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174 results on '"CRUZ-VALDEZ AURELIO"'

1. Características de comportamiento sexual en hombres de la Ciudad de México

Author

Hernández-Girón Carlos, Cruz-Valdez Aurelio, Quiterio-Trenado Manuel, Peruga Armando, and Hernández-Avila Mauricio

Subjects
conducta sexual, condones, hombres, México, Public aspects of medicine, RA1-1270
Abstract

Objetivo. Determinar las principales características de comportamiento sexual en hombres de la Ciudad de México, incluyendo número de parejas sexuales, antecedentes de enfermedades de transmisión sexual (ETS) y creencias acerca del síndrome de inmunodeficiencia adquirida (SIDA). Material y métodos. Durante 1995 se realizó un estudio epidemiológico transversal, basado en un muestreo multietápico por conglomerados; se entrevistó a 1 377 hombres de 15 a 49 años de edad, a quienes se les aplicó un cuestionario estructurado. Para el análisis estadístico de los datos se realizaron pruebas de significancia como t de Student y ji². Resultados. Entre los entrevistados la media de edad fue de 34.5 años (DE= 7.5 años), y la media de inicio de relaciones sexuales de 17.7 años (DE= 2.8 años). La proporción global de uso de condón durante la última relación sexual fue de 24.6%; de acuerdo con el tipo de pareja sexual femenina en el último año, 18.8% lo usaron con parejas regulares y 62.5% con múltiples parejas. El 2% refirió síntomas sugestivos de uretritis gonocócica. Finalmente 97.5% refirió saber qué significaba la palabra SIDA y conocer ciertas medidas protectoras contra la infección. Conclusiones. En este estudio se identificaron características de comportamiento sexual riesgoso para adquirir y transmitir alguna ETS, como tener múltiples parejas sexuales, no usar el condón y presentar antecedentes de ETS.

Published
1999

2. Factores que determinan la participación en el tamizaje de cáncer cervical en el estado de Morelos

Author

Lazcano-Ponce Eduardo César, Moss Sue, Cruz-Valdez Aurelio, Alonso de Ruiz Patricia, Casares-Queralt Salvador, and Martínez-León Carlos Javier

Subjects
neoplasmas del cuello uterino, detección oportuna de cáncer, México, Public aspects of medicine, RA1-1270
Abstract

OBJECTIVO. Determinar los principales factores relacionados con la participación en un programa de detección oportuna de cáncer (DOC) en una población con elevada mortalidad por cáncer cervical (CACU). MATERIAL Y MÉTODOS. En el estado de Morelos se desarrolló un estudio con base poblacional que incluyó 3 197 mujeres de entre 15 y 49 años de edad, seleccionadas aleatoriamente de un marco muestral de viviendas de los 33 municipios que componen dicha entidad. RESULTADOS. El conocimiento de la utilidad de la prueba de Papanicolaou (Pap) (RM 29.6, IC95% 23.6-37) y la historia previa de síntomas ginecológicos (RM 1.7; IC95% 1.2-2.4) predisponen a utilizar el programa de DOC. Los factores asociados a la utilización de la prueba de Pap fueron que las mujeres tuvieran antecedentes en la utilización de uno (RM 1.4; IC95% 1.1-1.8), dos o más métodos de planificación familiar (RM 2.1; IC95% 1.6-2.8). CONCLUSIONES. En el estado de Morelos, México, el tamizaje en CACU se ofrece predominantemente en forma oportunista, por lo que el antecedente de utilización de los servicios de salud constituye el principal determinante para la utilización del programa de DOC. Estos resultados revelan la necesidad de establecer estrategias alternativas para integrar a las mujeres que no tienen acceso a dichos servicios de atención médica, ya que constituyen el grupo de más alto riesgo para contraer CACU.

Published
1999

3. Prevalencia y factores de riesgo asociados a sífilis en mujeres

Author

Hernández-Girón Carlos A., Cruz-Valdez Aurelio, Figueroa Luis Juárez, and Hernández-Avila Mauricio

Subjects
Sífilis/prevención, Prostitución, Infecciones oportunistas, Conducta sexual, Public aspects of medicine, RA1-1270
Abstract

INTRODUCCIÓN: Se ha demostrado que la sífilis, debido a la ulceración genital que produce, es un cofactor asociado para adquirir otras enfermedades de transmisión sexual (ETS), principalmente de origen viral como herpes tipo-2, hepatitis B, y el VIH. Aunque las mujeres trabajadoras del sexo comercial (MTSC) han adquirido mejores conocimientos para prevenir las ETS, constituyen un grupo que por su heterogenicidad en términos de condición socioeconómica, estado de salud, ambiente y sitio de trabajo, manifiestan diferentes actitudes y conocimientos que hacen latente la posibilidad de adquirir y transmitir ETS incluyendo sífilis, por lo que lo estudio hace un acercamiento hacia los factores asociados a infección por Treponema pallidum en este grupo de mujeres. MÉTODO: Basado en un marco muestral, que identifica sitios donde se practica el comercio sexual femenino en la ciudad de México, se seleccionó una muestra de 807 MTSC, a quienes previo consentimiento informado, se entrevistó para que respondieran un cuestionario estructurado. Se obtuvo una muestra sanguínea para la identificación de diversos marcadores serológicos de ETS de acuerdo al manual de procedimientos para el diagnóstico de ETS. Para el diagnóstico de Treponema pallidum se utilizó una prueba de tamizaje de RPR (Bigaux Diagnóstica), y prueba confirmatoria de FTA-ABS (Pasteur Diagnostics). RESULTADOS: Las prevalencias de sífilis en la muestra de MTSC fue de 6,4% (52/807), siendo mayor en quienes trabajaban en sitios de calle comparadas con aquellas de estéticas. La edad de las mujeres entrevistadas osciló entre 17 y 58 años con una media de 29,2 años (d.s. 7,3 años). La prevalencia de sífilis fue mayor en los grupos etáreos mayores de 30 anos. La edad de inicio de relaciones sexuales varió desde 11 hasta 30 anos con una media de 16 años (d.s. 3,1 años). Los factores predictores de infección por T. pallidum, determinados mediante regresión logística ajustada, fueron: sitio de trabajo (bar y puntos de calle), NSE (medio y bajo), edad (mayores de 30 anos), antiguedad en el trabajo sexual (> 5 años), y número de clientes en una semana (>10). CONCLUSIONES: A pesar de las limitaciones de precisión estadística, queda demostrado que existe una heterogenicidad de MTSC, diferenciado principalmente por el sitio donde se desempeñan. Debe entenderse que más que grupos de riesgo de adquirir y transmitir ETS, existen prácticas sexuales de riesgo en cualquier individuo que tiene relaciones sexuales, que aunadas a infecciones predisponentes como sífilis, facilitan la transmisibilidad de otras ETS. Por lo tanto, las campañas de prevención y fomento de uso de condón, deben orientarse no sólo a las MTSC sino también a sus clientes y parejas, con la finalidad de que todos asuman la responsabilidad del sexo seguro.

Published
1998

4. Análisis costo beneficio del Programa de Detección Oportuna del Cáncer Cervicouterino

Author

HERNÁNDEZ-PEÑA PATRICIA, LAZCANO-PONCE EDUARDO CÉSAR, ALONSO-DE RUIZ PATRICIA, CRUZ-VALDEZ AURELIO, MENESES-GONZÁLEZ FERNANDO, and HERNÁNDEZ-AVILA MAURICIO

Subjects
neoplamas del cuello uterino, citodiagnóstico, servicios de salud de las mujeres, análisis de costo beneficio, control de calidad, tamizaje, Public aspects of medicine, RA1-1270
Abstract

Objetivo. Determinar el costo beneficio de la reorganización del Programa de Detección Oportuna del Cáncer Cervicouterino (PDOC) mediante intervenciones de garantía de calidad. Material y métodos. Se siguieron tres etapas: a) identificación y cuantificación de costos; b) identificación y cuantificación de beneficios, y c) evaluación económica del costo beneficio. Resultados. El costo unitario de operación por citología -obtención, fijación, el traslado al centro de lectura, su tinción e interpretación y la notificación de resultados- se estimó en USD$ 11.6. En conjunto, las intervenciones en calidad al PDOC elevarían el costo de cada citología en 32.7%. Sin embargo, la nueva organización generaría una razón beneficio/costo de 2 y un beneficio neto de 88 millones de dólares para los próximos cinco años. Conclusiones. La operación del programa propuesto resulta socialmente deseable, siempre y cuando las modificaciones se lleven a cabo, particularmente la capacitación, la notificación personalizada de los casos positivos, el incremento de cobertura, la introducción de mecanismos de control de calidad, el monitoreo contínuo y el tratamiento en mujeres con anormalidades detectadas.

Published
1997

5. Asociación entre la presencia de anticuerpos anti-Ras y anti-VPH16 E4/E7 y lesiones intraepiteliales del cérvix

Author

Vázquez-Corzo Sara, Trejo-Becerril Catalina, Cruz-Valdez Aurelio, Hernández-Nevarez Pilar, Esquivel-Guadarrama Fernando Roger, and Gutiérrez-Xicotencatl Ma de Lourdes

Subjects
papilomavirus humano, anticuerpos séricos, lesiones tempranas de cérvix uterino, antígenos virales, oncogén Ras, México, Public aspects of medicine, RA1-1270
Abstract

OBJETIVO: Determinar si anticuerpos séricos contra E4, E7 y Ras pueden ser utilizados como marcadores de lesiones tempranas del cérvix uterino asociadas al virus del papiloma humano. MATERIAL Y MÉTODOS: Entre marzo de 1999 y abril de 2000 se realizó un estudio sero-epidemiológico de casos y controles en la clínica de displasias del Hospital General Doctor Gea González, en la Ciudad de México, en 116 muestras de suero para evaluar la presencia de anticuerpos anti-E4, E7 y Ras utilizando un ELISA de captura. Se estimaron razones de momios e intervalos de confianza de 95% RESULTADOS: Anticuerpos anti-E7 se asociaron a mujeres con lesiones NIC III, mientras que anticuerpos anti-E4 y anti-Ras fueron más frecuentes en lesiones NIC I-II. Al evaluar el perfil de anticuerpos que presentaron las mujeres, encontramos que a) anticuerpos contra dos proteínas predicen la existencia de una lesión NIC I-II, y b) la presencia de tres anticuerpos predicen una lesión NIC III. CONCLUSIONES: La detección de anticuerpos séricos contra E4, E7 y Ras en combinación con otras técnicas de diagnóstico, podrían ser de utilidad para detectar oportunamente a mujeres con lesiones tempranas asociadas al Virus del Papiloma Humano y en riesgo de desarrollar cáncer.

Published
2003

6. Performance of cervical cytology and HPV testing for primary cervical cancer screening in Latin America: an analysis within the ESTAMPA study

Author

Rol, Mary Luz, Lucas, Eric, Hernández, María de la Luz, Sánchez, Gloria Inés, Murillo, Raul, Jerónimo, Jose, Ferreccio, Catterina, Rodríguez, María Isabel, Cabrera, Yessy, Salgado, Brenda, Colucci, María Celeste, Saino, Maria Agustina, Rodríguez de la Peña, Margarita, Fernández, Daniel Llanos, García, Laura, Caserta, Benedicta, Doimi, Franco, Lazcano-Ponce, Eduardo, Ramírez, Arianis Tatiana, Valls, Joan, Baena, Armando, Rojas, Freddy David, Ramírez, Katherine, Álvarez, Rodrigo, Cristaldo, Carmen, Henríquez, Odessa, Moreno, Adrián, Reynaga, Daysi Colque, Palma, Hans González, Robinson, Isabel, Hernández, Diana Carolina, Bardales, Rosa, Cardinal, Lucia, Salgado, Yuly, Martínez, Sandra, González, Emmanuel, Guillén, Diego, Fleider, Laura, Tatti, Silvio, Villagra, Verónica, Venegas, Gino, Cruz-Valdez, Aurelio, Valencia, Marleny, Rodríguez, Guillermo, Terán, Carolina, Picconi, María Alejandra, Ferrera, Annabelle, Kasamatsu, Elena, Mendoza, Laura, Calderon, Alejandro, Luciani, Silvana, Broutet, Nathalie, Darragh, Teresa, Almonte, Maribel, and Herrero, Rolando

Published
2023
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7. Risk of COVID-19 after natural infection or vaccination

