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Intestinal parasitic diseases constitute a cosmopolitan public health concern, with greater prevalence in developing countries, and mainly affecting children. The aim of this study was to develop an educational intervention aimed at mothers/guardians of children attending three child development centers (CDI) in Santa Fe, Argentina, during 2018. An educational intervention was conducted using a descriptive, quasi-experimental design, with pre- and post-intervention assessment. This intervention included 36 mothers, and was carried out in three stages: diagnosis, intervention and final evaluation. Simultaneously, a coproparasitological study was performed on 48 children under 5 years of age, who were assisted in the CDI, with the aim to understand and address the parasitic infections prevalent in the child population. It was possible to compare the correct answers before and after the educational intervention, observing a statistically significant increase (p=0.008742) in the average number of correct answers. Enteroparasites were identified in 54% of the population of children analyzed, 10% were biparasitized and 6% had more than two parasitic species. The most frequently detected parasites were Blastocystis spp., Giardia intestinalis and Ascaris lumbricoides. The educational intervention was positive, resulting in an improvement in the level of knowledge related to intestinal parasitosis and its prevention. This educational intervention experience highlights the importance of ongoing education in promoting a healthy lifestyle and preventing parasitosis in vulnerable populations., (Copyright © 2024 The Authors. Publicado por Elsevier España, S.L.U. All rights reserved.)

Objectives: primary objective: to improve the FPS rates after an educational intervention., Secondary Objective: to describe variables related to FPS in an ED and determine which ones were related to the highest number of attempts., Design: it was a prospective quasi-experimental study., Setting: done in an ED in a public Hospital in Argentina., Patients: there were patients of all ages with intubation in ED., Interventions: in the middle of the study, an educational intervention was done to improve FPS. Cognitive aids and pre- intubation Checklists were implemented., Main Variables of Interest: the operator experience, the number of intubation attempts, intubation judgment, predictors of a difficult airway, Cormack score, assist devices, complications, blood pressure, heart rate, and pulse oximetry before and after intubation All the intubations were done by direct laryngoscopy (DL)., Results: data from 266 patients were included of which 123 belonged to the basal period and 143 belonged to the post-intervention period. FPS percentage of the pre-intervention group was 69.9% (IC95%: 60.89-77.68) whereas the post-intervention group was 85.3% (IC95%: 78.20-90.48). The difference between these groups was statistically significant (p=0.002). Factors related to the highest number of attempts were low operator experience, Cormack-Lehane 3 score and no training., Conclusions: a low-cost and simple educational intervention in airway management was significantly associated with improvement in FPS, reaching the same rate of FPS than in high income countries., (Copyright © 2023 Elsevier España, S.L.U. and SEMICYUC. All rights reserved.)

In this study, we examined the relationship between screen time use, sleep characteristics, daytime somnolence, and academic performance in school-aged adolescents. We surveyed 1,257 12- to 18-year-old adolescents attending 52 schools in urban or suburban areas of Argentina. We recorded the daily exposure to various screen-based activities, including video- and online-gaming, social media, TV or streaming. Screen time and device type in the hour before bedtime, sleep patterns during weekdays and weekends, somnolence (Pediatric Daytime Sleepiness Scale score), and grades in language and mathematics were also assessed. Structural Equation Modelling was used to identify a path connecting the latent variables. Results are expressed as standardized regression weights (srw). Missing data were present in 393 subjects, and thus the final sample consisted of 864 complete responses. Daytime somnolence (i.e., PDSS score ≥ 15) was observed in 614 participants (71%), and academic failure (i.e., grades < 7/10) in 352 of them (41%). Time spent using video gaming consoles was negatively associated with sleep duration (srw = -0.22, p<0.01) and positively connected with daytime somnolence (srw = 0.11, p<0.01). Use of mobile devices was associated with lower academic performance (srw = -0.11, p<0.01). Sleep duration was inversely related to daytime somnolence (srw = -0.27, p<0.01), which was in turn negatively associated with academic performance (srw = -0.18, p<0.05). Bedtime computer use did not influence any outcome. In summary, among adolescents, screen use adversely affected nighttime sleep, daytime somnolence, and academic performance. These findings call for the implementation of educational public campaigns aimed at promoting healthy sleep and reducing screen exposure among adolescents., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Pérez-Chada et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Introduction: Scorpion envenomation by Tityus carrilloi n. sp. represents a threat to life. Depending on its clinical manifestations, it is classified as mild, moderate or severe., Objective: To compare the epidemiological and biochemical characteristics among children with mild, moderate, and severe scorpionism., Population and Methods: Descriptive, crosssectional, and retrospective study. The consultations at a tertiary care children's hospital in Santa Fe (Argentina) of children under 15 years of age stung by Tityus carrilloi n. sp. between January 2017 and December 2018 were analyzed., Results: In total, 524 children were included, 81% (421) with local pain and 19% (103) with systemic manifestations. Children with systemic symptoms of scorpionism were younger in age than those with local manifestations (p < 0.001). In the winter, children developed 8 times more systemic manifestations of scorpionism; during the spring, 2.4 times more than during the summer. Out of the 103 hospitalized children, 80 were moderate cases and 23 severe cases. There were no differences between age groups (p = 0.29) or in the delay in receiving the anti-scorpion serum (p = 0.81). The length of hospital stay was longer among severe cases (p < 0.001). WBC and blood glucose levels higher than 30 000 cell/mL and 300 mg/dL, respectively, were present almost exclusively in severe scorpionism cases., Conclusions: In children stung by the scorpion Tityus carrilloi n. sp., the younger the age and during winter and spring, the higher the risk for systemic manifestations. WBC and blood glucose levels were higher in children with severe scorpionism., Competing Interests: None., (Sociedad Argentina de Pediatría.)

