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Background: Acute undifferentiated febrile illness is a common challenge for clinicians, especially in tropical and subtropical countries. Incorrect or delayed diagnosis of febrile patients may result in medical complications or preventable deaths. Common causes of acute undifferentiated febrile illness in Colombia include leptospirosis, rickettsioses, dengue fever, malaria, chikungunya, and Zika virus infection. In this study, we described the acute undifferentiated febrile illness in postmortem patients reported as suspected cases of leptospirosis through the national leptospirosis surveillance in Colombia, 2016–2019. Methodology/principal findings: We retrospectively analyze human fresh and formalin-fixed tissue samples from fatal suspected leptospirosis cases reported by the Public Health Laboratories in Colombia. Leptospirosis confirmation was made by immunohistochemistry, real-time polymerase chain reaction (PCR) in the tissue samples. In some cases, the serum sample was used for confirmation by Microagglutination test (MAT). Simultaneously, tissue samples were tested by PCR for the most common viral (dengue, Zika, and chikungunya), bacterial (Brucella spp., and Rickettsia spp.), and parasitic (malaria). Fresh tissue samples from 92 fatal suspected leptospirosis cases were reported to the National Reference Laboratory from 22/32 departments in Colombia. We confirmed leptospirosis in 27% (25/92) of cases. Other pathogens identified by real-time PCR were Brucella spp. (10.9%), Rickettsia spp. (14.1%), and dengue (2.2%). Dengue (6.9%), hepatitis (3.5%), and Yellow Fever cases (2.2%) were detected by the pathology. All patients were negative for chikungunya and Plasmodium spp. Most cases were classified as undifferentiated febrile illnesses (45.7%; 42/92). Conclusions/Significance: This study underscores the importance of early and accurate recognition of leptospirosis to prevent mortalities. Moreover, it draws attention to the existence of other febrile syndromes in Colombia, including rickettsiosis and brucellosis, that currently lack sufficient human surveillance and regular reporting. Expanding laboratory surveillance to include viruses such as Hantavirus, Mayaro virus, Oropouche virus, and West Nile virus is crucial. Author summary: Leptospirosis is a potentially fatal disease caused by the bacteria Leptospira. Its signs and symptoms typically appear one to two weeks following infection, range from mild (e.g., fever, headache) to severe (e.g., meningitis). Despite knowledge of risk factors for leptospirosis, there are still significant gaps in knowledge about symptoms, infection routes, and risk. A correct and timely diagnosis of leptospirosis could potentially avoid medical complications or death but is challenging due to non-specific presentation and limited availability of diagnostics. This is particularly difficult in a tropical country where acute undifferentiated febrile illnesses can be caused by many pathogens. One such country is Colombia, where leptospirosis is endemic. In this study, we retrospectively study acute undifferentiated febrile illness in 92 postmortem cases reported as suspected leptospirosis cases through the national leptospirosis surveillance in Colombia, 2016–2019. Only a small proportion (27%) of cases were confirmed as leptospirosis; other etiologies including dengue, hepatitis, and yellow fever were found. However, 45.7% of cases were acute undifferentiated febrile illness, underscoring diagnostic limitations common in the tropics, and the need to recognize local pathogens and clinical characteristics to perform early presumptive diagnosis in cases with acute undifferentiated febrile illness. [ABSTRACT FROM AUTHOR]