Author

Adams, Atoya, Miller, Eric, Rankin, Bruce G., Shinn, Steven, Nash, Marshall, Green, Sinikka L., Jacobsen, Colleen, Krishnankutty, Jayasree, Phungwayo, Sikhongi, Glover, Richard M., II, Slechta, Stacy, Holdeman, Troy, Hartvickson, Robyn, Grant, Amber, Poling, Terry L., Klein, Terry D., Klein, Thomas C., Klein, Tracy R., Smith, William B., Gibson, Richard L., Winbigler, Jennifer, Parker, Elizabeth, Wijewardane, Priyantha N., Bravo, Eric, Thessing, Jeffrey, Maxwell, Michelle, Horn, Amanda, Healy, Catherine Mary, Akamine, Christine, Chu, Laurence, Chouteau, R. Michelle, Cotugno, Michael J., Bauer, George H., Jr., Hachigian, Greg, Oshita, Masaru, Cancilla, Michael, Kiersey, Kristen, Seger, William, Antwi, Mohammed, Green, Allison, Kim, Anthony, Desjardins, Michael, Johnson, Jennifer A., Sherman, Amy, Walsh, Stephen R., Borger, Judith, Saleem, Nafisa, Solis, Joel, Medina, Martha Carmen, Keating, Westly, Garcia, Edgar, Bueno, Cynthia, Segall, Nathan, Denham, Douglas S., Weiss, Thomas, Avworo, Ayoade, Hedges, Parke, Strout, Cynthia Becher, Santiago, Rica, Davis, Yvonne, Howenstine, Patty, Bondell, Alison, Marks, Kristin, Wang, Tina, Wilkin, Timothy, Vogler, Mary, Johnston, Carrie, Andrasik, Michele P., Andriesen, Jessica G., Broder, Gail, Eaton, Niles, Gelderblom, Huub G., McClennen, Rachael, Michael, Nelson, Robb, Merlin, Sopher, Carrie, Miller, Vicki E., Santiago, Fredric, Gomez, Blanca, Valika, Insiya, Starr, Amy, Cantos, Valeria D., Kandiah, Sheetal, Rio, Carlos del, Rouphael, Nadine, Edupuganti, Srilatha, Anderson, Evan J., Camacho-Gonzalez, Andres, Kamidani, Satoshi, Teherani, Meghan, Diemert, David J., Malkin, Elissa, Siegel, Marc, Roberts, Afsoon, Simon, Gary, Balani, Bindu, Stephenson, Carolene, Sperber, Steven, Cicogna, Cristina, Zervos, Marcus J., Kilgore, Paul, Ramesh, Mayur, Herc, Erica, Zenlea, Kate, Burgher, Abram, Milliken, Ann M., Davis, Joseph D., Levy, Brendan, Kelman, Sandra, Doust, Matthew W., Sample, Denise, Erickson, Sandra, Christensen, Shane G., Matich, Christopher, Longe, James, Witbeck, John, Peterson, James T., Clark, Alexander, Kelty, Gerald, Pena-Renteria, Issac, Koren, Michael J., Bartilucci, Darlene, Patel, Alpa, Tran, Carolyn, Kennelly, Christina, Brownlee, Robert, Coleman, Jacob, Webster, Hala, Fierro, Carlos A., Leistner, Natalia, Thompson, Amy, Gonzalez, Celia, Jackson, Lisa A., Suyehira, Janice, Haber, Milton, Regalado, Maria M., Procasky, Veronica, Lutat, Alisha, Griffin, Carl P., Hollister, Ripley R., Brown, Jeremy, Ronk, Melody, Harper, Wayne L., Cohen, Lisa, Eckert, Lynn, Hong, Matthew, Rouhbakhsh, Rambod, Danford, Elizabeth, Johnson, John, Calderone, Richard, Khetan, Shishir K., Olanrewaju, Oyebisi, Zhai, Nan, Nieves, Kimberly, O'Brien, Allison, Bradley, Paul S., Lilienthal, Amanda, Callis, Jim, Brosz, Adam B., Clement, Andrea, West, Whitney, Friesen, Luke, Cramer, Paul, Eder, Frank S., Little, Ryan, Engler, Victoria, Rattenbury-Shaw, Heather, Ensz, David J., Oplinger, Allie, Essink, Brandon J., Meyer, Jay, Raiser, Frederick, III, Mueller, Kimberly, Vrbicky, Keith W., Harper, Charles, Nutsch, Chelsie, Lewis, Wendell, III, Laflan, Cathy, Whatley, Jordan L., Harrell, Nicole, Shannon, Amie, Rowell, Crystal, Dedon, Christopher, Makhene, Mamodikoe, Gottschlich, Gregory M., Harden, Kate, Gottschlich, Melissa, Smith, Mary, Powell, Richard, Kimmel, Murray A., Pinto, Simmy, Vachris, Timothy P., Hutchens, Mark, Daniels, Stephen, Wells, Margaret, Van Der Leden, Mimi, Jackson-Booth, Peta-Gay, Baron, Mira, Kane, Pamela, Seversen, Shannen, Kryvicky, Mara, Lord, Julia, Saleh, Jamshid, Miles, Matthew, Lupercio, Rafael, McGettigan, John W., Jr., Patton, Walter, Brakema, Riemke, Choquette, Karin, McGettigan, Jonlyn, Kirstein, Judith L., Bernard, Marcia, Manning, Mary Beth, Rothenberg, Joan, Briskin, Toby, Roadman, Denise, Tedder-Edwards, Sharita, Schwartz, Howard I., Mederos, Surisday, Swaminathan, Shobha, Nyaku, Amesika, Varughese, Tilly, DallaPiazza, Michelle, Frey, Sharon E., Graham, Irene, Abate, Getahun, Hoft, Daniel, Allen, Leland N., III, Edwards, Leslie A., Davis, William S., Jr., Mena, Jessica M., Kutner, Mark E., Caso, Jorge, Moran, Maria Hernandez, Carvajal, Marianela, Mendez, Janet, Wadsworth, Larkin T., III, Adams, Michael R., Iverson, Leslie, Newberg, Joseph L., Pearlman, Laura, Nugent, Paul J., Reynolds, Michele D., Bashour, Jennifer, Schmidt, Robert, Sheth, Neil P., Steil, Kenneth, Toma, Ramy J., Kirby, William, Folmar, Pink, Williams, Samantha, Pickrell, Paul, Mott, Stefanie, Linebarger, Carol Ann, Malbari, Hussain, Pampe, David, Fragoso, Veronica G., Holloway, Lisa, McKeown-Bragas, Cecilia, Becker, Teresa, Williams, Barton G., Jones, William H., Clark, Jesse L., Shoptaw, Steven, Vertucci, Michele, Hernandez, Will, Spector, Stephen A., Moodley, Amaran, Blumenthal, Jill, Stangl, Lisa, Deutsch, Karen, Mullane, Kathleen M., Pitrak, David, Nuss, Cheryl, Pi, Judy, Fichtenbaum, Carl, Powers-Fletcher, Margaret, Saemann, Michelle, Kohrs, Sharon, Campbell, Thomas B., Lauria, Andrew, Mancilla, Jose C., Dunlevy, Hillary, Novak, Richard M., Wendrow, Andrea, Borgetti, Scott, Ladner, Ben, Chrisley, Lisa, Young, Cheryl, Doblecki-Lewis, Susanne, Alcaide, Maria L., Gonzales-Zamora, Jose, Morris, Stephen, Wohl, David, Eron, Joseph, Jr., Frank, Ian, Dunbar, Debora, Metzger, David, Momplaisir, Florence, Martin, Judith, Hoberman, Alejandro, Shope, Timothy, Muniz, Gysella, Rupp, Richard, Stanford, Amber, Berman, Megan, Porterfield, Laura, Lewis, Michael, Ghadishah, Elham, Yusin, Joseph, Pham, Mai, Creech, Clarence B., II, Walker, Shannon, Rolsma, Stephanie, Samuels, Robert, Thomsen, Isaac, Kalams, Spyros A., Wilson, Greg, Lucksinger, Gregg H., Parks, Kevin, Israelsen, Ryan, Ostovar, Jaleh, Kelly, Kary, Overcash, Jeffrey S., Chu, Hanh, Lee, Kia, De La Cruz, Luis I., Clemons, Steve, Everette, Elizabeth, Studdard, Suzanna, Mohan, Gowdhami, Tyson, Stefanie, Peay, Alyssa-Kay, Johnson, Danyel, Feldman, Gregory J., Suen, May-Yin, Muenzner, Jacqueline, Boscia, Joseph, Siddiqui, Farhan, Sanders, John, Peacock, James, Nasim, Julio, Levin, Michael L., Hussey, Julie, Kulic, Marcy, McKenzie, Mark M., Deese, Teresa, Osmundsen, Erica, Sweet, Christy, Ebuh, Valentine M., Elnagar, Elwaleed, Ebuh, Georgette, Iwuala, Genevieve, Han-Conrad, Laurie J., Simmons, Todd, Tarakjian, Denis, Ackermann, Jeremy, Adams, Mark S., Alemán, José O., Al-Ibrahim, Mohamed S., Andes, David R., Andrews, Jeb, Arduino, Roberto C., Bäcker, Martín, Badillo, Diana, Bainbridge, Emma, Batteiger, Teresa A., Bazan, Jose A., Bedimo, Roger J., Benitez, Jorge A., Bennett, Annette R., Bernstein, David I., Bialobok, Kristin, Boas, Rebecca, Brady, Judith, Brown, Cynthia, Bunce, Catherine A., Call, Robert S., Campbell, Wesley, Carmody, Ellie, Carpenter, Christopher, Carsons, Steven E., Castellon, Marvin, Castro, Mario, Catan, Hannah, Chang, Jennifer, Chebib, Mouna G., Chen, Corey M., Cheng, Margaret, Chow, Brian D.W., Ciambruschini, Annie, Connor, Joseph P., Conway, James H., Cooney, Maureen, Curlin, Marcel, De La Matta Rodriguez, Claudia, Dedon, Jon F., Degan, Emily, Dickey, Michelle, Dietz, Craig, Dong, Jennifer L., Dorcely, Brenda, Dube, Michael P., Dyer, Carmel B., Eckhardt, Benjamin, Ellerbeck, Edward, Ewers, Evan C., Falk, Amy, Feijoo, Brittany, Felsen, Uriel R., Fiel, Tom, Fitz-Patrick, David, Fogarty, Charles M., Ford, Stacy, Forero, Lina M., Formentini, Elizabeth, Franco-Vitteri, Doris, Frenck, Robert W., Jr., Gharib, Elie, Gharib, Suzanne, Rucker, Rola G., Goldenberg, James N., González, Luis H., Gray, Brett, Greene, Rusty, Grossberg, Robert M., Guanira-Carranza, Juan V., Guerreros Benavides, Alfredo Gilberto, Guillory, Clint C., Gunaratne, Shauna H., Halpert, David, Hamilton, Holli, Hartman, William R., Henderson, Sheryl L., Herati, Ramin, Guarin, Laura Hernandez, Hilder, Robin, Ho, Ken, Hojat, Leila, Hosek, Sybil G., Jacobson, Jeffrey M., Jay, Melanie, Johnson, Diane H., Jones, Kathleen S., Jones-López, Edward C., Justman, Jessica E., Kahney, Scott, Katz, Lois, Katz, Melinda, Kaul, Daniel, Keefer, Michael C., Kennedy, Ashley, Knishinsky, Jennifer, Kogelman, Laura, Koletar, Susan L., Kottkamp, Angelica, Laguio-Vila, Maryrose, Landovitz, Raphael J., Lee, Jessica L., Liu, Albert, Llerena Zegarra, Eneyda Giuvanela, Lok, Anna S., Lovell, James, Lubelchek, Ronald, Lucaj, John, Luckasen, Gary, Luetkemeyer, Annie, Lugogo, Njira Lucia, Maenza, Janine, Malvestutto, Carlos, Mauri, Monica, Maves, Ryan C., Mayer, Kenneth H., McCartney, Michael J., McCort, Margaret E., McElrath, M. Juliana, McNairy, Meredith, Merino, Fernando L., Meyerowitz, Eric A., Mitchell, Carol L., Monaco, Cynthia L., Muhammad, Sauda, Muñoz-Gómez, Sigridh, Munsiff, Sonal, Nee, Paul, Nollen, Nicole L., Noor, Asif, Lagos, Claudio Nuñez, Okulicz, Jason F., Oliver, Patrick A., Ortega, Jessica, Palmer, Steven, Parameswaran, Lalitha, Parikh, Purvi, Parker, Susan, Parungao, Reza, Pavie, Juana R., Madan, Rebecca P., Peralta, Henry, Petts, Jennifer, Pierce, Kristen K., Pretell Alva, E. Javier, Purpura, Lawrence J., Raabe, Vanessa, Recuenco, Sergio E., Richards, Tamara, Riddler, Sharon A., Rizzardi, Barbara, Rokser, Rachel, Rolle, Charlotte-Paige, Rosen, Adam, Rosen, Jeffrey, Freese, Lena R., Santolaya, María E., Schipani, Linda M., Schwartz, Adam, Schwasinger-Schmidt, Tiffany, Scott, Hyman, Sha, Beverly E., Shankaran, Shivanjali, Shapiro, Adrienne E., Sharp, Stephan C., Shopsin, Bo, Sims, Matthew D., Skipper, Stephanie, Smith, Derek M., Smith, Michael J., Sobhanie, M. Mahdee, Sovic, Brit, Sterling, Stephanie, Striker, Robert, Tafur Bances, Karla Beatriz, Talaat, Kawsar R., Tavel, Edward M., Jr., Tieu, Hong V., Tomaszewski, Christian, Tomlinson, Ryan, Torres, Juan P., Torres, Julian A., Treanor, John J., Tukuru, Sade, Ulrich, Robert J., Utz, Gregory C., Viar, Veronica, Viau Colindres, Roberto A., Walsh, Edward E., Walsh, Mary C., Walter, Emmanuel B., Weidler, Jessica L., Wu, Yi H., Yang, Kinara S., Yrivarren Giorza, Juan Luis, Zemanek, Arthur L., Zhang, Kevin, Zingman, Barry S., Gorman, Richard, Paez, Carmen A., Swann, Edith, Takuva, Simbarashe G., Greninger, Alex, Roychoudhury, Pavitra, Coombs, Robert W., Jerome, Keith R., Castellino, Flora, Tong, Xiaomi, Pavetto, Corrina, Gipson, Teletha, Tong, Tina, Lee, Marina, Zhou, James, Fay, Michael, McQuarrie, Kelly, Nnadi, Chimeremma, Sogbetun, Obiageli, Ahmad, Nina, De Proost, Ian, Hoseyni, Cyrus, Coplan, Paul, Khan, Najat, Ronco, Peter, Furey, Dawn, Meck, Jodi, Vingerhoets, Johan, Brandenburg, Boerries, Custers, Jerome, Hendriks, Jenny, Juraszek, Jarek, Marit de Groot, Anne, Van Roey, Griet, Heerwegh, Dirk, Van Dromme, Ilse, Méndez Galván, Jorge F., Carrascal, Monica B., Duran, Adriana Sordo, Sanchez Guerrero, Laura Ruy, Gómora Madrid, Martha Cecilia, Barrat Hernández, Alejandro Quintín, Guizar, Sharzhaad Molina, González Estrada, Denisse Alejandra, Martínez Pérez, Silvano Omar, Zárate Hinojosa, Zindy Yazmín, Ruiz-Palacios, Guillermo Miguel, Cruz-Valdez, Aurelio, Pacheco-Flores, Janeth, Lara, Anyela, Díaz-Miralrio, Secia, Reyes Fentanes, María José, Olmos Vega, Jocelyn Zuleica, Méndez, Daniela Pineda, Martínez, Karina Cano, Alvarez León, Winniberg Stephany, Ruiz Herrera, Vida Veronica, Vázquez Saldaña, Eduardo Gabriel, Camacho Choza, Laura Julia, Vega Orozco, Karen Sofia, Ortega Domínguez, Sandra Janeth, Chacón, Jorge A., Rivera, Juan J., Cutz, Erika A., Ortegón, Maricruz E., Rivera, María I., Browder, David, Burch, Cortney, Moye, Terri, Bondy, Paul, Browder, Lesley, Manning, Rickey D., Hurst, James W., Sturgeon, Rodney E., Wakefield, Paul H., Kirby, John A., Andersen, James, Fearon, Szheckera, Negron, Rosa, Medina, Amy, Hill, John M., Rajasekhar, Vivek, Williams, Hayes, Cade, LaShondra, Fouts, Rhodna, Moya, Connie, Anderson, Corey G., Devine, Naomi, Ramsey, James, Perez, Ashley, Tatelbaum, David, Jacobs, Michael, Menasche, Kathleen, Mirkil, Vincent, Winkle, Peter J., Haggag, Amina Z., Haynes, Michelle, Villegas, Marysol, Raja, Sabina, Riesenberg, Robert, Plavin, Stanford, Lerman, Mark, Woodside, Leana, Johnson, Maria, Healy, C. Mary, Whitaker, Jennifer A., Keitel, Wendy A., Atmar, Robert L., Horwith, Gary, Mason, Robin, Johnson, Lisa, Dora, Tambra, Murray, Deborah, Ledbetter, Logan, Ewing, Beverly, Stephenson, Kathryn E., Tan, Chen S., Zash, Rebecca, Ansel, Jessica L., Jaegle, Kate, Guiney, Caitlin J., Henderson, Jeffrey A., O'Leary, Marcia, Enright, Kendra, Kessler, Jill, Ducheneaux, Pete, Inniss, Asha, Brandon, Donald M., Davis, William B., Lawler, Daniel T., Oppong, Yaa D., Starr, Ryan P., Syndergaard, Scott N., Shelly, Rozeli, Majumder, Mashrur Islam, Sugimoto, Danny, Dugas, Jeffrey, Sr., Rijos, Dolores, Shelton, Sandra, Hong, Stephan, Schwartz, Howard, Sanchez-Crespo, Nelia, Schwartz, Jennifer, Piedra, Terry, Corral, Barbara, Medina, Carmen, Dever, Michael E., Shah, Mitul, Delgado, Michael, Scott, Tameika, Usdan, Lisa S., McGill, Lora J., Arnold, Valerie K., Scatamacchia, Carolyn, Anthony, Codi M., Merchant, Rajan, Yoon, Anelgine C., Hill, Janet, Ng-Price, Lucy, Thompson-Seim, Teri, Ackerman, Ronald, Ackerman, Jamie, Aristy, Florida, Ketter, Nzeera, Finley, Jon, Stull, Mildred, Murray, Monica, Rizvi, Zainab, Guerrero, Sonia, Paliwal, Yogesh K., Paliwal, Amit, Gordon, Sarah, Gordon, Bryan, Montano-Pereira, Cynthia, Galloway, Christopher, Montros, Candice, Aleman, Lily, Shairi, Samira, Van Ever, Wesley, Freeman, George H., Harmon, Esther L., Cross, Marshall A., Sales, Kacie, Gular, Catherine Q., Hepburn, Matthew, Alderson, Nathan, Harshell, Shana, Mahgoub, Siham, Maxwell, Celia, Mellman, Thomas, Thompson, Karl M., Wortman, Glenn, Kingsley, Jeff, Pixler, April, Curry, LaKondria, Afework, Sarah, Swanson, Austin, Jacqmein, Jeffry, Bowers, Maggie, Robison, Dawn, Mosteller, Victoria, Garvey, Janet, Easley, Mary, Kurnat, Rebecca J., Cornelison, Raymond, Gower, Shanda, Schnitz, William, Heinzig-Cartwright, Destiny S., Lewis, Derek, Newton, Fred E., Duhart, Aeiress, Watkins, Breanz, Ball, Brandy, York, Jill, Pickle, Shelby, Musante, David B., Silver, William P., Belhorn, Linda R., Viens, Nicholas A., Dellaero, David, Patel, Priti, Lisec, Kendra, Safirstein, Beth, Zapata, Luz, Gonzalez, Lazaro, Quevedo, Evelyn, Irani, Farah, Grillo, Joseph, Potts, Amy, White, Julie, Flume, Patrick, Headden, Gary, Taylor, Brandie, Warden, Ashley, Chamberlain, Amy, Jeanfreau, Robert, Jeanfreau, Susan, Matherne, Paul G., Caldwell, Amy, Stahl, Jessica, Vowell, Mandy, Newhouse, Lauren, Berthaud, Vladimir, Takizala, Zudi-Mwak, Beninati, Genevieve, Snell, Kimberly, Baker, Sherrie, Walker, James, Harrison, Tavane, Miller, Meagan, Otto, Janet, Gray, Roni, Wilson, Christine, Nemecek, Tiffany, Harrington, Hannah, Eppenbach, Sally, Lewis, Wendell, Bourgeois, Tana, Folsom, Lyndsea, Holt, Gregory, Mirsaeidi, Mehdi, Calderon, Rafael, Lichtenberger, Paola, Quintero, Jalima, Martinez, Becky, Immergluck, Lilly, Johnson, Erica, Chan, Austin, Fas, Norberto, Thomas-Seaton, LaTeshia, Khizer, Saadia, Staben, Jonathan, Beresnev, Tatiana, Jahromi, Maryam, Marovich, Mary A., Hutter, Julia, Nason, Martha, Ledgerwood, Julie, Mascola, John, Leibowitz, Mark, Morales, Fernanda, Delgado, Mike, Sanchez, Rosario, Vega, Norma, Áñez, Germán, Albert, Gary, Coston, Erin, Desai, Chinar, Dunbar, Haoua, Eickhoff, Mark, Garcia, Jenina, Kautz, Margaret, Lee, Angela, Lewis, Maggie, McGarry, Alice, McKnight, Irene, Nelson, Joy, Newingham, Patrick, Price-Abbott, Patty, Reed, Patty, Vegas, Diana, Wilkinson, Bethanie, Smith, Katherine, Woo, Wayne, Cho, Iksung, Glenn, Gregory M., Dubovsky, Filip, Fried, David L., Haughey, Lynne A., Stanton, Ariana C., Rameaka, Lisa Stevens, Rosenberg, David, Tomatsu, Lee, Gonzalez, Viviana, Manalo, Millie, Grunstra, Bernard, Quinn, Donald, Claybrook, Phillip, Olds, Shelby, Dye, Amy, Cannon, Kevin D., Chadwick, Mesha M., Jordan, Bailey, Hussey, Morgan, Nevarez, Hannah, Kelley, Colleen F., Chung, Michael, Moran, Caitlin, Rebolledo, Paulina, Bacher, Christina, Barranco-Santana, Elizabeth, Rodriguez, Jessica, Mendoza, Rafael, Ruperto, Karen, Olivieri, Odette, Ocaña, Enrique, Wylie, Paul E., Henderson, Renea, Jenson, Natasa, Yang, Fan, Kelley, Amy, Finkelstein, Kenneth, Beckmann, David, Hutchins, Tanya, Escallon, Sebastian Garcia, Johnson, Kristen, Sligh, Teresa S., Desai, Parul, Huynh, Vincent, Lopez, Carlos, Mendoza, Erika, Adelglass, Jeffrey, Naifeh, Jerome G., Kucera, Kristine J., Chughtai, Waseem, Jaffer, Shireen H., Davis, Matthew G., Foley, Jennifer, Burgett, Michelle L., Shlotzhauer, Tammi L., Ingalsbe-Geno, Sarah M., Duncanson, Daniel, Kush, Kelly, Nesbitt, Lori, Sonnier, Cora, McCarter, Jennifer, Butcher, Michael B., Fry, James, Percy, Donna, Freudemann, Karen, Gebhardt, Bruce C., Mangu, Padma N., Schroeck, Debra B., Davit, Rajesh K., Hennekes, Gayle D., Luft, Benjamin J., Carr, Melissa, Nachman, Sharon, Pellecchia, Alison, Smith, Candace, Valenti, Bruno, Bermudez, Maria I., Peraita, Noris, Delgado, Ernesto, Arrazcaeta, Alicia, Ramirez, Natalie, Amador, Carmen, Marafioti, Horacio, Dang, Lyly, Clement, Lauren, Berry, Jennifer, Allaw, Mohammed, Geuss, Georgettea, Miles, Chelsea, Bittner, Zachary, Werne, Melody, Calinescu, Cornell, Rodman, Shannon, Rindt, Joshua, Cooksey, Erin, Harrison, Kristina, Cooper, Deanna, Horton, Manisha, Philyaw, Amanda, Jennings, William, Alvarado, Hilario, Baka, Michele, Regalado, Malina, Murray, Linda, Naguib, Sherif, Singletary, Justin, Richmond, Sha-Wanda, Omodele, Sarah, Oppenheim, Emily, Martinez, Reuben, Andriulis, Victoria, Singer, Leonard, Blevins, Jeanne, Thomas, Meagan, Hull, Christine, Pereira, Isabel, Rivero, Gina, Okonya, Tracy, Downing, Frances, Miller, Paulina, Rhee, Margaret, Stapleton, Katherine, Klein, Jeffrey, Hong, Rosamond, Swan, Suzanne, Wahlin, Tami, Bennett, Elizabeth, Salzl, Amy, Phan, Sharine, White, Jewel J., Occhino, Amanda, Paiano, Ruth, McLaughlin, Morgan, Swieboda, Elisa, Garcia-Fragoso, Veronica, Becerra, Maria G., White, Toni, Turley, Christine B., McWilliams, Andrew, Esinhart, Tiffany, Montoya, Natasha, Huskey, Shamika, Paul, Leena, Tashima, Karen, Johnson, Jennie, Neill, Marguerite, Sanchez, Martha, Rybak, Natasha, Mileno, Maria, Cohen, Stuart H., Ruiz, Monica, Boswell, Dean M., Robison, Elizabeth E., Reynolds, Trina L., Neumeister, Sonja, Zorrilla, Carmen D., Rivera, Juana, Ibarra, Jessica, García, Iris, Sierra, Dianca, Ramon, Wanda, Fiorillo, Suzanne, Pitotti, Rebecca, Anderson, Victoria R., Mancilla, Jose Castillo, Le, Nga, Winokur, Patricia L., Ince, Dilek, Hegmann, Theresa, Meier, Jeffrey, Stapleton, Jack, Stulken, Laura, McArthur, Monica, Berry, Andrea, Tapia, Milagritos, Hammershaimb, Elizabeth, Robinson, Toni, MacBryde, Rosa, Kline, Susan, Billings, Joanne L., Cavert, Winston, Forgosh, Les B., Schacker, Timothy W., Bold, Tyler D., Dandachi, Dima, Nelson, Taylor, Bran, Andres, Geiger, Grant, Naqvi, S. Hasan, Florescu, Diana F., Starlin, Richard, Kline, David, Zimmer, Andrea, Abbas, Anum, Wilson, Natasha, Eron, Joseph J., Sciaudone, Michael, Rosengren, A. Lina, Kizer, John S., Rutstein, Sarah E., Bruce, Elizabeth, Espinosa, Claudia, Sanders, Lisa J., Kim, Kami, Casey, Denise, Taylor, Barbara S., Patterson, Thomas, Pinilla, Ruth S., Bullock, Delia, Ponce, Philip, Patterson, Jan, McClelland, R. Scott, Lane, Dakotah C., Wald, Anna, James, Frank, Duke, Elizabeth, Hauge, Kirsten, Heimonen, Jessica, Goecker, Erin A., Huang, Yunda, Fong, Youyi, Kauffman, Carol, Linder, Kathleen, Nofz, Kimberly, McConnell, Andrew, Buynak, Robert J., Webb, Angella, Petty, Taryn, Andree, Stephanie, Sanchez, Erica, Mackey, Nolan, Baudelaire, Clarisse, Dzigiel, Sarah, Marquez, Adrienna, Quillin, Kim, King, Michelle, Abad, Vanessa, Knowles, Jennifer, Waters, Michael, Zepeda, Karla, Coslet, Jordan, Tovar, Dalia, Shaw, Marian E., Turner, Mark A., Huffine, Cory J., Huffine, Esther S., Ake, Julie A., Secord, Elizabeth, McGrath, Eric, Levy, Phillip, Stewart, Brittany, Cromer, Charnell, Walters, Ayanna, Ellsworth, Grant, Greene, Caroline, Galloway, Sarah, Kapadia, Shashi, DeHaan, Elliot, Wilson, Clint, Milligan, Jason, Raley, Danielle, Bocchini, Joseph, McClenathan, Bruce, Hussain, Mary, Lomasney, Evelyn, Hall, Evelyn, Lamberth, Sherry, Schmeck, Christy, Leathers, Vickie, Theodore, Deborah A., Branche, Angela R., Graciaa, Daniel S., Hatlen, Timothy J., Miller, Jacqueline, Sadoff, Jerald, Falsey, Ann R., Sobieszczyk, Magdalena E., Rick, Anne-Marie, Laurens, Matthew B., Huang, Ying, Yu, Chenchen, Martin, Thomas C.S., Rodriguez, Carina A., Rostad, Christina A., Maboa, Rebone M., Baden, Lindsey R., El Sahly, Hana M., Grinsztejn, Beatriz, Gray, Glenda E., Gay, Cynthia L., Gilbert, Peter B., Janes, Holly E., Kublin, James G., Leav, Brett, Hirsch, Ian, Struyf, Frank, Dunkle, Lisa M., Neuzil, Kathleen M., Corey, Lawrence, Goepfert, Paul A., Follmann, Dean, and Kotloff, Karen L.