The SARS-CoV-2 Omicron variant has increased infectivity and immune escape compared with previous variants, and caused the surge of massive COVID-19 waves globally. Despite a vast majority (~90%) of the population of Santa Fe city, Argentina had been vaccinated and/or had been infected by SARS-CoV-2 when Omicron emerged, the epidemic wave that followed its arrival was by far the largest one experienced in the city. A serosurvey conducted prior to the arrival of Omicron allowed to assess the acquired humoral defences preceding the wave and to conduct a longitudinal study to provide individual-level real-world data linking antibody levels and protection against COVID-19 during the wave. A very large proportion of 1455 sampled individuals had immunological memory against COVID-19 at the arrival of Omicron (almost 90%), and about half (48.9%) had high anti-spike immunoglobulin G levels (>200 UI/ml). However, the antibody titres varied greatly among the participants, and such variability depended mainly on the vaccine platform received, on having had COVID-19 previously and on the number of days elapsed since last antigen exposure (vaccine shot or natural infection). A follow-up of 514 participants provided real-world evidence of antibody-mediated protection against COVID-19 during a period of high risk of exposure to an immune-escaping highly transmissible variant. Pre-wave antibody titres were strongly negatively associated with COVID-19 incidence and severity of symptoms during the wave. Also, receiving a vaccine shot during the follow-up period reduced the COVID-19 risk drastically (15-fold). These results highlight the importance of maintaining high defences through vaccination at times of high risk of exposure to immune-escaping variants.

Background: Reported cases of COVID-19 may be underestimated due to mild or asymptomatic cases and a low testing rate in the general population., Research Question: What is the seroprevalence of SARS-CoV-2 infection in the general population and how it compares with the data on SARS-CoV-2 cases reported by a national health surveillance system (SNVS 2.0)., Study Design and Methods: This was a population-based, seroepidemiological, cross-sectional study in the city of Puerto Madryn, a middle size city in the Province of Chubut, Argentina. The study period was between March 3 and April 17, 2021. The sample size was calculated using the technique of calculation of confidence intervals for a proportion. Participants were selected using stratified and cluster probability sampling. A total of 1405 subjects were invited to participate in the study. Participants were divided into the following four age groups: 1) 0 to 14, 2) 15 to 39, 3) 40 to 64, and 4) 65 or older. After informed consent was obtained, a blood sample was taken by puncture of the fingertip, and a structured questionnaire was administered to evaluate demographics, socioeconomic status, level of education, comorbidities and symptoms suggestive of COVID-19. COVID-19 seroprevalence was documented using an immunoenzymatic test for the in vitro detection of IgG antibodies specific to the spike protein of SARS-CoV-2., Results: A total of 987 participants completed the survey. Seropositivity in the full study population was 39,2% and in those under 15 years of age, 47.1%. Cases reported by the SNSV 2.0 amounted to 9.35% of the total population and 1.4% of those under 15 years of age., Interpretation: The prevalence of COVID-19 infection in the general population is four times higher than the number of cases reported by the SNVS 2.0 in the city of Puerto Madryn. For each child under the age of 15 identified by the SNVS 2.0 with COVID-19, there are more than 30 unrecognized infections. Seroepidemiological studies are important to define the real extent of SARS-CoV-2 infection in a particular community. Children may play a significant role in the progression of the current pandemic., Competing Interests: The authors have declared that no competing interests exist.