Background: Leptospirosis is a common zoonoses and is a major global public health threat. Most cases are mild, typically presenting as a non-specific acute febrile illness. However, leptospirosis can have life-threatening manifestations, including pulmonary hemorrhage syndrome, and acute kidney injury. In Colombia, notification and lab-confirmation of suspected human cases are mandatory. However, little is known about the demographic and clinical factors associated with severe leptospirosis, which could help to reduce clinical complications and mortality. Our aim was to identify risk factors associated with severe leptospirosis, intensive care unit (ICU) admission, and mortality in lab-confirmed cases in Colombia, 2015–2020. Methods and findings: We analyzed 201 lab-confirmed human leptospirosis cases by microagglutination test. We used a logistic regression to identify the demographic and clinical risk factors associated with severe leptospirosis, admission to ICU, and death. Most leptospirosis confirmed cases occurred in men (85.6%); the mean age was 36.7 years. We classified severe cases (43.3%) by clinical manifestations as renal (29.9%) and liver (27.4%) failure, multiple-organ failure (24.4%), septic shock (24.4%), Weil syndrome (18.4%), pulmonary hemorrhage (18.4%), and meningitis (2.5%), admitted to the ICU (30.3%), and fatal (8.5%). Clinical conditions associated with severe leptospirosis were dyspnea (OR: 5.54; 95% CI: 1.46 to 20.98), tachycardia (OR:9.69; 95% CI: 15.96 to 58.8), and rash (OR: 10.25; 95% CI: 25.01 to 42.08). Conclusions: We identified demographic characteristics and clinical symptoms associated with severe leptospirosis in Colombia. We hope these results can support clinicians in providing timely treatment to leptospirosis patients to avoid preventable medical complications or deaths. Author summary: Leptospirosis is a neglected tropical disease and a public health concern worldwide. Infection in humans usually occurs through direct or indirect contact with the urine of infected animals. Most leptospirosis cases are mild, but between 5–15% of cases can be severe and even fatal, primarily due to delays in diagnosis, misrecognition, inadequate treatment, or pathogenicity of some strains. The factors associated with severity could be used to support triaging and avoid preventable medical complications or death. Colombia is an endemic country for leptospirosis, with mandatory laboratory surveillance. Our objective was to determine the demographic and clinical risk factors associated with severe leptospirosis. We used a unique dataset of 201 lab-confirmed leptospirosis cases notified to the National Reference Laboratory with a reported clinical history from several regions in Colombia. The cases presented severe illness (43.3%), ICU admission (30.3%), and fatal (8.5%). Severe leptospirosis was associated with dyspnea, tachycardia, and rash; fatal cases were associated with jaundice. We hope these results raise awareness among healthcare workers and support clinicians in avoiding preventable medical complications or death in human leptospirosis in Colombia and elsewhere. [ABSTRACT FROM AUTHOR]

To mitigate the coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), vaccines have been rapidly developed and introduced in many countries. In Colombia, the population was vaccinated with four vaccines. Therefore, this research aimed to determine the ability of the vaccines introduced in the National Vaccination Plan to prevent SARS-CoV-2 infection and induce seroconversion and sought to investigate the longevity of antibodies in the blood. We conducted a prospective, nonprobabilistic, consecutive cross-sectional cohort study in a population with access to vaccination with CoronaVac, Ad26.COV2.S, AZD1222, and BNT162b2 from March 2021 to March 2022. The study included 1327 vaccinated people. A plurality of participants were vaccinated with BNT162b2 (36.1%; n = 480), followed by Ad26.COV2.S (26.9%; n = 358), CoronaVac (24%; n = 331), and AZD1222 (11.9%; n = 158). The crude seroprevalence on day zero varied between 18.1% and 57.8%. Participants who received BNT162b2 had a lower risk of SARS-CoV-2 infection than those who received the other vaccines. Participants who were immunized with BNT162b2 and AZD1222 had a higher probability of losing reactivity on day 210 after receiving the vaccine. [ABSTRACT FROM AUTHOR]

The present research aimed to identify and discuss the social representations of trans women related to gender identity and transphobia in Brazil and Colombia. In this study participated 43 Trans women, 22 from Brazil, aged between 18 and 55 years (M=29.09, SD=8.53) and 21 from Colombia, aged between 21 and 41 years (M=28.19, SD=7.63). This study adopted a qualitative approach in which semi-structured interviews were used. The data were analyzed by the Iramuteq software, which identified the social representations in classes. The results showed what the participants understood about transphobia and how they regarded their experiences with this gender identity. The participants presented negative social representations, aiming at their personal experiences related to their social context. Themes related to violence, discrimination, prejudice, denial of rights and family support emerged from both the Brazilian and Colombian sample. Implications for Tran´s quality of life are discussed. [ABSTRACT FROM AUTHOR]

Introduction: Burnout syndrome has been recently included in the 11th revision of the International Classification of Diseases (ICD-11) as an occupational phenomenon. This syndrome has often been studied in the occupational context, but very little research has been conducted on sex workers. The present study examined the prevalence of burnout in cisgender and transgender women from Colombia for whom no laws regulate their job. It also analyzed the relation of burnout with sociodemographic variables and working conditions: number of working hours/week, monthly income, number of clients, experience as sex workers, and clients' sex. Methods: We examined data from 98 sex workers using non probabilistic sampling. Self-reported measures of burnout syndrome were administered. Results: Our results indicated that a considerable amount of women experience high burnout levels. However, 43.9% of the transgender women reported considerable personal accomplishment. Lower level of education and less income were related to more burnout, while the women who worked fewer years as sex workers reported less personal accomplishment. Conclusions: These findings shed light on sex workers' burnout to raise awareness, improve their protection, and move toward regulatory laws that increase their safety and protection. Policy Implications: Some implications may emerge which comprehends (1) security and safety, (2) whether performing sex work is deliberate or pressured, and (3) protective working conditions. [ABSTRACT FROM AUTHOR]