Published
2023
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8. Multicentric study of cervical cancer screening with human papillomavirus testing and assessment of triage methods in Latin America: the ESTAMPA screening study protocol.

Author

Almonte, Maribel, Murillo, Raúl, Sánchez, Gloria Inés, González, Paula, Ferrera, Annabelle, Picconi, María Alejandra, Wiesner, Carolina, Cruz-Valdez, Aurelio, Lazcano-Ponce, Eduardo, Jerónimo, Jose, Ferreccio, Catterina, Kasamatsu, Elena, Mendoza, Laura, Rodríguez, Guillermo, Calderón, Alejandro, Venegas, Gino, Villagra, Verónica, Tatti, Silvio, Fleider, Laura, Terán, Carolina, Baena, Armando, Hernández, María de la Luz, Rol, Mary Luz, Lucas, Eric, Barbier, Sylvaine, Ramírez, Arianis Tatiana, Arrossi, Silvina, Rodríguez, María Isabel, González, Emmanuel, Celis, Marcela, Martínez, Sandra, Salgado, Yuly, Ortega, Marina, Beracochea, Andrea Verónica, Pérez, Natalia, Rodríguez de la Peña, Margarita, Ramón, María, Hernández-Nevarez, Pilar, Arboleda-Naranjo, Margarita, Cabrera, Yessy, Salgado, Brenda, García, Laura, Retana, Marco Antonio, Colucci, María Celeste, Arias-Stella, Javier, Bellido-Fuentes, Yenny, Bobadilla, María Liz, Olmedo, Gladys, Brito-García, Ivone, Méndez-Herrera, Armando, Cardinal, Lucía, Flores, Betsy, Peñaranda, Jhacquelin, Martínez-Better, Josefina, Soilán, Ana, Figueroa, Jacqueline, Caserta, Benedicta, Sosa, Carlos, Moreno, Adrián, Mural, Juan, Doimi, Franco, Giménez, Diana, Rodríguez, Hernando, Lora, Oscar, Luciani, Silvana, Broutet, Nathalie, Darragh, Teresa, and Herrero, Rolando

Subjects
Humans, Papillomavirus Infections, Cervical Intraepithelial Neoplasia, Colposcopy, Adult, Middle Aged, Triage, Latin America, Uterine Cervical Neoplasms, Female, Alphapapillomavirus, Early Detection of Cancer, colposcopy, gynaecological oncology, molecular diagnostics, preventive medicine, public health, risk management, Clinical Sciences, Public Health and Health Services, Other Medical and Health Sciences
Abstract

IntroductionHuman papillomavirus (HPV) testing is replacing cytology in primary screening. Its limited specificity demands using a second (triage) test to better identify women at high-risk of cervical disease. Cytology represents the immediate triage but its low sensitivity might hamper HPV testing sensitivity, particularly in low-income and middle-income countries (LMICs), where cytology performance has been suboptimal. The ESTAMPA (EStudio multicéntrico de TAMizaje y triaje de cáncer de cuello uterino con pruebas del virus del PApiloma humano; Spanish acronym) study will: (1) evaluate the performance of different triage techniques to detect cervical precancer and (2) inform on how to implement HPV-based screening programmes in LMIC.Methods and analysisWomen aged 30-64 years are screened with HPV testing and Pap across 12 study centres in Latin America. Screened positives have colposcopy with biopsy and treatment of lesions. Women with no evident disease are recalled 18 months later for another HPV test; those HPV-positive undergo colposcopy with biopsy and treatment as needed. Biological specimens are collected in different visits for triage testing, which is not used for clinical management. The study outcome is histological high-grade squamous intraepithelial or worse lesions (HSIL+) under the lower anogenital squamous terminology. About 50 000 women will be screened and 500 HSIL+ cases detected (at initial and 18 months screening). Performance measures (sensitivity, specificity and predictive values) of triage techniques to detect HSIL+ will be estimated and compared with adjustment by age and study centre.Ethics and disseminationThe study protocol has been approved by the Ethics Committee of the International Agency for Research on Cancer (IARC), of the Pan American Health Organisation (PAHO) and by those in each participating centre. A Data and Safety Monitoring Board (DSMB) has been established to monitor progress of the study, assure participant safety, advice on scientific conduct and analysis and suggest protocol improvements. Study findings will be published in peer-reviewed journals and presented at scientific meetings.Trial registration numberNCT01881659.

Published
2020

9. Performance of standardised colposcopy to detect cervical precancer and cancer for triage of women testing positive for human papillomavirus: results from the ESTAMPA multicentric screening study

Author

Valls, Joan, Baena, Armando, Venegas, Gino, Celis, Marcela, González, Mauricio, Sosa, Carlos, Santin, Jorge Luis, Ortega, Marina, Soilán, Ana, Turcios, Elmer, Figueroa, Jacqueline, Rodríguez de la Peña, Margarita, Figueredo, Alicia, Beracochea, Andrea Verónica, Pérez, Natalia, Martínez-Better, Josefina, Lora, Oscar, Jiménez, Julio Yamil, Giménez, Diana, Fleider, Laura, Salgado, Yuly, Martínez, Sandra, Bellido-Fuentes, Yenny, Flores, Bettsy, Tatti, Silvio, Villagra, Verónica, Cruz-Valdez, Aurelio, Terán, Carolina, Sánchez, Gloria Inés, Rodríguez, Guillermo, Picconi, Maria Alejandra, Ferrera, Annabelle, Mendoza, Laura, Calderón, Alejandro, Murillo, Raul, Wiesner, Carolina, Broutet, Nathalie, Luciani, Silvana, Pérez, Carlos, Darragh, Teresa M, Jerónimo, José, Herrero, Rolando, and Almonte, Maribel

Published
2023
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10. Serum Antibodies Against the E5 Oncoprotein from Human Papillomavirus Type 16 Are Inversely Associated with the Infection and the Degree of Cervical Lesions.

