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BACKGROUND: Coccidioides spp infection (C. immitis and C. posadasii) is an endemic disease from south of United States and north of Mexico, but it is also present in other areas of central and south of America. It can be classified according to its clinical presentation in: asymptomatic, pulmonary/pleural, cutaneous and disseminated. CLINICAL CASE: A 30 year-old male patient whom started with disseminated skin lesions accompanied with fever, lymphadenopathy and subsequently neurological manifestations (headache and syncope). A skin and ganglionar biopsy was performed, where Coccidioides sp was identified, in cerebrospinal fluid hypoglycorrhachia and hyperproteinorrachia were found. A cerebral magnetic resonance imaging test with gadolinium contrast evidenced findings compatible with meningitis. The diagnosis of disseminated coccidioidomycosis was made, and treatment with amphotericin B was started with clinical improvement and subsequent discharge with fluconazole. CONCLUSIONS: Disseminated coccidioidomycosis has been described usually in immunocompromised patients (elderly, pregnancy, HIV, etc.). None of these were present in our patient, therefore it is important that endemic regions with a compatible clinical picture form part of the clinical suspicion. [ABSTRACT FROM AUTHOR]

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Introduction: Visceral leishmaniasis is a zoonotic disease transmitted by vectors of the Lutzomyia genus, distributed in 98 countries, including Colombia, which can cause a serious clinical picture that, in the absence of treatment, can be fatal. Objective: To determine the knowledge, attitudes, and practices (KAP) acquired on vectors and reservoirs, as well as the characteristics of visceral Leishmaniasis in communes 8, 9 and 10 of the city of Neiva in 2019. Material and Methods: A descriptive cross-sectional study was carried out from June to December 2019. Three communes (8, 9 y 10) were sampled from a total of 30 neighborhoods of the city of Neiva – Huila. In addition, 385 CAP-type surveys were applied, with a margin of error of 5% and a reliability of 95%. People aged 18 years or older (267 women and 117 men) who voluntarily wished to participate, with prior informed consent, were included. Results: According to the analyzed information, it was determined that the majority of the surveyed population did not know about visceral leishmaniasis (77%), did not identify it as a zoonotic disease (52%), nor did they know who the causative agent is (82%); furthermore, they were not clear about the symptoms that occur in humans, nor the treatment used to manage them. Conclusions: Although preventive campaigns have been carried out in the affected communes, the level of knowledge about the disease, the vector, the reservoir, and the specific preventive practices to counteract visceral leishmaniasis are little known in the study population, despite the fact that the identified practices and attitudes are positive.

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Objetivo. Describir el comportamiento epidemiológico de la lepra en varios países latinoamericanos durante 2011-2020, tomando como base los indicadores de la Organización Mundial de la Salud (OMS). Método. Estudio transversal, descriptivo y cuantitativo con datos oficiales sobre incidencia y prevalencia en la población en general, niños, forma clínica y casos de discapacidad de grado 2 registrados por la OMS entre 2011 y 2020. Se seleccionaron los ocho países latinoamericanos con más casos y se realizaron análisis de estadística descriptiva simple y comparativa entre las variables. Resultados. Entre 2011-2020 se reportaron 301 312 casos de lepra en los países seleccionados: Argentina, Brasil, Colombia, Cuba, México, Paraguay, República Dominicana y Venezuela. Brasil fue el único con una prevalencia mayor a 1 por 10 000 habitantes y representó 93,77% de casos. En Brasil y República Dominicana se observó un aumento de la prevalencia durante 2011-2019, mientras que en los demás países esta tendió a disminuir. La enfermedad fue más frecuente en hombres, y los casos multibacilares superaron significativamente a los paucibacilares. En Brasil se encontraron las mayores incidencias de casos de lepra infantil y discapacidad de grado 2 durante el período evaluado. Conclusión. A pesar de que en América Latina la lepra solo es considerada un problema de salud pública en Brasil, la mayoría de los países de la región continúa reportando casos cada año, lo que revela una falta de atención médica adecuada. El estudio confirmó la importancia de la vigilancia activa, el diagnóstico temprano y la planificación de acciones contra la enfermedad en todos los países evaluados, con el propósito de disminuir o detener su transmisión.

The word “epidemiology” was written for the first time in a report on the plague in Alghero in 1583. Although its etymology has it intricacy. For centuries it has been concerned with understanding and trying to control and prevent epidemics. During the cholera epidemic in London in 1848 the London Society of Epidemiology was formed, main instrument of public health since then. The increase in chronic diseases —supposedly no communicable— gave way to the epidemiology of black boxes and the predominance of risk factors. And later to an enormous methodological progress increasingly complex and intricate but professionally very appealing. So few epidemiologists have experience in field control of epidemics. Thus, perhaps it is convenient to return, although partially, to the origins. Looking at the future. Resumen: La palabra «epidemiología» se escribió por primera vez en un informe sobre la peste en Alghero, en 1583. Aunque su etimología tiene su intríngulis. Durante siglos se ha ocupado en comprender y tratar de controlar y prevenir las epidemias. Durante la epidemia de cólera en Londres en 1848 se creó la Sociedad de Epidemiología de Londres, principal instrumento de salud pública desde entonces. El aumento de las enfermedades crónicas —supuestamente no transmisibles— dio paso a la epidemiología de las cajas negras y al predominio de los factores de riesgo. Y más tarde a un enorme desarrollo metodológico cada vez más complejo e intrincado, pero profesionalmente muy atractivo. Muy pocos epidemiólogos tienen experiencia en el control de epidemias en el campo. Así, quizás convenga volver, aunque sea parcialmente, a los orígenes. Mirando al futuro.

