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The diagnosis of fungal Neglected Tropical Diseases (NTD) is primarily based on initial visual recognition of a suspected case followed by confirmatory laboratory testing, which is often limited to specialized facilities. Although molecular and serodiagnostic tools have advanced, a substantial gap remains between the desirable and the practical in endemic settings. To explore this issue further, we conducted a survey of subject matter experts on the optimal diagnostic methods sufficient to initiate treatment in well-equipped versus basic healthcare settings, as well as optimal sampling methods, for three fungal NTDs: mycetoma, chromoblastomycosis, and sporotrichosis. A survey of 23 centres found consensus on the key role of semi-invasive sampling methods such as biopsy diagnosis as compared with swabs or impression smears, and on the importance of histopathology, direct microscopy, and culture for mycetoma and chromoblastomycosis confirmation in well-equipped laboratories. In basic healthcare settings, direct microscopy combined with clinical signs were reported to be the most useful diagnostic indicators to prompt referral for treatment. The survey identified that the diagnosis of sporotrichosis is the most problematic with poor sensitivity across the most widely available laboratory tests except fungal culture, highlighting the need to improve mycological diagnostic capacity and to develop innovative diagnostic solutions. Fungal microscopy and culture are now recognized as WHO essential diagnostic tests and better training in their application will help improve the situation. For mycetoma and sporotrichosis, in particular, advances in identifying specific marker antigens or genomic sequences may pave the way for new laboratory-based or point-of-care tests, although this is a formidable task given the large number of different organisms that can cause fungal NTDs.

Las sales disueltas en aguas freáticas y la proximidad de un río y costas marinas son condiciones que generan acumulación de sales en el suelo. El objetivo del trabajo fue estudiar la tendencia de la salinidad de las aguas freáticas someras en el área de influencia de la desembocadura del río Sinú en Córdoba-Colombia. El área de estudio de 82 km² se subdividió en cuatro localidades próximas a la desembocadura del río Sinú, donde se instalaron 39 pozos de observación distribuidos en 25 pozos en vértices principales con espaciamiento de 2 km entre sí y 14 en vértices auxiliares con espaciamiento de 1 km respecto de los principales. Para el muestreo de las aguas freáticas se definieron los periodos correspondientes a la época seca y lluviosa del año. El análisis químico de las muestras de agua se realizó en el Laboratorio de Suelos y Aguas de la Universidad de Córdoba. En las muestras se determinó la conductividad eléctrica (CE), pH, Ca, Mg, Na, K, HCO3, CO3 y SO4. Los datos obtenidos fueron analizados mediante análisis de varianza y pruebas de separación de medias (Tukey) (p≤0.05), además análisis de correlación simple entre CE e iones solubles y la estimación de modelos de CE por el método de regresión por pasos (The Stepwise regresión procedure) y clasificación de las aguas freáticas basándose en la contribución de cada variable en los modelos. Los resultados indican que las aguas son marcadamente salinas en localidades próximas a la desembocadura del río Sinú y asociadas a los niveles de iones Cl, Na y Mg. Los modelos de CE calculados para las localidades presentan R² ≥ 0,94; indicando alto grado de confiabilidad para la estimación de la CE, igualmente se determinó que el tipo de aguas que predomina son las cloruradas en el periodo lluvioso y en el periodo seco no predomina ningún tipo de sal., The dissolved salts in groundwater and proximity to a river and coastal seas are conditions that generate accumulation of salts in the soil. The objective was to study the trend of the salinity of the shallow groundwater in the catchment area of the river mouth of Sinú River in Cordoba - Colombia. The study area of 82 km² was divided into four locations near the river mouth of the Sinú River, where 39 observation wells distributed in 25 wells in main vertices with spacing of 2 km apart and 14 auxiliary vertices with spacing 1 km of the main. For the sampling of groundwater two periods were chosen and corresponded to season of dry and rainy seasons. Chemical analysis was performed in the Laboratory of Soil and Water at the University of Córdoba. In the samples were evaluated the electrical conductivity (EC), pH, Ca, Mg, Na, K, HCO3, CO3 and SO4. The data obtained were analyzed by analysis of variance and tests separation of means (Tukey) (p ≤ 0.05). Simple correlation analysis between CE and soluble ions and estimating EC models by the method of regression by Steps (The Stepwise regression procedure) and water classification based on the contribution of each variable in the models. The results indicate that the water is strongly saline in locations near the river mouth of the Sinú River and associated levels to ions Cl, Na and Mg. The CE models calculated for localities have R² ≥ 0.94 indicating high reliability for estimating the EC. Also were found that the predominant types of waters are as chloride classified in the rainy season and the dry season not prevails any salt.

Contains fulltext : 137488.pdf (publisher's version ) (Open Access)

Contains fulltext : 137491.pdf (publisher's version ) (Open Access), Although epidemiological cutoff values (ECVs) have been established for Candida spp. and the triazoles, they are based on MIC data from a single laboratory. We have established ECVs for eight Candida species and fluconazole, posaconazole, and voriconazole based on wild-type (WT) MIC distributions for isolates of C. albicans (n=11,241 isolates), C. glabrata (7,538), C. parapsilosis (6,023), C. tropicalis (3,748), C. krusei (1,073), C. lusitaniae (574), C. guilliermondii (373), and C. dubliniensis (162). The 24-h CLSI broth microdilution MICs were collated from multiple laboratories (in Canada, Brazil, Europe, Mexico, Peru, and the United States). The ECVs for distributions originating from >/=6 laboratories, which included >/=95% of the modeled WT population, for fluconazole, posaconazole, and voriconazole were, respectively, 0.5, 0.06 and 0.03 mug/ml for C. albicans, 0.5, 0.25, and 0.03 mug/ml for C. dubliniensis, 8, 1, and 0.25 mug/ml for C. glabrata, 8, 0.5, and 0.12 mug/ml for C. guilliermondii, 32, 0.5, and 0.25 mug/ml for C. krusei, 1, 0.06, and 0.06 mug/ml for C. lusitaniae, 1, 0.25, and 0.03 mug/ml for C. parapsilosis, and 1, 0.12, and 0.06 mug/ml for C. tropicalis. The low number of MICs (<100) for other less prevalent species (C. famata, C. kefyr, C. orthopsilosis, C. rugosa) precluded ECV definition, but their MIC distributions are documented. Evaluation of our ECVs for some species/agent combinations using published individual MICs for 136 isolates (harboring mutations in or upregulation of ERG11, MDR1, CDR1, or CDR2) and 64 WT isolates indicated that our ECVs may be useful in distinguishing WT from non-WT isolates.