Author

Salazar-Piña, Azucena, Maldonado-Gama, Minerva, Gonzalez-Jaimes, Ana M., Cruz-Valdez, Aurelio, Ortiz-Panozo, Eduardo, Esquivel-Guadarrama, Fernando, and Gutierrez-Xicotencatl, Lourdes

Subjects
HUMAN papillomavirus, CERVICAL intraepithelial neoplasia, DNA antibodies, HUMORAL immunity, EARLY detection of cancer
Abstract

Background: The humoral immune response against human papillomavirus (HPV) has been suggested as a source of biomarkers for the early detection of cervical cancer (CC). Therefore, we aimed to characterize the antibody response against HPV16 E5 in the natural history of cervical cancer and to determine its usefulness as a biomarker of HPV-associated cervical lesions. Methods: This study was conducted at the Cuautla General Hospital, Morelos, Mexico, with women (18 to 64 years) who agreed to participate. Samples were obtained from 335 women with cervical lesions and 150 women with negative Papanicolaou tests. HPV genotyping was performed by PCR and pyrosequencing, and anti-E5 antibodies were detected by slot blot. Results: The overall anti-E5 antibodies prevalence in the study was 17.9%, with the higher prevalence observed in the no lesion (NL, 49.4%) group, and with a downward trend according to the degree of the cervical lesion, from cervical intraepithelial neoplasia-1 (CIN1, 32.2%) to CIN2 (11.5%) and CIN3/CC (6.9%). The logistic regression model showed negative associations of anti-E5 antibodies with CIN1 (OR = 0.38), CIN2 (OR = 0.42), and CIN3/CC (OR = 0.32) groups, being statistically significant. Contrast analysis showed an inverse relationship between anti-E5 antibodies with HPV DNA and the CIN1 (OR = 0.35), CIN2 (OR = 0.39), and CIN3/CC (OR = 0.31) groups. Conclusions: These results suggest that anti-E5 antibodies could be associated with clearance of infection in women without lesions and with CIN1 lesions since an inverse relationship was observed between the presence of HPV DNA and anti-E5 antibodies. In contrast, with progression from CIN2/CIN3 to CC, the relationship was reversed, as the anti-E5 antibodies disappeared, and the frequency of the viral genome increased. [ABSTRACT FROM AUTHOR]

Published
2024
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13. Risk of COVID-19 after natural infection or vaccination