Objetivo: analizar el perfil sociodemográfico y clínico de los casos notificados de lepra en niños menores de 15 años, en el municipio de São Luís - Maranhão - Brasil. Método: estudio descriptivo realizado con 826 casos notificados en el Sistema de Información de Enfermedades de Declaración Obligatoria, en São Luís - Maranhão, en el período de 2010 a 2019. Los datos se analizaron mediante estadísticas descriptivas y se expresaron en frecuencias absolutas y relativas. Resultados: edad entre 10 y 14 años (60,29%), sexo masculino (51,09%), color marrón (69,59%), educación elemental incompleta (39,58%), multibacilar (62,71%), forma clínica dimórfica (54,24%), hasta cinco lesiones (74,45%), de cero a dos nervios afectados (83,23%), sin baciloscopia (46,28%), casos nuevos (93,70%), demanda espontánea (46,38%) y cero grado de discapacidad en el momento del diagnóstico (78,98%). Conclusión: se demostraron parámetros hiperendémicos con alto riesgo de enfermedad. Destaca la importancia de crear estrategias de control y prevención para reducir la transmisión de la lepra en los niños.

Objective. To describe the epidemiological behavior of leprosy in several Latin American countries during 2011-2020, based on World Health Organization (WHO) indicators. Methods. Cross-sectional, descriptive and quantitative study with official data on incidence and prevalence in the general population, children, clinical form and cases with grade 2 disability from WHO records between 2011 and 2020. The eight countries in Latin America that reported most cases were selected and analyses were carried out using simple descriptive and comparative statistics between different variables. Results. During the study period, 301 312 cases of leprosy were reported in the selected countries: Argentina, Brazil, Colombia, Cuba, Dominican Republic, Mexico, Paraguay, and Venezuela. Brazil is the only country in the region with a prevalence greater than 1 per 10 000, representing 93.77% of all cases. Brazil and the Dominican Republic showed an increase in prevalence during 2011-2019, while in other countries the trend was decreasing. The disease is more frequent in men, and multibacillary cases significantly exceed paucibacillary ones. Brazil showed the highest incidences of cases of childhood leprosy and grade 2 disability during the evaluated period. Conclusion. In Latin America, leprosy is only considered a public health problem in Brazil; however, most countries in the region continue to report cases annually, revealing a lack of adequate medical care. This study confirmed the importance of active surveillance, early diagnosis and planning of actions against the disease in all the countries evaluated with the aim of reducing its transmission. [ABSTRACT FROM AUTHOR]

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Introduction: Hydatidosis is an endemic disease in Chile, A high index of suspicion should be had in patients with symptoms in risk areas. Splenic hydatidosis is a rare clinical presentation to watch, patients may be asymptomatic or present symptoms due to organ compression and / or complications. Treatment ranges from partial to total splenectomy, open or laparoscopic. Objectives: Present the clinical case report of a patient with a splenic cyst, diagnosed and treated in the pediatric and surgical services of the Herminda Martín Clinical Hospital. Clinical case: 14-year-old male patient, with no morbid history, admitted for fever of unknown origin associated with jaundice; During the ultrasound examination, the clinical finding of hepatosplenomegaly associated with free subhepatic peritoneal fluid, a 15.5-cm spleen with a 4.1-cm hypoechoic area was recorded. Due to a diagnostic doubt, it was decided to perform an abdominal CT that reported a hypodense replacement area in the spleen, of an uncertain nature. Due to a good clinical evolution, medical discharge and ultrasound control associated with serology for hydatidosis were decided. In control at two months, growth of the splenic collection is observed, deciding surgical resolution of the case, by means of partial splenectomy due to operative difficulty. Discussion: There is controversy about surgical treatment regarding the type of resection and surgical approach; The choice of total splenectomy has been described, however, recently there is a tendency to preserve all the spleen or at least a part of it when possible to avoid postplenectomy infection, especially in young patients. [ABSTRACT FROM AUTHOR]

En el siglo pasado la rabia canina fue endémica en nuestro país. En la década de los 1990's, el Perú implementó el plan de acción para la eliminación de la rabia urbana por recomendación de la Organización Panamericana de la Salud, logrando un control exitoso de la rabia. Pese a los esfuerzos desplegados, Puno mantuvo focos endémicos persistentes, y en el 2014, Arequipa reportó el primer evento de reintroducción de rabia urbana en Latinoamérica. El brote de rabia se intensificó en los últimos años en Arequipa, Puno y Cusco, con 19 casos de rabia canina el 2015, a 59 casos el 2016, continuando el 2017 con 47 casos, el 2018 con 46, y hasta julio del 2019, 17 casos. Así, hubo reintroducción de la rabia canina, estableciendo una situación de alta endemicidad no controlada. En el presente reporte, abordamos el contexto y persistencia de la reemergencia de la rabia canina en el sur del Perú.

Objective: To evaluate the epidemiological characteristics of calazar in the state of Ceará between 2011 and 2018. Methods: Retrospective and quantitative study, which had as data source notification forms of the National System of Notifiable Diseases of patients with calazar registered in Ceará. Results: During the study period, 7.894 cases of calazar were reported in Ceará. Fortaleza and Sobral were the municipalities with the highest number of cases, with males being the most affected. In addition, 46.63% of the cases used laboratory tests as a diagnosis. Regarding age, adults accounted for 46.5% of the cases, and children accounted for 31.39%. On the socio-educational conditions of the patients, the majority had incomplete elementary school and held occupations as a student and housewife. In the evolution of the patients, the cure rate was 71.2% and the death rate due to calazar was 3.6%, the other 7.7% correspond to transference and death from other causes. Among patients with VL, 9.79% had HIV co-infection. Conclusions: According to our results, calazar is a disease still very prevalent in the state of Ceará, with Fortaleza having the highest number of notifications. However, there is still a great underreporting of cases. [ABSTRACT FROM AUTHOR]

RESUMEN Introducción: En los últimos años, debido a los movimientos migratorios, se ha desarrollado una expansión de nuevas enfermedades, como chikungunya, zika, oropuche y mayaro. Caso clínico: Paciente que manifestaba síntomas de fiebre, cefalea y artralgias persistente. Después de un arduo estudio y eliminación de otras patologías se llega al diagnóstico de virus mayaro. El paciente residía en una zona nororiental del Perú. Se brindó tratamiento de soporte junto con hidratación, paracetamol 500 mg cada 8 horas y se indicó cita diaria para evaluación. El paciente evolucionó favorablemente a los pocos días. Conclusiones: La vigilancia, las pruebas y el control vectorial siguen siendo claves para prevenir la propagación de este tipo de virus. La posibilidad de que el virus mayaro se urbanice aún más. Se debe tener siempre en cuenta el diagnóstico diferencial de virus mayaro.

