptomatic individuals, and collected flies and swabs of environmental surfaces. All specimens were tested by PCR for H. ducreyi and T. p. pertenue DNA. Of 78 asymptomatic participants that had an adequate specimen for DNA detection, H. ducreyi-PCR positivity was identified in 16 (21%) and T. p. pertenue-PCR positivity in 1 (1%). In subgroup analyses, H. ducreyi-PCR positivity did not differ in participants exposed or not exposed to a case of H. ducreyi ulcer in the household (24% vs 18%; p = 0.76). Of 17 cultures obtained from asymptomatic participants, 2 (12%) yielded a definitive diagnosis of H. ducreyi, proving skin colonization. Of 10 flies tested, 9 (90%) had H. ducreyi DNA and 5 (50%) had T. p. pertenue DNA. Of 6 bed sheets sampled, 2 (33%) had H. ducreyi DNA and 1 (17%) had T. p. pertenue DNA. Conclusions/Significance This is the first time that H. ducreyi DNA and colonization has been demonstrated on the skin of asymptomatic children and that H. ducreyi DNA and T. p. pertenue DNA has been identified in flies and on fomites. The ubiquity of H. ducreyi in the environment is a contributing factor to the spread of the organism., Author summary Children in rural communities of tropical countries often suffer skin ulcers that are caused by the bacteria Haemophilus ducreyi–causative agent of chancroid- and Treponema pallidum subsp. pertenue -causative agent of yaws-. The currently recommended strategy for yaws eradication is one round of mass drug administration (MDA) with azithromycin. We attempted to find reasons for the limited impact of yaws MDA on the prevalence of H. ducreyi leg ulcers by examining potential sources of infection in healthy carriers, flies, and bed linen. H. ducreyi DNA was found in skin swabs from 20% of asymptomatic children, in 9/10 flies, and 3/6 bed sheets from the houses of children with ulcers. While H. ducreyi DNA has been detected in the genital tract of asymptomatic women without genital ulcers, this is the first report of such detection on the skin of asymptomatic individuals. Importantly, skin cultures obtained from two asymptomatic children yielded viable H. ducreyi, confirming colonization and a potential reservoir of infection. If confirmed to contain viable bacteria, flies and fomites may also contribute to the continued presence of this infection after mass treatment with azithromycin. Our findings provide evidence that persistence of H. ducreyi ulcers after antibiotic MDA is due to the ubiquity of the organism in the environment. Improved hygiene and additional strategies such as repeated rounds of MDA could be able to control such a reservoir.
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