Author

Rick, Anne-Marie, primary, Laurens, Matthew B., additional, Huang, Ying, additional, Yu, Chenchen, additional, Martin, Thomas C.S., additional, Rodriguez, Carina A., additional, Rostad, Christina A., additional, Maboa, Rebone M., additional, Baden, Lindsey R., additional, El Sahly, Hana M., additional, Grinsztejn, Beatriz, additional, Gray, Glenda E., additional, Gay, Cynthia L., additional, Gilbert, Peter B., additional, Janes, Holly E., additional, Kublin, James G., additional, Huang, Yunda, additional, Leav, Brett, additional, Hirsch, Ian, additional, Struyf, Frank, additional, Dunkle, Lisa M., additional, Neuzil, Kathleen M., additional, Corey, Lawrence, additional, Goepfert, Paul A., additional, Walsh, Stephen R., additional, Follmann, Dean, additional, Kotloff, Karen L., additional, Adams, Atoya, additional, Miller, Eric, additional, Rankin, Bruce G., additional, Shinn, Steven, additional, Nash, Marshall, additional, Green, Sinikka L., additional, Jacobsen, Colleen, additional, Krishnankutty, Jayasree, additional, Phungwayo, Sikhongi, additional, Glover, Richard M., additional, Slechta, Stacy, additional, Holdeman, Troy, additional, Hartvickson, Robyn, additional, Grant, Amber, additional, Poling, Terry L., additional, Klein, Terry D., additional, Klein, Thomas C., additional, Klein, Tracy R., additional, Smith, William B., additional, Gibson, Richard L., additional, Winbigler, Jennifer, additional, Parker, Elizabeth, additional, Wijewardane, Priyantha N., additional, Bravo, Eric, additional, Thessing, Jeffrey, additional, Maxwell, Michelle, additional, Horn, Amanda, additional, Healy, Catherine Mary, additional, Akamine, Christine, additional, Chu, Laurence, additional, Chouteau, R. Michelle, additional, Cotugno, Michael J., additional, Bauer, George H., additional, Hachigian, Greg, additional, Oshita, Masaru, additional, Cancilla, Michael, additional, Kiersey, Kristen, additional, Seger, William, additional, Antwi, Mohammed, additional, Green, Allison, additional, Kim, Anthony, additional, Desjardins, Michael, additional, Johnson, Jennifer A., additional, Sherman, Amy, additional, Borger, Judith, additional, Saleem, Nafisa, additional, Solis, Joel, additional, Medina, Martha Carmen, additional, Keating, Westly, additional, Garcia, Edgar, additional, Bueno, Cynthia, additional, Segall, Nathan, additional, Denham, Douglas S., additional, Weiss, Thomas, additional, Avworo, Ayoade, additional, Hedges, Parke, additional, Strout, Cynthia Becher, additional, Santiago, Rica, additional, Davis, Yvonne, additional, Howenstine, Patty, additional, Bondell, Alison, additional, Marks, Kristin, additional, Wang, Tina, additional, Wilkin, Timothy, additional, Vogler, Mary, additional, Johnston, Carrie, additional, Andrasik, Michele P., additional, Andriesen, Jessica G., additional, Broder, Gail, additional, Eaton, Niles, additional, Gelderblom, Huub G., additional, McClennen, Rachael, additional, Michael, Nelson, additional, Robb, Merlin, additional, Sopher, Carrie, additional, Miller, Vicki E., additional, Santiago, Fredric, additional, Gomez, Blanca, additional, Valika, Insiya, additional, Starr, Amy, additional, Cantos, Valeria D., additional, Kandiah, Sheetal, additional, Rio, Carlos del, additional, Rouphael, Nadine, additional, Edupuganti, Srilatha, additional, Anderson, Evan J., additional, Camacho-Gonzalez, Andres, additional, Kamidani, Satoshi, additional, Teherani, Meghan, additional, Diemert, David J., additional, Malkin, Elissa, additional, Siegel, Marc, additional, Roberts, Afsoon, additional, Simon, Gary, additional, Balani, Bindu, additional, Stephenson, Carolene, additional, Sperber, Steven, additional, Cicogna, Cristina, additional, Zervos, Marcus J., additional, Kilgore, Paul, additional, Ramesh, Mayur, additional, Herc, Erica, additional, Zenlea, Kate, additional, Burgher, Abram, additional, Milliken, Ann M., additional, Davis, Joseph D., additional, Levy, Brendan, additional, Kelman, Sandra, additional, Doust, Matthew W., additional, Sample, Denise, additional, Erickson, Sandra, additional, Christensen, Shane G., additional, Matich, Christopher, additional, Longe, James, additional, Witbeck, John, additional, Peterson, James T., additional, Clark, Alexander, additional, Kelty, Gerald, additional, Pena-Renteria, Issac, additional, Koren, Michael J., additional, Bartilucci, Darlene, additional, Patel, Alpa, additional, Tran, Carolyn, additional, Kennelly, Christina, additional, Brownlee, Robert, additional, Coleman, Jacob, additional, Webster, Hala, additional, Fierro, Carlos A., additional, Leistner, Natalia, additional, Thompson, Amy, additional, Gonzalez, Celia, additional, Jackson, Lisa A., additional, Suyehira, Janice, additional, Haber, Milton, additional, Regalado, Maria M., additional, Procasky, Veronica, additional, Lutat, Alisha, additional, Griffin, Carl P., additional, Hollister, Ripley R., additional, Brown, Jeremy, additional, Ronk, Melody, additional, Harper, Wayne L., additional, Cohen, Lisa, additional, Eckert, Lynn, additional, Hong, Matthew, additional, Rouhbakhsh, Rambod, additional, Danford, Elizabeth, additional, Johnson, John, additional, Calderone, Richard, additional, Khetan, Shishir K., additional, Olanrewaju, Oyebisi, additional, Zhai, Nan, additional, Nieves, Kimberly, additional, O'Brien, Allison, additional, Bradley, Paul S., additional, Lilienthal, Amanda, additional, Callis, Jim, additional, Brosz, Adam B., additional, Clement, Andrea, additional, West, Whitney, additional, Friesen, Luke, additional, Cramer, Paul, additional, Eder, Frank S., additional, Little, Ryan, additional, Engler, Victoria, additional, Rattenbury-Shaw, Heather, additional, Ensz, David J., additional, Oplinger, Allie, additional, Essink, Brandon J., additional, Meyer, Jay, additional, Raiser, Frederick, additional, Mueller, Kimberly, additional, Vrbicky, Keith W., additional, Harper, Charles, additional, Nutsch, Chelsie, additional, Lewis, Wendell, additional, Laflan, Cathy, additional, Whatley, Jordan L., additional, Harrell, Nicole, additional, Shannon, Amie, additional, Rowell, Crystal, additional, Dedon, Christopher, additional, Makhene, Mamodikoe, additional, Gottschlich, Gregory M., additional, Harden, Kate, additional, Gottschlich, Melissa, additional, Smith, Mary, additional, Powell, Richard, additional, Kimmel, Murray A., additional, Pinto, Simmy, additional, Vachris, Timothy P., additional, Hutchens, Mark, additional, Daniels, Stephen, additional, Wells, Margaret, additional, Van Der Leden, Mimi, additional, Jackson-Booth, Peta-Gay, additional, Baron, Mira, additional, Kane, Pamela, additional, Seversen, Shannen, additional, Kryvicky, Mara, additional, Lord, Julia, additional, Saleh, Jamshid, additional, Miles, Matthew, additional, Lupercio, Rafael, additional, McGettigan, John W., additional, Patton, Walter, additional, Brakema, Riemke, additional, Choquette, Karin, additional, McGettigan, Jonlyn, additional, Kirstein, Judith L., additional, Bernard, Marcia, additional, Manning, Mary Beth, additional, Rothenberg, Joan, additional, Briskin, Toby, additional, Roadman, Denise, additional, Tedder-Edwards, Sharita, additional, Schwartz, Howard I., additional, Mederos, Surisday, additional, Swaminathan, Shobha, additional, Nyaku, Amesika, additional, Varughese, Tilly, additional, DallaPiazza, Michelle, additional, Frey, Sharon E., additional, Graham, Irene, additional, Abate, Getahun, additional, Hoft, Daniel, additional, Allen, Leland N., additional, Edwards, Leslie A., additional, Davis, William S., additional, Mena, Jessica M., additional, Kutner, Mark E., additional, Caso, Jorge, additional, Moran, Maria Hernandez, additional, Carvajal, Marianela, additional, Mendez, Janet, additional, Wadsworth, Larkin T., additional, Adams, Michael R., additional, Iverson, Leslie, additional, Newberg, Joseph L., additional, Pearlman, Laura, additional, Nugent, Paul J., additional, Reynolds, Michele D., additional, Bashour, Jennifer, additional, Schmidt, Robert, additional, Sheth, Neil P., additional, Steil, Kenneth, additional, Toma, Ramy J., additional, Kirby, William, additional, Folmar, Pink, additional, Williams, Samantha, additional, Pickrell, Paul, additional, Mott, Stefanie, additional, Linebarger, Carol Ann, additional, Malbari, Hussain, additional, Pampe, David, additional, Fragoso, Veronica G., additional, Holloway, Lisa, additional, McKeown-Bragas, Cecilia, additional, Becker, Teresa, additional, Williams, Barton G., additional, Jones, William H., additional, Clark, Jesse L., additional, Shoptaw, Steven, additional, Vertucci, Michele, additional, Hernandez, Will, additional, Spector, Stephen A., additional, Moodley, Amaran, additional, Blumenthal, Jill, additional, Stangl, Lisa, additional, Deutsch, Karen, additional, Mullane, Kathleen M., additional, Pitrak, David, additional, Nuss, Cheryl, additional, Pi, Judy, additional, Fichtenbaum, Carl, additional, Powers-Fletcher, Margaret, additional, Saemann, Michelle, additional, Kohrs, Sharon, additional, Campbell, Thomas B., additional, Lauria, Andrew, additional, Mancilla, Jose C., additional, Dunlevy, Hillary, additional, Novak, Richard M., additional, Wendrow, Andrea, additional, Borgetti, Scott, additional, Ladner, Ben, additional, Chrisley, Lisa, additional, Young, Cheryl, additional, Doblecki-Lewis, Susanne, additional, Alcaide, Maria L., additional, Gonzales-Zamora, Jose, additional, Morris, Stephen, additional, Wohl, David, additional, Eron, Joseph, additional, Frank, Ian, additional, Dunbar, Debora, additional, Metzger, David, additional, Momplaisir, Florence, additional, Martin, Judith, additional, Hoberman, Alejandro, additional, Shope, Timothy, additional, Muniz, Gysella, additional, Rupp, Richard, additional, Stanford, Amber, additional, Berman, Megan, additional, Porterfield, Laura, additional, Lewis, Michael, additional, Ghadishah, Elham, additional, Yusin, Joseph, additional, Pham, Mai, additional, Creech, Clarence B., additional, Walker, Shannon, additional, Rolsma, Stephanie, additional, Samuels, Robert, additional, Thomsen, Isaac, additional, Kalams, Spyros A., additional, Wilson, Greg, additional, Lucksinger, Gregg H., additional, Parks, Kevin, additional, Israelsen, Ryan, additional, Ostovar, Jaleh, additional, Kelly, Kary, additional, Overcash, Jeffrey S., additional, Chu, Hanh, additional, Lee, Kia, additional, De La Cruz, Luis I., additional, Clemons, Steve, additional, Everette, Elizabeth, additional, Studdard, Suzanna, additional, Mohan, Gowdhami, additional, Tyson, Stefanie, additional, Peay, Alyssa-Kay, additional, Johnson, Danyel, additional, Feldman, Gregory J., additional, Suen, May-Yin, additional, Muenzner, Jacqueline, additional, Boscia, Joseph, additional, Siddiqui, Farhan, additional, Sanders, John, additional, Peacock, James, additional, Nasim, Julio, additional, Levin, Michael L., additional, Hussey, Julie, additional, Kulic, Marcy, additional, McKenzie, Mark M., additional, Deese, Teresa, additional, Osmundsen, Erica, additional, Sweet, Christy, additional, Ebuh, Valentine M., additional, Elnagar, Elwaleed, additional, Ebuh, Georgette, additional, Iwuala, Genevieve, additional, Han-Conrad, Laurie J., additional, Simmons, Todd, additional, Tarakjian, Denis, additional, Ackermann, Jeremy, additional, Adams, Mark S., additional, Alemán, José O., additional, Al-Ibrahim, Mohamed S., additional, Andes, David R., additional, Andrews, Jeb, additional, Arduino, Roberto C., additional, Bäcker, Martín, additional, Badillo, Diana, additional, Bainbridge, Emma, additional, Batteiger, Teresa A., additional, Bazan, Jose A., additional, Bedimo, Roger J., additional, Benitez, Jorge A., additional, Bennett, Annette R., additional, Bernstein, David I., additional, Bialobok, Kristin, additional, Boas, Rebecca, additional, Brady, Judith, additional, Brown, Cynthia, additional, Bunce, Catherine A., additional, Call, Robert S., additional, Campbell, Wesley, additional, Carmody, Ellie, additional, Carpenter, Christopher, additional, Carsons, Steven E., additional, Castellon, Marvin, additional, Castro, Mario, additional, Catan, Hannah, additional, Chang, Jennifer, additional, Chebib, Mouna G., additional, Chen, Corey M., additional, Cheng, Margaret, additional, Chow, Brian D.W., additional, Ciambruschini, Annie, additional, Connor, Joseph P., additional, Conway, James H., additional, Cooney, Maureen, additional, Curlin, Marcel, additional, De La Matta Rodriguez, Claudia, additional, Dedon, Jon F., additional, Degan, Emily, additional, Dickey, Michelle, additional, Dietz, Craig, additional, Dong, Jennifer L., additional, Dorcely, Brenda, additional, Dube, Michael P., additional, Dyer, Carmel B., additional, Eckhardt, Benjamin, additional, Ellerbeck, Edward, additional, Ewers, Evan C., additional, Falk, Amy, additional, Feijoo, Brittany, additional, Felsen, Uriel R., additional, Fiel, Tom, additional, Fitz-Patrick, David, additional, Fogarty, Charles M., additional, Ford, Stacy, additional, Forero, Lina M., additional, Formentini, Elizabeth, additional, Franco-Vitteri, Doris, additional, Frenck, Robert W., additional, Gharib, Elie, additional, Gharib, Suzanne, additional, Rucker, Rola G., additional, Goldenberg, James N., additional, González, Luis H., additional, Gray, Brett, additional, Greene, Rusty, additional, Grossberg, Robert M., additional, Guanira-Carranza, Juan V., additional, Guerreros Benavides, Alfredo Gilberto, additional, Guillory, Clint C., additional, Gunaratne, Shauna H., additional, Halpert, David, additional, Hamilton, Holli, additional, Hartman, William R., additional, Henderson, Sheryl L., additional, Herati, Ramin, additional, Guarin, Laura Hernandez, additional, Hilder, Robin, additional, Ho, Ken, additional, Hojat, Leila, additional, Hosek, Sybil G., additional, Jacobson, Jeffrey M., additional, Jay, Melanie, additional, Johnson, Diane H., additional, Jones, Kathleen S., additional, Jones-López, Edward C., additional, Justman, Jessica E., additional, Kahney, Scott, additional, Katz, Lois, additional, Katz, Melinda, additional, Kaul, Daniel, additional, Keefer, Michael C., additional, Kennedy, Ashley, additional, Knishinsky, Jennifer, additional, Kogelman, Laura, additional, Koletar, Susan L., additional, Kottkamp, Angelica, additional, Laguio-Vila, Maryrose, additional, Landovitz, Raphael J., additional, Lee, Jessica L., additional, Liu, Albert, additional, Llerena Zegarra, Eneyda Giuvanela, additional, Lok, Anna S., additional, Lovell, James, additional, Lubelchek, Ronald, additional, Lucaj, John, additional, Luckasen, Gary, additional, Luetkemeyer, Annie, additional, Lugogo, Njira Lucia, additional, Maenza, Janine, additional, Malvestutto, Carlos, additional, Mauri, Monica, additional, Maves, Ryan C., additional, Mayer, Kenneth H., additional, McCartney, Michael J., additional, McCort, Margaret E., additional, McElrath, M. Juliana, additional, McNairy, Meredith, additional, Merino, Fernando L., additional, Meyerowitz, Eric A., additional, Mitchell, Carol L., additional, Monaco, Cynthia L., additional, Muhammad, Sauda, additional, Muñoz-Gómez, Sigridh, additional, Munsiff, Sonal, additional, Nee, Paul, additional, Nollen, Nicole L., additional, Noor, Asif, additional, Lagos, Claudio Nuñez, additional, Okulicz, Jason F., additional, Oliver, Patrick A., additional, Ortega, Jessica, additional, Palmer, Steven, additional, Parameswaran, Lalitha, additional, Parikh, Purvi, additional, Parker, Susan, additional, Parungao, Reza, additional, Pavie, Juana R., additional, Madan, Rebecca P., additional, Peralta, Henry, additional, Petts, Jennifer, additional, Pierce, Kristen K., additional, Pretell Alva, E. Javier, additional, Purpura, Lawrence J., additional, Raabe, Vanessa, additional, Recuenco, Sergio E., additional, Richards, Tamara, additional, Riddler, Sharon A., additional, Rizzardi, Barbara, additional, Rokser, Rachel, additional, Rolle, Charlotte-Paige, additional, Rosen, Adam, additional, Rosen, Jeffrey, additional, Freese, Lena R., additional, Santolaya, María E., additional, Schipani, Linda M., additional, Schwartz, Adam, additional, Schwasinger-Schmidt, Tiffany, additional, Scott, Hyman, additional, Sha, Beverly E., additional, Shankaran, Shivanjali, additional, Shapiro, Adrienne E., additional, Sharp, Stephan C., additional, Shopsin, Bo, additional, Sims, Matthew D., additional, Skipper, Stephanie, additional, Smith, Derek M., additional, Smith, Michael J., additional, Sobhanie, M. Mahdee, additional, Sovic, Brit, additional, Sterling, Stephanie, additional, Striker, Robert, additional, Tafur Bances, Karla Beatriz, additional, Talaat, Kawsar R., additional, Tavel, Edward M., additional, Tieu, Hong V., additional, Tomaszewski, Christian, additional, Tomlinson, Ryan, additional, Torres, Juan P., additional, Torres, Julian A., additional, Treanor, John J., additional, Tukuru, Sade, additional, Ulrich, Robert J., additional, Utz, Gregory C., additional, Viar, Veronica, additional, Viau Colindres, Roberto A., additional, Walsh, Edward E., additional, Walsh, Mary C., additional, Walter, Emmanuel B., additional, Weidler, Jessica L., additional, Wu, Yi H., additional, Yang, Kinara S., additional, Yrivarren Giorza, Juan Luis, additional, Zemanek, Arthur L., additional, Zhang, Kevin, additional, Zingman, Barry S., additional, Gorman, Richard, additional, Paez, Carmen A., additional, Swann, Edith, additional, Takuva, Simbarashe G., additional, Greninger, Alex, additional, Roychoudhury, Pavitra, additional, Coombs, Robert W., additional, Jerome, Keith R., additional, Castellino, Flora, additional, Tong, Xiaomi, additional, Pavetto, Corrina, additional, Gipson, Teletha, additional, Tong, Tina, additional, Lee, Marina, additional, Zhou, James, additional, Fay, Michael, additional, McQuarrie, Kelly, additional, Nnadi, Chimeremma, additional, Sogbetun, Obiageli, additional, Ahmad, Nina, additional, De Proost, Ian, additional, Hoseyni, Cyrus, additional, Coplan, Paul, additional, Khan, Najat, additional, Ronco, Peter, additional, Furey, Dawn, additional, Meck, Jodi, additional, Vingerhoets, Johan, additional, Brandenburg, Boerries, additional, Custers, Jerome, additional, Hendriks, Jenny, additional, Juraszek, Jarek, additional, Marit de Groot, Anne, additional, Van Roey, Griet, additional, Heerwegh, Dirk, additional, Van Dromme, Ilse, additional, Méndez Galván, Jorge F., additional, Carrascal, Monica B., additional, Duran, Adriana Sordo, additional, Sanchez Guerrero, Laura Ruy, additional, Gómora Madrid, Martha Cecilia, additional, Barrat Hernández, Alejandro Quintín, additional, Guizar, Sharzhaad Molina, additional, González Estrada, Denisse Alejandra, additional, Martínez Pérez, Silvano Omar, additional, Zárate Hinojosa, Zindy Yazmín, additional, Ruiz-Palacios, Guillermo Miguel, additional, Cruz-Valdez, Aurelio, additional, Pacheco-Flores, Janeth, additional, Lara, Anyela, additional, Díaz-Miralrio, Secia, additional, Reyes Fentanes, María José, additional, Olmos Vega, Jocelyn Zuleica, additional, Méndez, Daniela Pineda, additional, Martínez, Karina Cano, additional, Alvarez León, Winniberg Stephany, additional, Ruiz Herrera, Vida Veronica, additional, Vázquez Saldaña, Eduardo Gabriel, additional, Camacho Choza, Laura Julia, additional, Vega Orozco, Karen Sofia, additional, Ortega Domínguez, Sandra Janeth, additional, Chacón, Jorge A., additional, Rivera, Juan J., additional, Cutz, Erika A., additional, Ortegón, Maricruz E., additional, Rivera, María I., additional, Browder, David, additional, Burch, Cortney, additional, Moye, Terri, additional, Bondy, Paul, additional, Browder, Lesley, additional, Manning, Rickey D., additional, Hurst, James W., additional, Sturgeon, Rodney E., additional, Wakefield, Paul H., additional, Kirby, John A., additional, Andersen, James, additional, Fearon, Szheckera, additional, Negron, Rosa, additional, Medina, Amy, additional, Hill, John M., additional, Rajasekhar, Vivek, additional, Williams, Hayes, additional, Cade, LaShondra, additional, Fouts, Rhodna, additional, Moya, Connie, additional, Anderson, Corey G., additional, Devine, Naomi, additional, Ramsey, James, additional, Perez, Ashley, additional, Tatelbaum, David, additional, Jacobs, Michael, additional, Menasche, Kathleen, additional, Mirkil, Vincent, additional, Winkle, Peter J., additional, Haggag, Amina Z., additional, Haynes, Michelle, additional, Villegas, Marysol, additional, Raja, Sabina, additional, Riesenberg, Robert, additional, Plavin, Stanford, additional, Lerman, Mark, additional, Woodside, Leana, additional, Johnson, Maria, additional, Healy, C. Mary, additional, Whitaker, Jennifer A., additional, Keitel, Wendy A., additional, Atmar, Robert L., additional, Horwith, Gary, additional, Mason, Robin, additional, Johnson, Lisa, additional, Dora, Tambra, additional, Murray, Deborah, additional, Ledbetter, Logan, additional, Ewing, Beverly, additional, Stephenson, Kathryn E., additional, Tan, Chen S., additional, Zash, Rebecca, additional, Ansel, Jessica L., additional, Jaegle, Kate, additional, Guiney, Caitlin J., additional, Henderson, Jeffrey A., additional, O'Leary, Marcia, additional, Enright, Kendra, additional, Kessler, Jill, additional, Ducheneaux, Pete, additional, Inniss, Asha, additional, Brandon, Donald M., additional, Davis, William B., additional, Lawler, Daniel T., additional, Oppong, Yaa D., additional, Starr, Ryan P., additional, Syndergaard, Scott N., additional, Shelly, Rozeli, additional, Majumder, Mashrur Islam, additional, Sugimoto, Danny, additional, Dugas, Jeffrey, additional, Rijos, Dolores, additional, Shelton, Sandra, additional, Hong, Stephan, additional, Schwartz, Howard, additional, Sanchez-Crespo, Nelia, additional, Schwartz, Jennifer, additional, Piedra, Terry, additional, Corral, Barbara, additional, Medina, Carmen, additional, Dever, Michael E., additional, Shah, Mitul, additional, Delgado, Michael, additional, Scott, Tameika, additional, Usdan, Lisa S., additional, McGill, Lora J., additional, Arnold, Valerie K., additional, Scatamacchia, Carolyn, additional, Anthony, Codi M., additional, Merchant, Rajan, additional, Yoon, Anelgine C., additional, Hill, Janet, additional, Ng-Price, Lucy, additional, Thompson-Seim, Teri, additional, Ackerman, Ronald, additional, Ackerman, Jamie, additional, Aristy, Florida, additional, Ketter, Nzeera, additional, Finley, Jon, additional, Stull, Mildred, additional, Murray, Monica, additional, Rizvi, Zainab, additional, Guerrero, Sonia, additional, Paliwal, Yogesh K., additional, Paliwal, Amit, additional, Gordon, Sarah, additional, Gordon, Bryan, additional, Montano-Pereira, Cynthia, additional, Galloway, Christopher, additional, Montros, Candice, additional, Aleman, Lily, additional, Shairi, Samira, additional, Van Ever, Wesley, additional, Freeman, George H., additional, Harmon, Esther L., additional, Cross, Marshall A., additional, Sales, Kacie, additional, Gular, Catherine Q., additional, Hepburn, Matthew, additional, Alderson, Nathan, additional, Harshell, Shana, additional, Mahgoub, Siham, additional, Maxwell, Celia, additional, Mellman, Thomas, additional, Thompson, Karl M., additional, Wortman, Glenn, additional, Kingsley, Jeff, additional, Pixler, April, additional, Curry, LaKondria, additional, Afework, Sarah, additional, Swanson, Austin, additional, Jacqmein, Jeffry, additional, Bowers, Maggie, additional, Robison, Dawn, additional, Mosteller, Victoria, additional, Garvey, Janet, additional, Easley, Mary, additional, Kurnat, Rebecca J., additional, Cornelison, Raymond, additional, Gower, Shanda, additional, Schnitz, William, additional, Heinzig-Cartwright, Destiny S., additional, Lewis, Derek, additional, Newton, Fred E., additional, Duhart, Aeiress, additional, Watkins, Breanz, additional, Ball, Brandy, additional, York, Jill, additional, Pickle, Shelby, additional, Musante, David B., additional, Silver, William P., additional, Belhorn, Linda R., additional, Viens, Nicholas A., additional, Dellaero, David, additional, Patel, Priti, additional, Lisec, Kendra, additional, Safirstein, Beth, additional, Zapata, Luz, additional, Gonzalez, Lazaro, additional, Quevedo, Evelyn, additional, Irani, Farah, additional, Grillo, Joseph, additional, Potts, Amy, additional, White, Julie, additional, Flume, Patrick, additional, Headden, Gary, additional, Taylor, Brandie, additional, Warden, Ashley, additional, Chamberlain, Amy, additional, Jeanfreau, Robert, additional, Jeanfreau, Susan, additional, Matherne, Paul G., additional, Caldwell, Amy, additional, Stahl, Jessica, additional, Vowell, Mandy, additional, Newhouse, Lauren, additional, Berthaud, Vladimir, additional, Takizala, Zudi-Mwak, additional, Beninati, Genevieve, additional, Snell, Kimberly, additional, Baker, Sherrie, additional, Walker, James, additional, Harrison, Tavane, additional, Miller, Meagan, additional, Otto, Janet, additional, Gray, Roni, additional, Wilson, Christine, additional, Nemecek, Tiffany, additional, Harrington, Hannah, additional, Eppenbach, Sally, additional, Bourgeois, Tana, additional, Folsom, Lyndsea, additional, Holt, Gregory, additional, Mirsaeidi, Mehdi, additional, Calderon, Rafael, additional, Lichtenberger, Paola, additional, Quintero, Jalima, additional, Martinez, Becky, additional, Immergluck, Lilly, additional, Johnson, Erica, additional, Chan, Austin, additional, Fas, Norberto, additional, Thomas-Seaton, LaTeshia, additional, Khizer, Saadia, additional, Staben, Jonathan, additional, Beresnev, Tatiana, additional, Jahromi, Maryam, additional, Marovich, Mary A., additional, Hutter, Julia, additional, Nason, Martha, additional, Ledgerwood, Julie, additional, Mascola, John, additional, Leibowitz, Mark, additional, Morales, Fernanda, additional, Delgado, Mike, additional, Sanchez, Rosario, additional, Vega, Norma, additional, Áñez, Germán, additional, Albert, Gary, additional, Coston, Erin, additional, Desai, Chinar, additional, Dunbar, Haoua, additional, Eickhoff, Mark, additional, Garcia, Jenina, additional, Kautz, Margaret, additional, Lee, Angela, additional, Lewis, Maggie, additional, McGarry, Alice, additional, McKnight, Irene, additional, Nelson, Joy, additional, Newingham, Patrick, additional, Price-Abbott, Patty, additional, Reed, Patty, additional, Vegas, Diana, additional, Wilkinson, Bethanie, additional, Smith, Katherine, additional, Woo, Wayne, additional, Cho, Iksung, additional, Glenn, Gregory M., additional, Dubovsky, Filip, additional, Fried, David L., additional, Haughey, Lynne A., additional, Stanton, Ariana C., additional, Rameaka, Lisa Stevens, additional, Rosenberg, David, additional, Tomatsu, Lee, additional, Gonzalez, Viviana, additional, Manalo, Millie, additional, Grunstra, Bernard, additional, Quinn, Donald, additional, Claybrook, Phillip, additional, Olds, Shelby, additional, Dye, Amy, additional, Cannon, Kevin D., additional, Chadwick, Mesha M., additional, Jordan, Bailey, additional, Hussey, Morgan, additional, Nevarez, Hannah, additional, Kelley, Colleen F., additional, Chung, Michael, additional, Moran, Caitlin, additional, Rebolledo, Paulina, additional, Bacher, Christina, additional, Barranco-Santana, Elizabeth, additional, Rodriguez, Jessica, additional, Mendoza, Rafael, additional, Ruperto, Karen, additional, Olivieri, Odette, additional, Ocaña, Enrique, additional, Wylie, Paul E., additional, Henderson, Renea, additional, Jenson, Natasa, additional, Yang, Fan, additional, Kelley, Amy, additional, Finkelstein, Kenneth, additional, Beckmann, David, additional, Hutchins, Tanya, additional, Escallon, Sebastian Garcia, additional, Johnson, Kristen, additional, Sligh, Teresa S., additional, Desai, Parul, additional, Huynh, Vincent, additional, Lopez, Carlos, additional, Mendoza, Erika, additional, Adelglass, Jeffrey, additional, Naifeh, Jerome G., additional, Kucera, Kristine J., additional, Chughtai, Waseem, additional, Jaffer, Shireen H., additional, Davis, Matthew G., additional, Foley, Jennifer, additional, Burgett, Michelle L., additional, Shlotzhauer, Tammi L., additional, Ingalsbe-Geno, Sarah M., additional, Duncanson, Daniel, additional, Kush, Kelly, additional, Nesbitt, Lori, additional, Sonnier, Cora, additional, McCarter, Jennifer, additional, Butcher, Michael B., additional, Fry, James, additional, Percy, Donna, additional, Freudemann, Karen, additional, Gebhardt, Bruce C., additional, Mangu, Padma N., additional, Schroeck, Debra B., additional, Davit, Rajesh K., additional, Hennekes, Gayle D., additional, Luft, Benjamin J., additional, Carr, Melissa, additional, Nachman, Sharon, additional, Pellecchia, Alison, additional, Smith, Candace, additional, Valenti, Bruno, additional, Bermudez, Maria I., additional, Peraita, Noris, additional, Delgado, Ernesto, additional, Arrazcaeta, Alicia, additional, Ramirez, Natalie, additional, Amador, Carmen, additional, Marafioti, Horacio, additional, Dang, Lyly, additional, Clement, Lauren, additional, Berry, Jennifer, additional, Allaw, Mohammed, additional, Geuss, Georgettea, additional, Miles, Chelsea, additional, Bittner, Zachary, additional, Werne, Melody, additional, Calinescu, Cornell, additional, Rodman, Shannon, additional, Rindt, Joshua, additional, Cooksey, Erin, additional, Harrison, Kristina, additional, Cooper, Deanna, additional, Horton, Manisha, additional, Philyaw, Amanda, additional, Jennings, William, additional, Alvarado, Hilario, additional, Baka, Michele, additional, Regalado, Malina, additional, Murray, Linda, additional, Naguib, Sherif, additional, Singletary, Justin, additional, Richmond, Sha-Wanda, additional, Omodele, Sarah, additional, Oppenheim, Emily, additional, Martinez, Reuben, additional, Andriulis, Victoria, additional, Singer, Leonard, additional, Blevins, Jeanne, additional, Thomas, Meagan, additional, Hull, Christine, additional, Pereira, Isabel, additional, Rivero, Gina, additional, Okonya, Tracy, additional, Downing, Frances, additional, Miller, Paulina, additional, Rhee, Margaret, additional, Stapleton, Katherine, additional, Klein, Jeffrey, additional, Hong, Rosamond, additional, Swan, Suzanne, additional, Wahlin, Tami, additional, Bennett, Elizabeth, additional, Salzl, Amy, additional, Phan, Sharine, additional, White, Jewel J., additional, Occhino, Amanda, additional, Paiano, Ruth, additional, McLaughlin, Morgan, additional, Swieboda, Elisa, additional, Garcia-Fragoso, Veronica, additional, Becerra, Maria G., additional, White, Toni, additional, Turley, Christine B., additional, McWilliams, Andrew, additional, Esinhart, Tiffany, additional, Montoya, Natasha, additional, Huskey, Shamika, additional, Paul, Leena, additional, Tashima, Karen, additional, Johnson, Jennie, additional, Neill, Marguerite, additional, Sanchez, Martha, additional, Rybak, Natasha, additional, Mileno, Maria, additional, Cohen, Stuart H., additional, Ruiz, Monica, additional, Boswell, Dean M., additional, Robison, Elizabeth E., additional, Reynolds, Trina L., additional, Neumeister, Sonja, additional, Zorrilla, Carmen D., additional, Rivera, Juana, additional, Ibarra, Jessica, additional, García, Iris, additional, Sierra, Dianca, additional, Ramon, Wanda, additional, Fiorillo, Suzanne, additional, Pitotti, Rebecca, additional, Anderson, Victoria R., additional, Mancilla, Jose Castillo, additional, Le, Nga, additional, Winokur, Patricia L., additional, Ince, Dilek, additional, Hegmann, Theresa, additional, Meier, Jeffrey, additional, Stapleton, Jack, additional, Stulken, Laura, additional, McArthur, Monica, additional, Berry, Andrea, additional, Tapia, Milagritos, additional, Hammershaimb, Elizabeth, additional, Robinson, Toni, additional, MacBryde, Rosa, additional, Kline, Susan, additional, Billings, Joanne L., additional, Cavert, Winston, additional, Forgosh, Les B., additional, Schacker, Timothy W., additional, Bold, Tyler D., additional, Dandachi, Dima, additional, Nelson, Taylor, additional, Bran, Andres, additional, Geiger, Grant, additional, Naqvi, S. Hasan, additional, Florescu, Diana F., additional, Starlin, Richard, additional, Kline, David, additional, Zimmer, Andrea, additional, Abbas, Anum, additional, Wilson, Natasha, additional, Eron, Joseph J., additional, Sciaudone, Michael, additional, Rosengren, A. Lina, additional, Kizer, John S., additional, Rutstein, Sarah E., additional, Bruce, Elizabeth, additional, Espinosa, Claudia, additional, Sanders, Lisa J., additional, Kim, Kami, additional, Casey, Denise, additional, Taylor, Barbara S., additional, Patterson, Thomas, additional, Pinilla, Ruth S., additional, Bullock, Delia, additional, Ponce, Philip, additional, Patterson, Jan, additional, McClelland, R. Scott, additional, Lane, Dakotah C., additional, Wald, Anna, additional, James, Frank, additional, Duke, Elizabeth, additional, Hauge, Kirsten, additional, Heimonen, Jessica, additional, Goecker, Erin A., additional, Fong, Youyi, additional, Kauffman, Carol, additional, Linder, Kathleen, additional, Nofz, Kimberly, additional, McConnell, Andrew, additional, Buynak, Robert J., additional, Webb, Angella, additional, Petty, Taryn, additional, Andree, Stephanie, additional, Sanchez, Erica, additional, Mackey, Nolan, additional, Baudelaire, Clarisse, additional, Dzigiel, Sarah, additional, Marquez, Adrienna, additional, Quillin, Kim, additional, King, Michelle, additional, Abad, Vanessa, additional, Knowles, Jennifer, additional, Waters, Michael, additional, Zepeda, Karla, additional, Coslet, Jordan, additional, Tovar, Dalia, additional, Shaw, Marian E., additional, Turner, Mark A., additional, Huffine, Cory J., additional, Huffine, Esther S., additional, Ake, Julie A., additional, Secord, Elizabeth, additional, McGrath, Eric, additional, Levy, Phillip, additional, Stewart, Brittany, additional, Cromer, Charnell, additional, Walters, Ayanna, additional, Ellsworth, Grant, additional, Greene, Caroline, additional, Galloway, Sarah, additional, Kapadia, Shashi, additional, DeHaan, Elliot, additional, Wilson, Clint, additional, Milligan, Jason, additional, Raley, Danielle, additional, Bocchini, Joseph, additional, McClenathan, Bruce, additional, Hussain, Mary, additional, Lomasney, Evelyn, additional, Hall, Evelyn, additional, Lamberth, Sherry, additional, Schmeck, Christy, additional, Leathers, Vickie, additional, Theodore, Deborah A., additional, Branche, Angela R., additional, Graciaa, Daniel S., additional, Hatlen, Timothy J., additional, Miller, Jacqueline, additional, Sadoff, Jerald, additional, Falsey, Ann R., additional, and Sobieszczyk, Magdalena E., additional