Introducción: La transmisión e incidencia del virus del dengue ha aumentado de manera importante en las tres últimas décadas, por lo cual se considera actualmente la enfermedad infecciosa re-emergente que genera mayor morbilidad y mortalidad en el mundo. Objetivo: Observar el comportamiento del dengue no complicado en los últimos cuatro años en Santander, Colombia. Metodología: Se realizó un estudio analítico con datos secundarios de dengue no complicado en Santander, entre el año 2007 y el 2015. Se calculó la incidencia por semana epidemiológica y se construyeron canales endémicos de los años 2012 al 2015 mediante logaritmo en base 10, con media geométrica e intervalos de confianza del 95%. La investigación se clasificó como sin riesgo según la Ley 8430 de 1993 de la República de Colombia. Resultados: El Sistema Nacional de Vigilancia en Salud Pública (SIVIGILA) reportó 26,849 casos de dengue no grave en Santander entre el año 2007 y el 2015. Los puntos de corte (éxito, seguridad, riesgo y epidemia) varían para las diferentes zonas, con diferencias estadísticamente significativas con picos de incidencia de 4.2 (en el 2007), 2.9 (en el año 2010), 8.1 (entre el 2013 y 2014) por cada 100,000 habitantes. Conclusiones: Los canales endémicos de dengue se deben tener en cuenta junto con el impacto de la incidencia calculada para monitoreo de la enfermedad. Según la tendencia secular cada 3 a 4 años se presenta un pico de incidencia, por lo que es probable que en el 2016 se presente un nuevo pico de dengue incluso mayor a los registrados hasta el momento en Santander. Se requieren estrategias medidas e inmediatas para el control de la enfermedad. [Serrano-Gómez SE, De-Montijo C, Rey-Serrano JJ. Comportamiento del dengue no grave en los últimos cuatro años en Santander, Colombia. MedUNAB 2015; 18 (2): 107-115] Introduction: Transmission and incidence of dengue virus have greatly increased during the last three decades which is the reason why it is currently considered the most emergent infectious disease that causes morbidity and mortality around the world. Objective: Observe simple dengue behavior in the last four years in Santander, Colombia. Method: An analytical study based on secondary data of simple dengue in Santander was performed between the years 2007 and 2015. The weekly epidemiological incidence was calculated and endemic channels between the years of 2012 and 2015 were built using logarithm base 10 with geometric mean and confidence intervals of 95%. The investigation was classified as non-risky according to Law 8430 of 1993, Republic of Colombia. Results: The National Service of Public Health Surveillance (SIVIGILA) reported 26.849 cases of simple dengue in Santander between the years of 2007 and 2015. The cutoff points (success, security, risk, and epidemic) vary in different zones, with significant statistically differences of 4.2 (in 2007), 2.9 (in 2010), and 8.1 (between 2013 and 2014) for each 100.000 inhabitants. Conclusions: The endemic channels of dengue must be taken into account as well as the impact of calculated incidence for monitoring the disease. According to the secular trend, every 3 to 4 years, there is a peak incidence. It is possible that in 2016 a new and bigger peak incidence of dengue will take place in Santander. It is therefore necessary to consider strategies and immediate measures to control this disease. [Serrano-Gómez SE, De-Montijo C, Rey-Serrano JJ. Behavior of simple dengue during the last four years in Santander, Colombia. MedUNAB 2015; 18 (2): 107-115] Introdução: A transmissão e a incidência do vírus da dengue tem aumentado significativamente ao longo das últimas três décadas, por isso agora é considerada a doença infecciosa re-emergente, que gera aumento da morbidade e mortalidade no mundo. Objetivo: Observar o comportamento da dengue descomplicada nos últimos quatro anos, em Santander, Colômbia. Metodologia: Se fez um estudo analítico com dados secundários de dengue não complicada em Santander, entre 2007 e 2015. A incidência foi calculada por semana epidemiológica y se construiram os canais endémicos entre 2012 a 2015 por meio do log 10, com media e intervalos de confiança geométricos de 95%. A pesquisa foi classificada como segura, de acordo com a Lei 8430 de 1993, da República da Colômbia. Resultados: O Sistema Nacional de Vigilância em Saúde Pública (SIVIGILA) informou 26.849 casos de dengue não grave em Santander, entre 2007 e 2015. Os pontos de corte (o sucesso, segurança, risco e epidemia) manifestam diferenças estatisticamente significativas, nas diversas áreas da região, apresentando uma incidência de 4,2 (em 2007), 2,9 (em 2010), 8,1 (entre 2013 e 2014) por 100.000 habitantes. Conclusões: Os canais endémicas da dengue devem ser tidos em conta, juntamente com o impacto da incidência calculada para a monitorização da doença. De acordo com a tendência secular cada 3 a 4 anos, ocontece um novo pico de incidência, então é provável que em 2016 ocorra um novo pico da dengue ainda maior aos já registrados em Santander. São necessárias estratégias de ação imediata para controlar a doença. [Serrano-Gómez SE, De-Montijo C, Rey-Serrano JJ. O comportamento da dengue não é grave nos últimos quatro anos, em Santander, Colômbia. MedUNAB 2015; 18 (2): 107-115]

A hanseníase é hiperendêmica no Estado do Tocantins, Brasil. O objetivo do estudo foi analisar as tendências dos indicadores da hanseníase no Tocantins em 2001-2012. Análise de dados advindos do Sistema de Informação de Agravos de Notificação (SINAN). Incluíram-se casos novos de residentes no Tocantins. Calcularam-se os indicadores da hanseníase e analisaram-se as tendências temporais por meio de regressão polinomial. Houve tendência significativa e decrescente para a detecção geral (R2 = 0,40; p < 0,05) e proporção de casos paucibacilares (R2 = 0,81). Foi estável a detecção em < 15 anos (R2 = 0,48; p > 0,05), detecção de casos com grau 2 de incapacidade física (R2 = 0,37; p > 0,05) e proporção de casos com grau 2 (R2 = 0,49; p > 0,05). Houve aumento significativo para a proporção de casos com grau 1 de incapacidade (R2 = 0,82; p < 0,05) e proporção de casos multibacilares (R2 = 0,81; p < 0,05). O Tocantins apresenta regiões com alta transmissão e diagnóstico tardio da hanseníase, apontando a expansão da doença de forma heterogênea na análise temporal.