The classic statistics and geo-statistics are some of the analysis tools of soil saltiness that contribute to the identification of affected areas, monitoring the space-temporary variations, and the formulation of management strategies. The objective of this study was to generate and validate models for the electric conductivity estimation of the soil saturation extract (EC) on the area of influence of the Sinu River mouth in dry and rainy periods. The study area of 82 km² was divided into four locations near the river mouth of the Sinu River, where 39 observation wells distributed in 25 wells in main vertices with spacing of 2 km apart and 14 auxiliary vertices with spacing 1 km of the main. For the sampling of groundwater two periods were chosen and corresponded to season of dry and rainy seasons. In the samples were evaluated the electrical conductivity (EC), pH, Ca, Mg, Na, K, HCO3, CO3 and SO4. The data obtained were subjected to simple correlation analysis between the EC and the cations and anions present in the saturation extract. The estimating the models on CE was performed by the method of stepwise regression (The Stepwise regression procedure) and its validation was performed using the chi-square test between EC values generated by the models and that obtained in soil samples. The results indicate a highly significant correlation between the EC and the contents of Cl, Na and Mg ions. The CE models calculated for the depths and periods have R² between 0.84 and 0.96, indicating a high degree of reliability for the estimation of the EC. Similarly, the contribution of each ion on the models was determined, which predominantly were Cl, Na and Mg., La estadística clásica y geoestadística son algunas de las herramientas para el análisis de la salinidad de suelos que contribuyen en la identificación de áreas afectadas, monitoreo de variaciones espacio-temporales y la formulación de estrategias de manejo. El objetivo del trabajo fue generar y validar modelos para estimar la conductividad eléctrica de los suelos ubicados en área de influencia de la desembocadura del río Sinú en Córdoba, Colombia. En el área de estudio de 82 km² se instalaron 25 pozos en vértices principales con espaciamiento de 2 km entre sí y 14 en vértices auxiliares con espaciamiento de 1 km respecto de los principales. Próximo a cada vértice fueron instalados sistemáticamente 39 pozos de observación, en los cuales se colectaron muestras de suelos hasta los 50 cm de profundidad, durante 2002 a 2008. En las muestras de suelos se determinó la conductividad eléctrica (CE) de los iones Ca, Mg, Na, K, HCO3, CO3 y SO4 en pasta de saturación. Los datos obtenidos fueron sometidos a análisis de correlación simple, entre la CE y los cationes y aniones presentes en el extracto de saturación. La estimación de los modelos de CE se realizó por el método de regresión por pasos (The Stepwise regresión procedure) y su validación se realizó mediante la prueba chi-cuadrado entre valores de CE generados por los modelos y la obtenida en muestras de suelos. Los resultados indican una alta y significativa correlación entre la CE y los contenidos de iones Cl, Na y Mg. Los modelos de CE calculados para las profundidades y periodos presentan R² entre 0,84 y 0,96, indicando alto grado de confiabilidad para la estimación de la CE. De igual forma se determinó la contribución de cada ion sobre los modelos, donde fueron predominantes el Cl, Na y Mg.

Although epidemiological cutoff values (ECVs) have been established for Candida spp. and the triazoles, they are based on MIC data from a single laboratory. We have established ECVs for eight Candida species and fluconazole, posaconazole, and voricona- zole based on wild-type (WT) MIC distributions for isolates of C. albicans ( n 11,241 isolates), C. glabrata (7,538), C. parapsi- losis (6,023), C. tropicalis (3,748), C. krusei (1,073), C. lusitaniae (574), C. guilliermondii (373), and C. dubliniensis (162). The 24-h CLSI broth microdilution MICs were collated from multiple laboratories (in Canada, Brazil, Europe, Mexico, Peru, and the United States). The ECVs for distributions originating from > 6 laboratories, which included > 95% of the modeled WT popula- tion, for fluconazole, posaconazole, and voriconazole were, respectively, 0.5, 0.06 and 0.03 g/ml for C. albicans , 0.5, 0.25, and 0.03 g/ml for C. dubliniensis , 8, 1, and 0.25 g/ml for C. glabrata , 8, 0.5, and 0.12 g/ml for C. guilliermondii , 32, 0.5, and 0.25 g/ml for C. krusei , 1, 0.06, and 0.06 g/ml for C. lusitaniae , 1, 0.25, and 0.03 g/ml for C. parapsilosis , and 1, 0.12, and 0.06 g/ml for C. tropicalis . The low number of MICs ( < 100) for other less prevalent species ( C. famata , C. kefyr , C. orthopsilo- sis , C. rugosa ) precluded ECV definition, but their MIC distributions are documented. Evaluation of our ECVs for some species/ agent combinations using published individual MICs for 136 isolates (harboring mutations in or upregulation of ERG11 , MDR1 , CDR1 ,or CDR2 ) and 64 WT isolates indicated that our ECVs may be useful in distinguishing WT from non-WT isolates.