Published
2023
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14. Performance of cervical cytology and HPV testing for primary cervical cancer screening in Latin America: an analysis within the ESTAMPA study

Author

Ramírez, Arianis Tatiana, primary, Valls, Joan, additional, Baena, Armando, additional, Rojas, Freddy David, additional, Ramírez, Katherine, additional, Álvarez, Rodrigo, additional, Cristaldo, Carmen, additional, Henríquez, Odessa, additional, Moreno, Adrián, additional, Reynaga, Daysi Colque, additional, Palma, Hans González, additional, Robinson, Isabel, additional, Hernández, Diana Carolina, additional, Bardales, Rosa, additional, Cardinal, Lucia, additional, Salgado, Yuly, additional, Martínez, Sandra, additional, González, Emmanuel, additional, Guillén, Diego, additional, Fleider, Laura, additional, Tatti, Silvio, additional, Villagra, Verónica, additional, Venegas, Gino, additional, Cruz-Valdez, Aurelio, additional, Valencia, Marleny, additional, Rodríguez, Guillermo, additional, Terán, Carolina, additional, Picconi, María Alejandra, additional, Ferrera, Annabelle, additional, Kasamatsu, Elena, additional, Mendoza, Laura, additional, Calderon, Alejandro, additional, Luciani, Silvana, additional, Broutet, Nathalie, additional, Darragh, Teresa, additional, Almonte, Maribel, additional, Herrero, Rolando, additional, Rol, Mary Luz, additional, Lucas, Eric, additional, Hernández, María de la Luz, additional, Sánchez, Gloria Inés, additional, Murillo, Raul, additional, Jerónimo, Jose, additional, Ferreccio, Catterina, additional, Rodríguez, María Isabel, additional, Cabrera, Yessy, additional, Salgado, Brenda, additional, Colucci, María Celeste, additional, Saino, Maria Agustina, additional, Rodríguez de la Peña, Margarita, additional, Fernández, Daniel Llanos, additional, García, Laura, additional, Caserta, Benedicta, additional, Doimi, Franco, additional, and Lazcano-Ponce, Eduardo, additional

Published
2023
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15. Respiratory viruses and influenza-like illness: Epidemiology and outcomes in children aged 6 months to 10 years in a multi-country population sample

Author

Taylor, Sylvia, Lopez, Pio, Weckx, Lily, Borja-Tabora, Charissa, Ulloa-Gutierrez, Rolando, Lazcano-Ponce, Eduardo, Kerdpanich, Angkool, Angel Rodriguez Weber, Miguel, Mascareñas de Los Santos, Abiel, Tinoco, Juan-Carlos, Safadi, Marco Aurelio P., Lim, Fong Seng, Hernandez-de Mezerville, Marcela, Faingezicht, Idis, Cruz-Valdez, Aurelio, Feng, Yang, Li, Ping, Durviaux, Serge, Haars, Gerco, Roy-Ghanta, Sumita, Vaughn, David W., and Nolan, Terry

Published
2017
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16. Espacios cardioprotegidos en México: acciones para prevenir la muerte súbita cardiaca. Una postura de profesionales de la salud

Author

Martínez-Duncker R, David, primary, Urzúa-González, Agustín Ramiro, additional, Aguilera-Mora, Luisa Fernanda, additional, Laínez-Zelaya, José S, additional, Álvarez de la Cadena-Sillas, Jorge, additional, Celaya-Cota, Manuel de Jesús, additional, González-Cruz, Erik H, additional, Delgado, Elisa, additional, Campos-Nonato, Ismael, additional, Denova-Gutiérrez, Edgar, additional, Cruz-Valdez, Aurelio, additional, Cossio-Aranda, Jorge Eduardo, additional, Guerra-López, Arturo, additional, Enciso-Muñoz, José Manuel, additional, Sánchez-Arreola, Luis Daniel, additional, Magaña-Serrano, José Antonio, additional, Díaz-Aguilera, Miguel Ángel, additional, Gómez-Álvarez, Enrique, additional, Oseguera-Moguel, Jorge, additional, Barquera, Simón, additional, Sifuentes-Osornio, José, additional, and Lazcano Ponce, Eduardo C, additional

Published
2023
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17. Performance of standardised colposcopy to detect cervical precancer and cancer for triage of women testing positive for human papillomavirus : results from the ESTAMPA multicentric screening study

Author

Universidad Nacional de Asunción. Instituto de Investigaciones en Ciencias de la Salud, Valls, Joan, Baena, Armando, Venegas, Gino, Celis, Marcela, González, Mauricio, Sosa, Carlos, Santin, Jorge Luis, Ortega, Marina, Soilán, Ana, Turcios, Elmer, Figueroa, Jacqueline, Rodríguez de la Peña, Margarita, Figueredo, Alicia, Beracochea, Andrea Verónica, Pérez, Natalia, Martínez Better, Josefina, Lora, Oscar, Jiménez, Julio Yamil, Giménez, Diana, Fleider, Laura, Salgado, Yuly, Martínez, Sandra, Bellido Fuentes, Yenny, Flores, Bettsy, Tatti, Silvio, Villagra, Verónica, Cruz Valdez, Aurelio, Terán, Carolina, Sánchez, Gloria Inés, Rodríguez, Guillermo, Picconi, María Alejandra, Ferrera, Annabelle, Mendoza Torres, Laura Patricia, Calderón, Alejandro, Murillo, Raúl, Wiesner, Carolina, Broutet, Nathalie, Luciani, Silvana, Pérez, Carlos, Darragh, Teresa M., Jerónimo, José, Herrero, Rolando, Almonte, Maribel, Universidad Nacional de Asunción. Instituto de Investigaciones en Ciencias de la Salud, Valls, Joan, Baena, Armando, Venegas, Gino, Celis, Marcela, González, Mauricio, Sosa, Carlos, Santin, Jorge Luis, Ortega, Marina, Soilán, Ana, Turcios, Elmer, Figueroa, Jacqueline, Rodríguez de la Peña, Margarita, Figueredo, Alicia, Beracochea, Andrea Verónica, Pérez, Natalia, Martínez Better, Josefina, Lora, Oscar, Jiménez, Julio Yamil, Giménez, Diana, Fleider, Laura, Salgado, Yuly, Martínez, Sandra, Bellido Fuentes, Yenny, Flores, Bettsy, Tatti, Silvio, Villagra, Verónica, Cruz Valdez, Aurelio, Terán, Carolina, Sánchez, Gloria Inés, Rodríguez, Guillermo, Picconi, María Alejandra, Ferrera, Annabelle, Mendoza Torres, Laura Patricia, Calderón, Alejandro, Murillo, Raúl, Wiesner, Carolina, Broutet, Nathalie, Luciani, Silvana, Pérez, Carlos, Darragh, Teresa M., Jerónimo, José, Herrero, Rolando, and Almonte, Maribel