Copyright of Journal of Nursing UFPE / Revista de Enfermagem UFPE is the property of Revista de Enfermagem UFPE and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Fundamento y Objetivo: Los abscesos fríos tuberculosos o gomas son inusuales y producto de la diseminación hematógena de micobacterias latentes, formando abscesos en extremidades o tronco, generalmente sin compromiso de tejidos profundos.Se presenta un caso de goma como diagnóstico inicial de tuberculosis diseminada. Métodos: Caso estudiado en 2012 por los servicios médicos del centro penitenciario de Hombres de Barcelona y el Servicio de Medicina Interna del Hospital Consorci Sanitari de Terrassa. Se recogen los datos de la historia clínica, de los informes hospitalarios y de las pruebas complementarias practicadas. Resultados: Preso, 35 años, de Cabo Verde, residente en España desde los 4 años. IDR Mantoux positiva. Inmunocompetente. Por síndrome constitucional se programó estudio hospitalario. Exploración anodina, excepto palpación de masa en región lumbar. La punción aspirativa fue positiva para M. tuberculosis mediante PCR y cultivo Lowenstein. La TC mostró nódulos pulmonares, apical D cavitado y en LSD. Tras aislamiento respiratorio, tratamiento antituberculoso y excelente evolución fue dado de alta con diagnóstico de tuberculosis diseminada. Discusión: Se recomienda vigilar lesiones que, aunque infrecuentes, pueden ser secundarias a infección por M tuberculosis, especialmente en población inmunocomprometida y en inmigrantes procedentes de zonas hiperendémicas de tuberculosis.

Con el objetivo de estudiar la ecología de la flebotomofauna en la población de La Rinconada, perteneciente al estado de Lara, Venezuela, zona endémica donde se han descrito casos de leshmaniasis visceral americana (LVA), se realizó un estudio longitudinal durante cinco meses, en los que una noche por mes se capturó flebótomos en los alrededores de una casa en la que previamente se había informado de un caso de LVA. Se encontró una diversidad de seis especies, de las cuales solo dos eran antropofílicas, siendo Lutzomyia pseudolongipalpis la más abundante (90%). El pico de abundancia se observó en julio, mes seco que precede a los meses más lluviosos del año. Aunque en nuestra muestra no encontramos evidencia de que los flebótomos estuvieran infectados por Leishmania; la evidencia presentada es importante para el mejor entendimiento de un vector que participa de la transmisión de la LVA.In order to study the ecology of phlebotominae in the population of La Rinconada, in the state of Lara, Venezuela, endemic zone of Leishmaniasis, where cases of American Visceral Leshmaniasis (AVL) have been described, a longitudinal study was conducted during five months, and the presence of phlebotominae was identified one night per month in the surrounding areas of a home where an AVL case had been reported. Six species were found, of which only two were anthropophilic. The most abundant species was Lutzomyia pseudolongipalpis (90%), the abundance peak was observed in July - a dry month preceding the rainiest months of the year. Although in our sample we have not found any evidence that phlebotominae were infected by Leishmania; evidence presented is important for a better understanding of a vector that participates in AVL transmission.

Se presenta el caso de un paciente varón de 38 años, procedente de una zona endémica para fascioliasis hepática en el Perú. Fue hospitalizado por presentar un cuadro de cuatro semanas de evolución; con fiebre, mialgias intensas, lesiones eritematosas y dolorosas en las regiones de extensión de las extremidades. La electromiografía y la velocidad de conducción nerviosa mostraron una miopatía inflamatoria global. La biopsia de piel evidenció una vasculitis de tipo poliarteritis nodosa. En el proceso de evaluación previa a la terapia inmunosupresora, se hallaron huevos de Fasciola hepática en el examen coproparasitológico. El diagnóstico de fascioliasis se confirmó con fas2-ELISA: 0,46 (VN There is a case of a 38 year-old male patient coming from an area where hepatic fascioliasis is endemic in Peru. He was hospitalized because he showed 4 weeks of symptoms like fever, intense myalgias, erythematous and painful injuries on limb extensions. The electromyography and nerve conduction velocity showed a global inflammatory myopathy. A skin biopsy showed polyarteritis nodosa-type vasculitis. During the evaluation process prior to the immunosuppressive therapy, hepatic Fasciola eggs were found in the parasitological examination of stools. The fascioliasis diagnosis was confirmed by fas2-ELISA: 0.46 (VN

Objetivos. Identificar las especies de Leishmania presentes en las lesiones cutáneas del paciente y en las Lutzomyias que cohabitan en las áreas endémicas de la región La Libertad en el Perú. Materiales y métodos. Se usaron métodos moleculares basados en PCR y RFLP lo cual permitió obtener datos eficientes con poca muestra (pequeños especímenes), debido a su alta sensibilidad y las facilidades de aplicación en el trabajo de campo. Resultados. Los resultados del PCR de pacientes y de vectores, mostraron la presencia de Leishmania (V.) peruviana como principal agente causal de la Leishmaniosis tipo andina, transmitidas por Lutzomyia peruensis. Así mismo, se reveló la presencia de Leishmania (V.) guyanensis en Lutzomyia ayacuchensis. Conclusiones. Se mostró la presencia de L. (V.) peruviana y L. (V.) guyanensis en las áreas andinas en estudio. Hallazgos que exigen realizar una investigación más amplia sobre la distribución geográfica de L. (V.) guyanensis y las características clínicas relacionadas con la infección en áreas endémicas de Leishmaniosis cutánea.Objectives. To identify the species of Leishmania present in the skin lesions of patients and Lutzomyias living in endemic areas of La Libertad, Peru. Materials and methods. Molecular methods based on PCR and RFLP were used, which allowed to have efficient data with small amounts of samples (small specimens), due to their high sensitivity and ease of application in the field work. Results. The results of PCR of clinical samples of patients and insect vectors showed the presence of Leishmania (V.) peruviana as a major causative agent of andean leishmaniasis transmitted by Lutzomyia peruensis. The presence of Leishmania (V.) guyanensis in Lutzomyia ayacuchensis, was found as well. Conclusions. The presence of L. (V.) peruviana and L. (V.) guyanensis in the Andean areas under study was found. These findings remark the need of a wider research about the geographical distribution of L. (V.) guyanensis and clinical features related to the infection in endemic areas of cutaneous leishmaniasis.