Abstract

Background. Colposcopy, currently included in WHO recommendations as an option to triage human papillomavirus (HPV)-positive women, remains as the reference standard to guide both biopsy for confirmation of cervical precancer and cancer and treatment approaches. We aim to evaluate the performance of colposcopy to detect cervical precancer and cancer for triage in HPV-positive women. Methods. This cross-sectional, multicentric screening study was conducted at 12 centres (including primary and secondary care centres, hospitals, laboratories, and universities) in Latin America (Argentina, Bolivia, Colombia, Costa Rica, Honduras, Mexico, Paraguay, Peru, and Uruguay). Eligible women were aged 30–64 years, sexually active, did not have a history of cervical cancer or treatment for cervical precancer or a hysterectomy, and were not planning to move outside of the study area. Women were screened with HPV DNA testing and cytology. HPV-positive women were referred to colposcopy using a standardised protocol, including biopsy collection of observed lesions, endocervical sampling for transformation zone (TZ) type 3, and treatment as needed. Women with initial normal colposcopy or no high-grade cervical lesions on histology (less than cervical intraepithelial neoplasia [CIN] grade 2) were recalled after 18 months for another HPV test to complete disease ascertainment; HPV-positive women were referred for a second colposcopy with biopsy and treatment as needed. Diagnostic accuracy of colposcopy was assessed by considering a positive test result when the colposcopic impression at the initial colposcopy was positive minor, positive major, or suspected cancer, and was considered negative otherwise. The main study outcome was histologically confirmed CIN3+ (defined as grade 3 or worse) detected at the initial visit or 18-month visit. Findings. Between Dec 12, 2012, and Dec 3, 2021, 42 502 women were recruited, and 5985 (14·1%) tested positive for HPV. 4499 participants with complete

Published
2023

18. Performance of cervical cytology and HPV testing for primary cervical cancer screening in Latin America : an analysis within the ESTAMPA study

Author

Universidad Nacional de Asunción. Instituto de Investigaciones en Ciencias de la Salud, Ramírez, Arianis Tatiana, Valls, Joan, Baena, Armando, Rojas, Freddy David, Ramírez, Katherine, Álvarez, Rodrigo, Cristaldo, Carmen, Henríquez, Odessa, Moreno, Adrián, Colque Reynaga, Daysi, González Palma, Hans, Robinson, Isabel, Hernández, Diana Carolina, Bardales, Rosa, Cardinal, Lucía, Salgado, Yuly, Martínez, Sandra, González, Emmanuel, Guillén, Diego, Fleider, Laura, Tatti, Silvio, Villagra, Verónica, Venegas, Gino, Cruz Valdez, Aurelio, Valencia, Marleny, Rodríguez, Guillermo, Terán, Carolina, Picconi, María Alejandra, Ferrera, Annabelle, Kasamatsu, Elena Satiko, Mendoza Torres, Laura Patricia, Calderón, Alejandro, Luciani, Silvana, Broutet, Nathalie, Darragh, Teresa M., Almonte, Maribel, Herrero, Rolando, Universidad Nacional de Asunción. Instituto de Investigaciones en Ciencias de la Salud, Ramírez, Arianis Tatiana, Valls, Joan, Baena, Armando, Rojas, Freddy David, Ramírez, Katherine, Álvarez, Rodrigo, Cristaldo, Carmen, Henríquez, Odessa, Moreno, Adrián, Colque Reynaga, Daysi, González Palma, Hans, Robinson, Isabel, Hernández, Diana Carolina, Bardales, Rosa, Cardinal, Lucía, Salgado, Yuly, Martínez, Sandra, González, Emmanuel, Guillén, Diego, Fleider, Laura, Tatti, Silvio, Villagra, Verónica, Venegas, Gino, Cruz Valdez, Aurelio, Valencia, Marleny, Rodríguez, Guillermo, Terán, Carolina, Picconi, María Alejandra, Ferrera, Annabelle, Kasamatsu, Elena Satiko, Mendoza Torres, Laura Patricia, Calderón, Alejandro, Luciani, Silvana, Broutet, Nathalie, Darragh, Teresa M., Almonte, Maribel, and Herrero, Rolando

Abstract

Background. Cervical cytology remains widely used as the initial tool in cervical cancer screening worldwide. WHO guidelines recommend replacing cytology with primary HPV testing to reach cervical cancer elimination goals. We assessed the performance of cytology and high-risk HPV testing to detect cervical precancer, cervical intraepithelial neoplasia (CIN) grade 3 or worse (CIN3+) among women aged 30–64 years participating in the ESTAMPA study. Methods. Women were screened with cytology and HPV across ESTAMPA study centres in Latin America. Screen-positives were referred to colposcopy with biopsy collection and treatment as needed. Those with no evident precancer were recalled at 18-months for a second HPV test to complete disease ascertainment. Performance indicators for cytology and HPV to detect CIN3+ were estimated. Findings. 30,606 participants with available cytology and HPV results were included in the analysis. A total of 440 histologically confirmed CIN3s and 30 cancers were diagnosed. Cytology sensitivity for CIN3+ was 48.5% (95% CI: 44.0–53.0), whereas HPV testing had a sensitivity of 98.1% (95% CI: 96.3–96.7). Specificity was 96.5% (95% CI: 96.3–96.7) using cytology and 88.7% (95% CI: 88.3–89.0) with HPV. Performance estimates varied substantially by study centre for cytology (ranging from 32.1% to 87.5% for sensitivity and from 89.2% to 99.5% for specificity) while for HPV results were more consistent across sites (96.7%–100% and 83.6–90.8%, respectively). Interpretation. The limited and highly variable sensitivity of cytology strongly supports transition to the more robust and reproducible HPV-based cervical screening to ensure progress towards global cervical cancer elimination targets in Latin America.

Published
2023

19. Cervical cancer prevention program in Mexico disrupted due to COVID-19 pandemic: Challenges and opportunities

Author

Cruz-Valdez, Aurelio, Palacio-Mejía, Lina Sofia, Quezada-Sánchez, Amado D., Hernández-Ávila, Juan Eugenio, Galicia-Carmona, Tatiana, Cetina-Pérez, Lucely del Carmen, Arango-Bravo, Eder A., Isla-Ortiz, David, Aranda-Flores, Carlos E., Uscanga-Sánchez, Santos-Regino, Madrid-Marina, Vicente, and Torres-Poveda, Kirvis

Subjects
Cancer Research, Oncology
Abstract

IntroductionThe COVID-19 pandemic disrupted the preventive services for cervical cancer (CC) control programs in Mexico, which will result in increased mortality. This study aims to assess the impact of the pandemic on the interruption of three preventive actions in the CC prevention program in Mexico.MethodsThis study is a retrospective time series analysis based on administrative records for the uninsured population served by the Mexican Ministry of Health. Patient data were retrieved from the outpatient service information system and the hospital discharge database for the period 2017–2021. Data were aggregated by month, distinguishing a pre-pandemic and a pandemic period, considering April 2020 as the start date of the pandemic. A Poisson time series analysis was used to model seasonal and secular trends. Five process indicators were selected to assess the disruption of the CC program, these were analyzed as monthly data (N=39 pre-pandemic, N=21 during the pandemic). HPV vaccination indicators (number of doses and coverage) and diagnostic characteristics of CC cases were analyzed descriptively. The time elapsed between diagnosis and treatment initiation in CC cases was modeled using restricted cubic splines from robust regression.ResultsAnnual HPV vaccination coverage declined dramatically after 2019 and was almost null in 2021. The number of positive Papanicolaou smears decreased by 67.8% (90%CI: -72.3, -61.7) in April–December 2020, compared to their expected values without the pandemic. The immediate pandemic shock (April 2020) in the number of first-time and recurrent colposcopies was -80.5% (95%CI:−83.5, −77.0) and -77.9% (95%CI: −81.0, −74.4), respectively. An increasing trend was observed in the proportion of advanced stage and metastatic CC cases. The fraction of CC cases that did not receive medical treatment or surgery increased, as well as CC cases that received late treatment after diagnosis.ConclusionsOur analyses show significant impact of the COVID-19 pandemic with declines at all levels of CC prevention and increasing inequalities. The restarting of the preventive programs against CC in Mexico offers an opportunity to put in place actions to reduce the disparities in the burden of disease between socioeconomic levels.

Published
2023
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20. Relative Efficacy of AS03-Adjuvanted Pandemic Influenza A(H1N1) Vaccine in Children: Results of a Controlled, Randomized Efficacy Trial

Author

Nolan, Terry, Roy-Ghanta, Sumita, Montellano, May, Weckx, Lily, Ulloa-Gutierrez, Rolando, Lazcano-Ponce, Eduardo, Kerdpanich, Angkool, Safadi, Marco Aurélio Palazzi, Cruz-Valdez, Aurelio, Litao, Sandra, Lim, Fong Seng, de Los Santos, Abiel Mascareñas, Weber, Miguel Angel Rodriguez, Tinoco, Juan-Carlos, Hernandez-de Mezerville, Marcela, Faingezicht, Idis, Kosuwon, Pensri, Lopez, Pio, Borja-Tabora, Charissa, Li, Ping, Durviaux, Serge, Fries, Louis, Dubin, Gary, Breuer, Thomas, Innis, Bruce L., and Vaughn, David W.

Published
2014

23. Implementing HPV testing in 9 Latin American countries: The laboratory perspective as observed in the ESTAMPA study

Author

Rol, Mary Luz, primary, Picconi, María Alejandra, additional, Ferrera, Annabelle, additional, Sánchez, Gloria Inés, additional, Hernández, María de la Luz, additional, Lineros, Joana, additional, Peraza, Ana, additional, Brizuela, Marisol, additional, Mendoza, Laura, additional, Mongelós, Pamela, additional, Cabrera, Yessy, additional, Rodríguez de la Peña, Margarita, additional, Correa, Rita Mariel, additional, Terán, Carolina, additional, Colque Reynaga, Deisy, additional, García, Laura, additional, Ramírez, Arianis Tatiana, additional, Hernández-Nevarez, Pilar, additional, Doimi, Franco, additional, Ramón, María, additional, Arias-Stella, Javier, additional, Zúñiga, Michael, additional, Villagra, Verónica, additional, Bobadilla, María Liz, additional, Cardinal, Lucía, additional, Valls, Joan, additional, Lucas, Eric, additional, Baena, Armando, additional, Fleider, Laura, additional, Venegas, Gino, additional, Cruz-Valdez, Aurelio, additional, Rodríguez, Guillermo, additional, Calderón, Alejandro, additional, Wiesner, Carolina, additional, Luciani, Silvana, additional, Broutet, Nathalie, additional, Herrero, Rolando, additional, and Almonte, Maribel, additional

Published
2022
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24. Implementing HPV testing in 9 Latin American countries : the laboratory perspective as observed in the ESTAMPA study

Author

Universidad Nacional de Asunción. Instituto de Investigaciones en Ciencias de la Salud, Rol, Mary Luz, Picconi, María Alejandra, Ferrera, Annabelle, Sánchez, Gloria Inés, Hernández, María de la Luz, Lineros, Joana, Peraza, Ana, Brizuela, Marisol, Mendoza Torres, Laura Patricia, Mongelós Dacunte, Pamela Esther, Cabrera, Yessy, Rodríguez de la Peña, Margarita, Correa, Rita Mariel, Terán, Carolina, Colque Reynaga, Deisy, García, Laura, Ramírez, Arianis Tatiana, Hernández Nevarez, Pilar, Doimi, Franco, Ramón, María, Arias Stella, Javier, Zúñiga, Michael, Villagra, Veronica, Bobadilla Frizzola, María Liz, Cardinal, Lucía, Valls, Joan, Lucas, Eric, Baena, Armando, Fleider, Laura, Venegas, Gino, Cruz Valdez, Aurelio, Rodríguez, Guillermo, Calderón, Alejandro, Wiesner, Carolina, Luciani, Silvana, Broutet, Nathalie, Herrero, Rolando, Almonte, Maribel, Universidad Nacional de Asunción. Instituto de Investigaciones en Ciencias de la Salud, Rol, Mary Luz, Picconi, María Alejandra, Ferrera, Annabelle, Sánchez, Gloria Inés, Hernández, María de la Luz, Lineros, Joana, Peraza, Ana, Brizuela, Marisol, Mendoza Torres, Laura Patricia, Mongelós Dacunte, Pamela Esther, Cabrera, Yessy, Rodríguez de la Peña, Margarita, Correa, Rita Mariel, Terán, Carolina, Colque Reynaga, Deisy, García, Laura, Ramírez, Arianis Tatiana, Hernández Nevarez, Pilar, Doimi, Franco, Ramón, María, Arias Stella, Javier, Zúñiga, Michael, Villagra, Veronica, Bobadilla Frizzola, María Liz, Cardinal, Lucía, Valls, Joan, Lucas, Eric, Baena, Armando, Fleider, Laura, Venegas, Gino, Cruz Valdez, Aurelio, Rodríguez, Guillermo, Calderón, Alejandro, Wiesner, Carolina, Luciani, Silvana, Broutet, Nathalie, Herrero, Rolando, and Almonte, Maribel

Abstract

Background: Replacement of cytology screening with HPV testing is recommended and essential for cervical cancer elimination. HPV testing for primary screening was implemented in 12 laboratories within 9 Latin American countries, as part of the ESTAMPA cervical cancer screening study. Our observations provide information on critical operational aspects for HPV testing implementation in diverse resource settings. Methods: We describe the implementation process of HPV testing in ESTAMPA, focusing on laboratory aspects. We assess the readiness of 12 laboratories to start HPV testing and their continuity capacity to maintain good quality HPV testing until end of recruitment or up to December 2021. Readiness was based on a checklist. Information from the study database; regular meetings and monitoring visits; and a questionnaire on laboratory operational aspects sent in May 2020 were used to assess continuity capacity. Compliance with seven basic requirements (readiness) and eight continuity requirements (continuity capacity) was scored (1 = compliant, 0 = not compliant) and totaled to classify readiness and continuity capacity as very limited, limited, moderate or high. Experiences, challenges, and enablers of the implementation process are also described. Results: Seven of 12 laboratories had high readiness, three moderate readiness, and of two laboratories new to HPV testing, one had limited readiness and the other very limited readiness. Two of seven laboratories with high readiness also showed high continuity capacity, one moderate continuity capacity, and the other four showed limited continuity capacity since they could not maintain good quality HPV testing over time. Among three laboratories with moderate readiness, one kept moderate continuity capacity and two reached high continuity capacity. The two laboratories new to HPV testing achieved high continuity capacity. Based on gained expertise, five laboratories have become part of national screening programs. Con

Published
2022

30. Differential Antibody Response against Conformational and Linear Epitopes of the L1 Proteins from Human Papillomavirus Types 16/18 Is Observed in Vaccinated Women or with Uterine Cervical Lesions

Author

Pedroza-Saavedra, Adolfo, primary, Rodriguez-Ocampo, Angelica Nallelhy, additional, Salazar-Piña, Azucena, additional, Perez-Morales, Aislinn Citlali, additional, Chihu-Amparan, Lilia, additional, Maldonado-Gama, Minerva, additional, Cruz-Valdez, Aurelio, additional, Esquivel-Guadarrama, Fernando, additional, and Gutierrez-Xicotencatl, Lourdes, additional

Published
2021
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33. Multicentric study of cervical cancer screening with human papillomavirus testing and assessment of triage methods in Latin America : the ESTAMPA screening study protocol