Considerando que o referencial teórico da Vigilância da Saúde (VS) pode constituir um importante modelo para monitoramento da situação de saúde, este estudo reflexivo tem por objetivo discutir as possibilidades de contribuição no controle da Tuberculose. Com base em estudos anteriores de grande escala, a discussão aponta que a identificação de áreas heterogêneas de risco pode fornecer subsídios para a escolha das intervenções direcionadas para as necessidades de grupos mais vulneráveis, contribuindo, assim, para diminuir as iniquidades em saúde. A VS utilizada na Estratégia de Saúde da Família torna-se um profícuo meio de transformar os processos de trabalho em saúde, ao propiciar a compreensão ampliada do objeto da atenção e estimular intervenções nos determinantes da Tuberculose.Considerando que la Vigilancia de Salud (VS) puede constituirse en un importante modelo para monitorizar la situación de la salud, este estudio reflexivo tiene objetivo discutir las posibilidades de contribución de este referencial en el control de la tuberculosis. Apoyados en los estudios anteriores de gran escala, la discusión apunta que la identificación de las áreas heterogéneas del riesgo pueden ofrecer subsidios para la escoja de las intervenciones direccionadas para las necesidades de salud de los grupos más vulnerables, de esa forma contribuyendo para disminuir las iniquidades en salud. El referencial de VS se utiliza en la Estrategia de Salud de la Familia y se convierte en un medio útil para la transformación de los procesos de trabajo en salud, para proporcionar una mayor comprensión del objeto de la atención y estimular la acción sobre los determinantes de la tuberculosis.Health Surveillance (HS) framework is important to become a model best follow up health situation in a community. This reflective study aims to discuss the possibilities of contribution of this framework to tuberculosis control in Brazil. Previous studies in this theme allow confirming that HS is essential to identify heterogeneous area of risk to tuberculosis and also allow to do better interventions according to health needs of social vulnerable groups. Thus is possible to contribute to decrease social inequalities. If the Health Surveillance is used in the Strategy of Family Health, it becomes a useful means to transform the health work process, to provide a broadened understanding of the object of attention and stimulate action on the determinants of tuberculosis.

Fasciola hepatica es el agente etiológico de la fasciolosis en el Perú. La fasciolosis es un problema de salud pública por la alta prevalencia de la infección humana, especialmente niños y un problema veterinario de importancia por las altas tasas de infección del ganado en la mayoría de regiones del País. La fasciolosis es endémica en la sierra y la costa, y esporádica en la región amazónica. La infección humana se reporta en 18 regiones y la animal en 21 de las 24 regiones del Perú. La transmisión humana ocurre en poblaciones andinas rurales dedicadas a la agricultura, pero hay un creciente número de casos en ciudades. Diferentes situaciones epidemiológicas de la infección humana se presentan: i) Regiones con casos no autóctonos, donde la infección es por consumo de vegetales contaminados traídos de zonas endémicas; ii) Regiones con poblados hipo- y mesoendémicos, transmisión local y prevalencia < 10%; y iii) Regiones con poblados hiperendémicos, transmisión local y prevalencia ≥ 10%. El parásito infecta a vacunos, ovinos, equinos, caprinos, porcinos, camélidos, cobayos y conejos. La pérdida ganadera anual por la fasciolosis es no menor de US$ 50 millones, estimada por la prevalencia de la infección y los decomisos de hígados de vacunos en mataderos. Es difícil estimar el impacto económico de la fasciolosis humana por su estatus de enfermedad desatendida, lo cierto es que la fasciolosis es endémica, y en algunos casos hiperendémica, en las regiones más pobres de nuestro país, donde la situación debe ser reconocida como una emergencia de salud pública.Fasciola hepatica is the causative agent of fasciolosis in Peru; the disease is an important public health problem by the high prevalence of the human infection affecting mainly children and a major veterinary problem by the high rates of infected livestock. The human disease is endemic in the Sierra and the Coast but sporadic in the Amazonia, and reported in 18 Departments, while the animal infection in 21 of 24 Departments of Peru. Transmission occurs in Andean rural populations engaged in agriculture, but recently an increasing number of people became infected in the cities. The epidemiological situation in Peru includes i) Departments with non-autochtonous cases, where infection occurs by consumption of contaminated vegetables brought from endemic areas or infection is acquired by visit to endemic areas; ii) Departments with hypoendemic and mesoendemic villages, where transmission occurs by ingest of contaminated vegetables and prevalence ≤10%; and iii) Departments with hyper-endemic villages with human prevalence >10 %, with an intense transmission by consumption of contaminated vegetables. The disease affects bovine, sheep, goat, swine, equine, South American camelids, rabbits and guinea pigs. The negative impact of fasciolosis in the livestock economy is not lesser than US$ 50 million per year, estimation based on the prevalence and the number of condemned livers in the abattoirs. It is difficult to estimate the economic impact of this infection in the human health due to its status of neglected disease, but fasciolosis is hyper-endemic in the poorest Andean areas of Peru where the situation has to be recognized as a public health emergency.

Este estudo objetivou analisar os motivos que levam os pacientes coinfectados TB/HIV a abandonar o tratamento da TB e conhecer a conduta da equipe de saúde frente a esse abandono. A abordagem foi qualitativa. Utilizou-se a entrevista semiestruturada, aplicada a quarenta e cinco profissionais que atuam em uma Unidade de Referência no Pará. Após análise temática, foram construídas duas unidades: fatores relacionados aos doentes que dificultam adesão ao tratamento da TB; e fatores relacionados ao serviço que contribuem para o abandono. Mostrou-se, com relação aos pacientes, que a baixa condição socioeconômica foi o fator mais frequente que propicia o abandono. Também efeitos adversos dos medicamentos, uso de drogas lícitas, e pouca motivação pessoal facilitam esse desfecho. Quanto ao Serviço, as questões relacionadas à estrutura física, organização do processo de trabalho e acesso mostraram-se relevantes para não adesão. Os resultados apontam para a necessidade de alterar as práticas desenvolvidas nos Serviços.Este estudio objetivó analizar los motivos que llevan a los pacientes coinfectados de TB/VIH a abandonar el tratamiento de la TB y conocer la conducta del equipo de salud frente a dicho abandono. El abordaje fue cualitativo. Se utilizó la entrevista semiestructurada, aplicada a cuarenta y cinco profesionales que actúan en una Unidad de Referencia en Pará. Luego del análisis temático fueron construidas dos unidades: factores relativos a los enfermos que dificultan su adhesión al tratamiento de la TB y factores relativos al servicio que contribuyen al abandono. Se demostró, con respecto a los pacientes, que la baja condición socio-económica fue el factor más frecuente que propicia el abandono. También los efectos adversos de los medicamentos, el uso de drogas lícitas y la poca motivación personal facilitan ese desenlace. Respecto del Servicio, las cuestiones relacionadas a la estructura física, organización del proceso de trabajo y acceso mostraron relevancia para la no adhesión. Los resultados apuntan a la necesidad de alterar las prácticas desarrolladas en los Servicios.This study aimed at analyzing the reasons that patients co-infected with tuberculosis and HIV leave the treatment of tuberculosis and to know the conduct of the health team toward that abandonment. The study, using a qualitative approach, performed semi-structured interviews on 45 professionals working at a referral health center in Pará state. Two units emerged based on the thematic analysis: patient-associated factors that make TB treatment adherence difficult; and service-associated factors that contribute to treatment abandonment. It was found that, in terms of the patients, that their low socioeconomic condition was the most common factor that led to abandonment. Other factors that led to this outcome included the adverse drug effects, the use of illegal drugs, and poor personal motivation. Regarding the service, issues related to the physical structure, working process organization and accessibility were also relevant to their non-adherence. Results show there is a need to change the practices performed at the health care services.

OBJETIVO: Analisar a situação epidemiológica da hanseníase em crianças, em zona urbana. MÉTODOS: Foram estudados 474 casos de hanseníase, em menores de 15 anos, detectados na zona urbana de Manaus (AM), de 1998 a 2005. A partir dos dados do Sistema de Informações de Agravos de Notificação foram analisados o perfil da endemia e a qualidade do atendimento nos serviços de saúde, utilizando os indicadores epidemiológicos e operacionais Programa Nacional de Eliminação da Hanseníase. RESULTADOS: Os casos de hanseníase em menores de 15 anos corresponderam a 10,4% do total de casos detectados no período. O coeficiente de detecção nessa faixa etária manteve-se no nível hiperendêmico entre 1998 e 2003, reduzindo a partir do ano de 2004 mas mantendo endemicidade muito alta. A forma clínica mais freqüente foi a tuberculóide, seguida da dimorfa. As formas paucibacilares corresponderam a 70,7% dos casos e no momento do diagnóstico, o grau de incapacidades foi avaliado em 94,7% dos pacientes, dos quais 2,9% apresentaram incapacidades físicas. A maioria dos casos (99,4%) foi tratada com o esquema poliquimioterápico da Organização Mundial da Saúde. CONCLUSÕES: Apesar de seu decréscimo, o coeficiente de detecção da hanseníase nas crianças em Manaus mantém nível de endemicidade muito alto.OBJETIVO: Analizar la situación epidemiológica de la hanseniasis en niños, en zona urbana. MÉTODOS: Fueron estudiados 474 casos de hanseniasis, en menores de 15 años, detectados en la zona urbana de Manaus (Norte de Brasil), de 1998 a 2005. A partir de los datos del Sistema de Informaciones de Agravios de Notificación fueron analizados el perfil de la endemia y la calidad de la atención en los servicios de salud, utilizando los indicadores epidemiológicos y operacionales del Programa Nacional de Eliminación de la Hanseniasis. RESULTADOS: Los casos de hanseniasis en menores de 15 años correspondieron a 10,4% del total de casos detectados en el período. El coeficiente de detección en ese rango etario se mantuvo en el nivel hiperendémico entre 1998 y 2003, disminuyendo a partir del año 2004 pero manteniendo endemicidad muy elevada. La forma clínica mas frecuente fue la tuberculoide, seguida de la dimorfa. Las formas paucibacilares correspondieron a 70,7% de los casos y en el momento del diagnóstico, el grado de incapacidades fue evaluado en 94,7% de los pacientes, de los cuales 2,9% presentaron incapacidades físicas. La mayoría de los casos (99,4%) fue tratada con el esquema poliquimioterapéutico de la Organización Mundial de la Salud. CONCLUSIONES: A pesar de su disminución, el coeficiente de la detección de la hanseniasis en niños en Manaus, mantiene nivel de endemicidad muy elevado.OBJECTIVE: To describe the epidemiological status of leprosy in children living in a metropolitan area. METHODS: There were studied 474 leprosy cases detected in children under 15 living in the metropolitan area of the city of Manaus, Northern Brazil, between 1998 and 2005. The endemic profile and quality of care services were assessed based on data from the Notifiable Diseases Information System using epidemiological and operational indicators of the National Leprosy Elimination Program. RESULTS: Of all leprosy cases detected in the period studied, 10.4% were found in children under 15. The detection rates in this age group remained at hyperendemic levels between 1998 and 2003, and decreased from 2004 onwards but keeping on very high endemic levels. The most common clinical form was tuberculoid followed by dimorphous. Paucibacillary forms were seen in 70.7% of the cases. The level of disability at the time of diagnosis was assessed in 94.7% of patients and 2.9% of them had physical disabilities. Most children (99.4%) were treated with the multiple drug regimen recommended by theWorld Health Organization. CONCLUSIONS: Despite its decrease, detection rate of leprosy in children in the city of Manaus remains at a very high endemic level.