Author

Universidad Nacional de Asunción. Instituto de Investigaciones en Ciencias de la Salud, Almonte, Maribel, Murillo, Raúl, Sánchez, Gloria Inés, González, Paula, Ferrera, Annabelle, Picconi, María Alejandra, Wiesner, Carolina, Cruz Valdez, Aurelio, Lazcano Ponce, Eduardo, Jerónimo, José, Ferreccio, Catterina, Kasamatsu, Elena Satiko, Mendoza Torres, Laura Patricia, Rodríguez, Guillermo, Calderón, Alejandro, Venegas, Gino, Villagra, Veronica, Tatti, Silvio, Fleider, Laura, Terán, Carolina, Baena, Armando, Hernández, María de la Luz, Rol, Mary Luz, Lucas, Eric, Barbier, Sylvaine, Ramírez, Arianis Tatiana, Arrossi, Silvina, Rodríguez Riveros, María Isabel, González, Emmanuel, Celis, Marcela, Martínez, Sandra, Salgado, Yuly, Ortega, Marina, Beracochea, Andrea Verónica, Pérez, Natalia, Rodríguez de la Peña, Margarita, Ramón, María, Hernández Nevarez, Pilar, Arboleda Naranjo, Margarita, Cabrera, Yessy, Salgado, Brenda, García, Laura, Retana, Marco Antonio, Colucci, María Celeste, Arias Stella, Javier, Bellido Fuentes, Yenny, Bobadilla Frizzola, María Liz, Olmedo, Gladys, Brito García, Ivone, Méndez Herrera, Armando, Cardinal, Lucía, Flores, Betsy, Peñaranda, Jhacquelin, Martínez Better, Josefina, Soilan, Ana María, Figueroa, Jacqueline, Caserta, Benedicta, Sosa, Carlos, Moreno, Adrián, Mural, Juan, Doimi, Franco, Giménez, Diana, Rodríguez, Hernando, Lora, Oscar, Luciani, Silvana, Broutet, Nathalie, Darragh, Teresa M., Herrero, Rolando, Universidad Nacional de Asunción. Instituto de Investigaciones en Ciencias de la Salud, Almonte, Maribel, Murillo, Raúl, Sánchez, Gloria Inés, González, Paula, Ferrera, Annabelle, Picconi, María Alejandra, Wiesner, Carolina, Cruz Valdez, Aurelio, Lazcano Ponce, Eduardo, Jerónimo, José, Ferreccio, Catterina, Kasamatsu, Elena Satiko, Mendoza Torres, Laura Patricia, Rodríguez, Guillermo, Calderón, Alejandro, Venegas, Gino, Villagra, Veronica, Tatti, Silvio, Fleider, Laura, Terán, Carolina, Baena, Armando, Hernández, María de la Luz, Rol, Mary Luz, Lucas, Eric, Barbier, Sylvaine, Ramírez, Arianis Tatiana, Arrossi, Silvina, Rodríguez Riveros, María Isabel, González, Emmanuel, Celis, Marcela, Martínez, Sandra, Salgado, Yuly, Ortega, Marina, Beracochea, Andrea Verónica, Pérez, Natalia, Rodríguez de la Peña, Margarita, Ramón, María, Hernández Nevarez, Pilar, Arboleda Naranjo, Margarita, Cabrera, Yessy, Salgado, Brenda, García, Laura, Retana, Marco Antonio, Colucci, María Celeste, Arias Stella, Javier, Bellido Fuentes, Yenny, Bobadilla Frizzola, María Liz, Olmedo, Gladys, Brito García, Ivone, Méndez Herrera, Armando, Cardinal, Lucía, Flores, Betsy, Peñaranda, Jhacquelin, Martínez Better, Josefina, Soilan, Ana María, Figueroa, Jacqueline, Caserta, Benedicta, Sosa, Carlos, Moreno, Adrián, Mural, Juan, Doimi, Franco, Giménez, Diana, Rodríguez, Hernando, Lora, Oscar, Luciani, Silvana, Broutet, Nathalie, Darragh, Teresa M., and Herrero, Rolando

Abstract

Introduction. Human papillomavirus (HPV) testing is replacing cytology in primary screening. Its limited specificity demands using a second (triage) test to better identify women at high-risk of cervical disease. Cytology represents the immediate triage but its low sensitivity might hamper HPV testing sensitivity, particularly in low-income and middle-income countries (LMICs), where cytology performance has been suboptimal. The ESTAMPA (EStudio multicéntrico de TAMizaje y triaje de cáncer de cuello uterino con pruebas del virus del PApiloma humano; Spanish acronym) study will: (1) evaluate the performance of different triage techniques to detect cervical precancer and (2) inform on how to implement HPV-based screening programmes in LMIC. Methods and analysis. Women aged 30–64 years are screened with HPV testing and Pap across 12 study centres in Latin America. Screened positives have colposcopy with biopsy and treatment of lesions. Women with no evident disease are recalled 18 months later for another HPV test; those HPV-positive undergo colposcopy with biopsy and treatment as needed. Biological specimens are collected in different visits for triage testing, which is not used for clinical management. The study outcome is histological high-grade squamous intraepithelial or worse lesions (HSIL+) under the lower anogenital squamous terminology. About 50 000 women will be screened and 500 HSIL+ cases detected (at initial and 18 months screening). Performance measures (sensitivity, specificity and predictive values) of triage techniques to detect HSIL+ will be estimated and compared with adjustment by age and study centre. Ethics and dissemination. The study protocol has been approved by the Ethics Committee of the International Agency for Research on Cancer (IARC), of the Pan American Health Organisation (PAHO) and by those in each participating centre. A Data and Safety Monitoring Board (DSMB) has been established to monitor progress of the study, assure participant sa

Published
2020

41. Persistence of Immunity When Using Different Human Papillomavirus Vaccination Schedules and Booster-Dose Effects 5 Years After Primary Vaccination

Author

Lazcano-Ponce, Eduardo, primary, Torres-Ibarra, Leticia, additional, Cruz-Valdez, Aurelio, additional, Salmerón, Jorge, additional, Barrientos-Gutiérrez, Tonatiuh, additional, Prado-Galbarro, Javier, additional, Stanley, Margaret, additional, Muñoz, Nubia, additional, Herrero, Rolando, additional, and Hernández-Ávila, Mauricio, additional

Published
2018
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42. MF59-adjuvanted influenza vaccine (FLUAD®) elicits higher immune responses than a non-adjuvanted influenza vaccine (Fluzone®): A randomized, multicenter, Phase III pediatric trial in Mexico

Author

Cruz-Valdez, Aurelio, primary, Valdez-Zapata, Gabriel, additional, Patel, Sanjay S., additional, Castelli, Flavia V., additional, Garcia, Marcia G., additional, Jansen, Wim T., additional, Arora, Ashwani Kumar, additional, and Heijnen, Esther, additional

Published
2018
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43. Conocimientos sobre virus del papiloma humano (VPH) y aceptación de auto-toma vaginal en mujeres mexicanas

Author

Hernandez Marquez, Clara Irene, Salinas Urbina, Addis Abeba, Hernandez Giron, Carlos, and Cruz Valdez, Aurelio

Subjects
Papillomavirus humano, atención médica, 36 Problemas y servicios sociales, asociaciones / Social problems and social services, 61 Ciencias médicas, Medicina / Medicine and health, infección, diagnóstico
Abstract

Objetivo Analizar la asociación del grado de conocimiento sobre Papillomavirus Humano y la aceptación de la auto-toma vaginal como prueba diagnóstica para la detección de cáncer cervical en mujeres mexicanas que ya han tenido la experiencia de una auto-toma vaginal en casa.Métodos Cuestionario estructurado de 22 preguntas a 690 mujeres del estado de Morelos que se realizaron la auto-toma vaginal en casa para explorar el nivel de conocimientos sobre transmisión del Papillomavirus Humano, identificación del virus como causa necesaria para cáncer cervicouterino, manifestaciones clínicas de la infección y tratamiento. Se construyó un índice de conocimientos identificando su asociación con la aceptación de la auto-toma y la confianza que las mujeres tienen en ella. El análisis estadístico incluyó regresión logística con estimación de medidas de asociación y sus respectivos intervalos de confianza al 95 %.Resultados El nivel de conocimientos sobre Papilloma virus Humano presentó una asociación positiva con el grado de aceptación de la auto-toma vaginal (OR 2.9 IC 95 % 1.0-5.01) y con el nivel de confianza de las mujeres (OR 2.9 IC 95 % 1.8-4.67). El nivel de conocimientos se incrementa con el grado de escolaridad y es mayor en las mujeres más jóvenes.Conclusiones Para lograr una participación continuada de las mujeres con mayor riesgo de cáncer cervicouterino en la auto-toma vaginal es necesario informarlas ampliamente sobre los aspectos generales del virus, en especial a aquellas mujeres de edad avanzada, de nivel escolar y socioeconómico bajos.

Published
2014

44. Validation of Serological Antibody Profiles Against Human Papillomavirus Type 16 Antigens as Markers for Early Detection of Cervical Cancer

Author

Salazar-Piña, Dolores Azucena, primary, Pedroza-Saavedra, Adolfo, additional, Cruz-Valdez, Aurelio, additional, Ortiz-Panozo, Eduardo, additional, Maldonado-Gama, Minerva, additional, Chihu-Amparan, Lilia, additional, Rodriguez-Ocampo, Angelica Nallelhy, additional, Orozco-Fararoni, Emilia, additional, Esquivel-Guadarrama, Fernando, additional, and Gutierrez-Xicotencatl, Lourdes, additional

Published
2016
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45. Evaluation of the immunogenicity of the quadrivalent HPV vaccine using 2 versus 3 doses at month 21: An epidemiological surveillance mechanism for alternate vaccination schemes

Author

Hernández-Ávila, Mauricio, primary, Torres-Ibarra, Leticia, additional, Stanley, Margaret, additional, Salmerón, Jorge, additional, Cruz-Valdez, Aurelio, additional, Muñoz, Nubia, additional, Herrero, Rolando, additional, Villaseñor-Ruíz, Ignacio F, additional, and Lazcano-Ponce, Eduardo, additional

Published
2015
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47. Prevalence and Incidence of Respiratory Syncytial Virus and Other Respiratory Viral Infections in Children Aged 6 Months to 10 Years With Influenza-like Illness Enrolled in a Randomized Trial

Author

Nolan, Terry, primary, Borja-Tabora, Charissa, additional, Lopez, Pio, additional, Weckx, Lily, additional, Ulloa-Gutierrez, Rolando, additional, Lazcano-Ponce, Eduardo, additional, Kerdpanich, Angkool, additional, Weber, Miguel Angel Rodriguez, additional, Mascareñas de Los Santos, Abiel, additional, Tinoco, Juan-Carlos, additional, Safadi, Marco Aurelio P., additional, Seng, Lim Fong, additional, Hernandez-de Mezerville, Marcela, additional, Faingezicht, Idis, additional, Cruz-Valdez, Aurelio, additional, Feng, Yang, additional, Li, Ping, additional, Durviaux, Serge, additional, Haars, Gerco, additional, Roy-Ghanta, Sumita, additional, Vaughn, David W., additional, and Taylor, Sylvia, additional

Published
2015
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48. Prevalencia y factores de riesgo asociados a sífilis en mujeres

Author

Hernández-Girón, Carlos A., Cruz-Valdez, Aurelio, Figueroa, Luis Juárez, and Hernández-Avila, Mauricio

Subjects
Conducta sexual, Sífilis, Infecciones oportunistas, Opportunistic infections, Syphilis, Prostitution, Sex behavior, Prostitución
Abstract

INTRODUCCIÓN: Se ha demostrado que la sífilis, debido a la ulceración genital que produce, es un cofactor asociado para adquirir otras enfermedades de transmisión sexual (ETS), principalmente de origen viral como herpes tipo-2, hepatitis B, y el VIH. Aunque las mujeres trabajadoras del sexo comercial (MTSC) han adquirido mejores conocimientos para prevenir las ETS, constituyen un grupo que por su heterogenicidad en términos de condición socioeconómica, estado de salud, ambiente y sitio de trabajo, manifiestan diferentes actitudes y conocimientos que hacen latente la posibilidad de adquirir y transmitir ETS incluyendo sífilis, por lo que lo estudio hace un acercamiento hacia los factores asociados a infección por Treponema pallidum en este grupo de mujeres. MÉTODO: Basado en un marco muestral, que identifica sitios donde se practica el comercio sexual femenino en la ciudad de México, se seleccionó una muestra de 807 MTSC, a quienes previo consentimiento informado, se entrevistó para que respondieran un cuestionario estructurado. Se obtuvo una muestra sanguínea para la identificación de diversos marcadores serológicos de ETS de acuerdo al manual de procedimientos para el diagnóstico de ETS. Para el diagnóstico de Treponema pallidum se utilizó una prueba de tamizaje de RPR (Bigaux Diagnóstica), y prueba confirmatoria de FTA-ABS (Pasteur Diagnostics). RESULTADOS: Las prevalencias de sífilis en la muestra de MTSC fue de 6,4% (52/807), siendo mayor en quienes trabajaban en sitios de calle comparadas con aquellas de estéticas. La edad de las mujeres entrevistadas osciló entre 17 y 58 años con una media de 29,2 años (d.s. 7,3 años). La prevalencia de sífilis fue mayor en los grupos etáreos mayores de 30 anos. La edad de inicio de relaciones sexuales varió desde 11 hasta 30 anos con una media de 16 años (d.s. 3,1 años). Los factores predictores de infección por T. pallidum, determinados mediante regresión logística ajustada, fueron: sitio de trabajo (bar y puntos de calle), NSE (medio y bajo), edad (mayores de 30 anos), antiguedad en el trabajo sexual (> 5 años), y número de clientes en una semana (>10). CONCLUSIONES: A pesar de las limitaciones de precisión estadística, queda demostrado que existe una heterogenicidad de MTSC, diferenciado principalmente por el sitio donde se desempeñan. Debe entenderse que más que grupos de riesgo de adquirir y transmitir ETS, existen prácticas sexuales de riesgo en cualquier individuo que tiene relaciones sexuales, que aunadas a infecciones predisponentes como sífilis, facilitan la transmisibilidad de otras ETS. Por lo tanto, las campañas de prevención y fomento de uso de condón, deben orientarse no sólo a las MTSC sino también a sus clientes y parejas, con la finalidad de que todos asuman la responsabilidad del sexo seguro. INTRODUCTION: Although the incidence of syphilis is generally low, it remains an important global public health problem, given its interaction with other sexually transmitted diseases (STDs). It has been shown that syphilis, due to the genital ulcers it produces, is a co-factor for acquiring other STDs, principally those of viral origin such as herpes simples type 2, hepatitis B and HIV. Many female commercial sex workers (FCSW) in Mexico have been found to have acquired good levels of knowledge about STD prevention. Nevertheless, they constitute a heterogeneous group in terms of socio-economic level, health status and type of work site; these factors in turn appear to determine their attitudes, knowledge and behavior related to acquiring and transmitting STDs, including syphilis. This study, therefore, focused on the factors associated with Treponema pallidum infection in this group of women. METHOD: Based on a sample frame of sites where female commercial sex work takes place within Mexico City, a sample of 807 FCSWs was selected; after providing informed consent, they completed a structured questionnaire. A blood sample for identifying serologic markers for STDs was collected and analyzed according to a procedure manual for STD diagnosis. Treponema pallidum was diagnosed using the RPR (Bigaux Diagnostica) screening test, and FTA - ABS (Pasteur Diagnostics) for confirmation. RESULTS: The prevalence of syphilis in this sample of FCSWs was 6.4% (52/807), and was higher among women who worked at street sites than among those who worked in massage parlors. The age of the women interviewed ranged from 17 to 58 years, with a mean of 29.2 years (SD 7.3 years); syphilis was more prevalent among women over 30 years of age. Age at first sexual intercourse ranged from 11 to 30 years, with a mean of 16 years (SD 3.1 years), which is similar to that of the general female population in Mexico. Predictive factors for T. pallidum infection, determined adjusted logistic regression, included: tupe of by work site (bar and street sites); socio-economic level (middle and low); age (over 30 years); duration of involvement in sex work (> 5 years) and number of clients per week (> 10). CONCLUSION: In spite of some limitations regarding statistical precision, this study shows that FCSWs are heterogeneous in terms of risk of acquiring STDs, including syphilis; the principal differentiating factor was shown to be the type of work site. Given that it is not belonging to a risk group but rather participating in risky practices that leads to acquiring STDs, situations that facilitate riskier or safer practices (such as type of sex work site, for sex workers) should be taken into account when studying people's risk level. STD prevention campaigns must also consider these factors, in addition to focusing on FCSWs and their clients and personal partners, so that all involved assume their responsibility for safer sex.

Published
1998

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