Estudo caso controle que objetivou identificar fatores individuais de risco relacionados à transmissão da doença. O grupo caso, composto por 90 pacientes de hanseníase notificados no SINAN entre 2003 e 2006; o grupo controle, constituído por 270 indivíduos sadios, pareados por sexo e faixa etária. Houve associação significativa entre a ocorrência da doença e a presença atual (OR= 2,9) e antiga (OR=5,0) de hanseníase entre parentes co-sangüíneos. Sabendo-se que o exame único dos contatos, no ato do diagnóstico, detecta uma parcela mínima dos casos, propõe-se a realização de exames periódicos dos contatos de hansenianos a fim de detectar os novos casos.Estudio caso controle que objetivó identificar factores individuales del riesgo relacionados a transmisión de la enfermedad. El grupo caso, compuesto por 90 pacientes con lepra notificados en el SINAN entre 2003 y 2006; y el grupo controle, constituido por 270 individuos saludables, pareados por sexo y edad. Hubo asociación significativa entre la ocurrencia de la enfermedad y la presencia actual (OR= 2,9) y antigua (OR=5,0) de la lepra entre parientes co-sanguíneos. Sabiéndose que el examen único de los contactos en el acto del diagnóstico detecta una parcela mínima de los casos, se propone a la realización del examen periódico de los contactos de leprosos a fin de detectar los nuevos casos.This case-control study aimed to identify individual risk factors regarding the transmission of leprosy. The group case represented by 90 cases of leprosy sick people pontificated at SINAN during 2003 and 2006 and a group control constituted by 270 healthy people, paired by gender and age. There was significant statistical between occurrence of the disease and its current presence (OR: 2,9) and old cases (OR= 5,0) of leprosy among co-sanguine relatives. Knowing that the only exam of the contact in the act of the diagnostic detects a minimum part of the new cases, it is proposed to execute periodical examinations of the contact of leprosy for detecting the new cases.

Copyright of Biomédica: Revista del Instituto Nacional de Salud is the property of Instituto Nacional de Salud of Colombia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

OBJECTIVE: This study aimed to assess whether randomized controlled trials conducted in Africa with collaborators from outside Africa were more closely associated with health conditions that have a burden of disease that is of specific importance to Africa than with conditions of more general global importance or with conditions important to developed countries. We also assessed whether the source of funding influenced a study's relevance to Africa. METHODS: We compared randomized controlled trials performed in Africa that looked at diseases specifically relevant to Africa (as determined by burden of disease criteria) with trials classified as looking at diseases of global importance or diseases important to developed countries in order to assess differences in collaboration and funding. FINDINGS: Of 520 trials assessed, 347 studied diseases that are specifically important to Africa; 99 studied globally important diseases and 74 studied diseases that are important to developed countries. The strongest independent predictor of whether a study was of specifically African or global importance was the corresponding author's country of origin: African importance was negatively associated with a corresponding author being from South Africa (odds ratio (OR) = 0.04; 95% confidence interval (CI) = 0.02-0.10) but there was little difference between corresponding authors from other African countries and corresponding authors from countries outside Africa. The importance of a study to Africa was independently associated with having more non-African authors (OR per author = 1.31; 95% CI = 1.08-1.58), fewer trial sites (OR per site = 0.69; 95% CI = 0.50-0.96), and reporting of funding (OR = 2.14; 95% CI = 1.15-4.00). Similar patterns were present in the comparisons of trials studying diseases important to Africa versus those studying diseases important to developed countries with stronger associations overall. When funding was reported, private industry funding was negatively associated with African importance compared with global importance (OR = 0.31, P = 0.008 for African importance and OR = 0.51, P = 0.57 for importance for developed countries). CONCLUSION: The relevance to Africa of trials conducted in Africa was not adversely affected by collaboration with non-African researchers but funding from private industry was associated with a decreased emphasis on diseases relevant to Africa.

Introduction: Introduction: The family keeps being the key foundation to the development of children in Latin America, and the woman has taken on the role of head of the household. However, diverse problems or changes affecting families put stress on them and therefore, on their children as well. Objective: To describe the effect of a Primary Health Care Program (PHC) in family functionality from the perception of mothers and school children, Guapi-Cauca. Methodology: A quasi-experimental study without a control group. Large and poor families participated in it. This program was built along with the community, with care actions culturally adapted. Data was collected with the Family Functioning Effectiveness Scale (ASF-E 20), processed and analyzed with descriptive methods and Wilcoxon signed rank test. Some ethical aspects were considered as well. Results: Both, children and mothers perceive low family functioning. The primary health care program achieved statistically significant effects on the perception of school children about general family functioning and on the goals of the family system: stability, control, spirituality and growth, contributing to improve communication, t ransmission of culture, special celebrations, family union with expressions of love, affection, happiness, increased self-esteem, individual and family confidence, participation, sense of responsibility about self- care and projection for the future of themselves and their families. In mothers, the outcomes were not statistically significant; however, the program was able to strengthen the celebration of special dates, communication, preservation of traditions and problem solving family, which allowed women to be prouder, safer and happier of themselves. Conclusions: The PHC program statistically achieved significant effects about the perception of family functioning in school children and not in mothers who cause family dysfunction when living in precarious conditions. [ABSTRACT FROM AUTHOR]

Introduction: Transmission and incidence of dengue virus have greatly increased during the last three decades which is the reason why it is currently considered the most emergent infectious disease that causes morbidity and mortality around the world. Objective: Observe simple dengue behavior in the last four years in Santander, Colombia. Method: An analytical study based on secondary data of simple dengue in Santander was performed between the years 2007 and 2015. The weekly epidemiological incidence was calculated and endemic channels between the years of 2012 and 2015 were built using logarithm base 10 with geometric mean and confidence intervals of 95%. The investigation was classified as non-risky according to Law 8430 of 1993, Republic of Colombia. Results: The National Service of Public Health Surveillance (SIVIGILA) reported 26.849 cases of simple dengue in Santander between the years of 2007 and 2015. The cutoff points (success, security, risk, and epidemic) vary in different zones, with significant statistically differences of 4.2 (in 2007), 2.9 (in 2010), and 8.1 (between 2013 and 2014) for each 100.000 inhabitants. Conclusions: The endemic channels of dengue must be taken into account as well as the impact of calculated incidence for monitoring the disease. According to the secular trend, every 3 to 4 years, there is a peak incidence. It is possible that in 2016 a new and bigger peak incidence of dengue will take place in Santander. It is therefore necessary to consider strategies and immediate measures to control this disease. [ABSTRACT FROM AUTHOR]

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Human behavior plays a key role in the dynamics of dengue transmission. However, research on the relationship between human movement and dengue transmission within endemic countries is limited. From January 2008 to December 2011, the authors of this study conducted a retrospective analysis of imported dengue infections in Bogotá, Colombia. Bogotá is a vector-transmission--free city that is also the capital district and most populated municipality in Colombia. The study revealed that 1) Bogotá inhabitants acquired dengue infection in diverse localities throughout the country but the largest proportion of cases (35.6%) were contracted at popular tourist destinations in dengue-endemic areas near Bogotá (< 200-km radius from city limits), and 2) the number of imported dengue cases increased after major holidays, a transmission pattern not seen in dengue-endemic areas, where disease incidence correlates with rainy periods. It is therefore recommended that physicians consider the effect of travel when diagnosing their patients' illnesses, especially outside dengue-endemic areas where diagnosis of the disease can be challenging due to its nonspecific symptoms. The study also showed that analysis of dengue cases imported to regions free of vector transmission can generate an evidence-based model for characterizing the impact of human movement on the spread of diseases like dengue in countries where they are endemic. [ABSTRACT FROM AUTHOR]

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Copyright of Revista Brasileira em Promoção da Saúde is the property of Revista Brasileira em Promocao da Saude and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The word "epidemiology" was written for the first time in a report on the plague in Alghero in 1583. Although its etymology has it intricacy. For centuries it has been concerned with understanding and trying to control and prevent epidemics. During the cholera epidemic in London in 1848 the London Society of Epidemiology was formed, main instrument of public health since then. The increase in chronic diseases -supposedly no communicable- gave way to the epidemiology of black boxes and the predominance of risk factors. And later to an enormous methodological progress increasingly complex and intricate but professionally very appealing. So few epidemiologists have experience in field control of epidemics. Thus, perhaps it is convenient to return, although partially, to the origins. Looking at the future., (Copyright © 2022 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.)

In order to study the ecology of phlebotominae in the population of La Rinconada, in the state of Lara, Venezuela, endemic zone of Leishmaniasis, where cases of American Visceral Leshmaniasis (AVL) have been described, a longitudinal study was conducted during five months, and the presence of phlebotominae was identified one night per month in the surrounding areas of a home where an AVL case had been reported. Six species were found, of which only two were anthropophilic. The most abundant species was Lutzomyia pseudolongipalpis (90%), the abundance peak was observed in July - a dry month preceding the rainiest months of the year. Although in our sample we have not found any evidence that phlebotominae were infected by Leishmania; evidence presented is important for a better understanding of a vector that participates in AVL transmission. [ABSTRACT FROM AUTHOR]

Objectives. To identify the species of Leishmania present in the skin lesions of patients and Lutzomyias living in endemic areas of La Libertad, Peru. Materials and methods. Molecular methods based on PCR and RfLP were used, which allowed to have eficient data with small amounts of samples (small specimens), due to their high sensitivity and ease of application in the ield work. Results. The results of PCR of clinical samples of patients and insect vectors showed the presence of Leishmania (V.) peruviana as a major causative agent of andean leishmaniasis transmitted by Lutzomyia peruensis. The presence of Leishmania (V.) guyanensis in Lutzomyia ayacuchensis, was found as well. Conclusions. The presence of L. (V.) peruviana and L. (V.) guyanensis in the Andean areas under study was found. These indings remark the need of a wider research about the geographical distribution of L. (V.) guyanensis and clinical features related to the infection in endemic areas of cutaneous leishmaniasis. [ABSTRACT FROM AUTHOR]

Fasciola hepatica is the causative agent of fasciolosis in Peru; the disease is an important public health problem by the high prevalence of the human infection affecting mainly children and a major veterinary problem by the high rates of infected livestock. The human disease is endemic in the Sierra and the Coast but sporadic in the Amazonia, and reported in 18 Departments, while the animal infection in 21 of 24 Departments of Peru. Transmission occurs in Andean rural populations engaged in agriculture, but recently an increasing number of people became infected in the cities. The epidemiological situation in Peru includes i) Departments with non-autochtonous cases, where infection occurs by consumption of contaminated vegetables brought from endemic areas or infection is acquired by visit to endemic areas; ii) Departments with hypoendemic and mesoendemic villages, where transmission occurs by ingest of contaminated vegetables and prevalence =10%; and iii) Departments with hyper-endemic villages with human prevalence >10 %, with an intense transmission by consumption of contaminated vegetables. The disease affects bovine, sheep, goat, swine, equine, South American camelids, rabbits and guinea pigs. The negative impact of fasciolosis in the livestock economy is not lesser than US$ 50 million per year, estimation based on the prevalence and the number of condemned livers in the abattoirs. It is dificult to estimate the economic impact of this infection in the human health due to its status of neglected disease, but fasciolosis is hyper-endemic in the poorest Andean areas of Peru where the situation has to be recognized as a public health emergency. [ABSTRACT FROM AUTHOR]

The health condition in Mexico was bad around de beginning of the revolutionary period. The movement of troops led the development of epidemics like yellow fever, typhus, smallpox, and influenza that were enhance with natural disasters and hunger in whole country, from cost to cost and in the north big cities like Monterrey, Guadalajara and Saltillo. Doctor Liceaga conducted a well planned campaign against yellow fever eradicating water stagnant deposits in order to combat the vector transmission, the Aedes aegypti, mosquito with satisfactory results. The first smallpox epidemic in the XX Century in Mexico was in 1916. The Mexican physicians used the smallpox vaccine against this epidemic. An American physician named Howard Taylor Ricketts arrived to Mexico for studying the typhus transmission. Accidentally he had been infected and finally, he died from typhus. Definitively, the epidemics predominate along de revolutionary period in Mexico [ABSTRACT FROM AUTHOR]