Background: There is limited evidence on the clinical characteristics of SARS-CoV-2 infection in Latin America. We present findings from a nationwide study in Argentina., Research Question: What is disease severity measures and risk factors are associated with admission to an intensive care unit and mortality?, Study Design and Methods: Data were extracted from the COVID-19 database of the Integrated Argentina Health Information System, encompassing the period of March 3rd to October 2nd, 2020, using a standardized case report form that included information on contact history, clinical signs and symptoms, and clinical diagnosis. Information was collected at the initial site of care and follow-up conducted through calls by the regional healthcare authorities. A confirmed case of COVID-19 was defined as having a positive result through sequencing or real-time reverse-transcriptase polymerase chain reaction (RT-PCR) assay of nasal and pharyngeal swab specimens., Results: RT-PCR testing was positive in 738,776 cases. Complete datasets were available for analysis in 207,079 cases. Mean age was 42.9±18.8 years, 50.0% were males. Frequent co-existing conditions included hypertension (19.2%), diabetes (9.7%), asthma (6.1%) and obesity (5.2%). Most common symptoms included fever (58.5%), cough (58.0%), headache (45.4%), and sore throat (42.1%). Death or ICU admission were independently associated with older age, male, coma, dyspnea or tachypnea, and seizures, with underlying co-morbidities such as immunodeficiency, chronic renal failure, and liver disease showing the strongest effects., Interpretation: Most cases of COVID-19 diagnosed in Argentina were mild and had a favorable outcome, but fatality rates were relatively elevated. Risk factors for adverse outcome included older age, male sex, coma and seizures, and the concurrent presence of several morbidities. These data may be useful for healthcare providers and healthcare policy makers of low-middle income and Latin American countries to guide decisions toward optimized care during the pandemic., Competing Interests: Commercial affiliation: This does not alter our adherence to PLOS ONE policies on sharing data and materials.

Background: Parotitis is an acute viral disease characterized by swelling and pain in one or both salivary glands, submaxillary or submental, fever, headache, muscle ache and/or fatigue., Aim: To investigate the occurrence of influenza virus infection in parotitis cases in a population of Santa Fe during 2017 and analyze clinical and epidemiological characteristics of the cases., Methods: We studied patients with diagnosis of mumps without age restriction, who came for examination from week 26 to the network of clinicians forming the Sentinel Influenza Unit in Santa Fe., Results: Between epidemiological weeks 26 and 44, 22 clinical parotitis cases we enrolled. The influenza virus was detected in 68.2%, influenza A (H3N2) 93%, and influenza B, 7%. The clinical signs of cases were mild, with an average swelling development of 5 days and no complications. 74% presented with influenza-like illness in tandem with parotitis., Conclusions: This study provides evidence that a proportion of children presenting with parotitis had influenza A(H3N2) virus infection. It is necessary to implement systematic surveillance of parotitis associated with influenza and differential diagnosis even in the absence of respiratory symptoms.

Background: Influenza disease burden varies by age and this has important public health implications. We compared the proportional distribution of different influenza virus types within age strata using surveillance data from twenty-nine countries during 1999-2014 (N=358,796 influenza cases)., Methods: For each virus, we calculated a Relative Illness Ratio (defined as the ratio of the percentage of cases in an age group to the percentage of the country population in the same age group) for young children (0-4 years), older children (5-17 years), young adults (18-39 years), older adults (40-64 years), and the elderly (65+ years). We used random-effects meta-analysis models to obtain summary relative illness ratios (sRIRs), and conducted meta-regression and sub-group analyses to explore causes of between-estimates heterogeneity., Results: The influenza virus with highest sRIR was A(H1N1) for young children, B for older children, A(H1N1)pdm2009 for adults, and (A(H3N2) for the elderly. As expected, considering the diverse nature of the national surveillance datasets included in our analysis, between-estimates heterogeneity was high (I 2 >90%) for most sRIRs. The variations of countries' geographic, demographic and economic characteristics and the proportion of outpatients among reported influenza cases explained only part of the heterogeneity, suggesting that multiple factors were at play., Conclusions: These results highlight the importance of presenting burden of disease estimates by age group and virus (sub)type.

Objective: To investigate the burden of asthma in a young adult population in urban areas of Argentina., Design: A nationwide telephone survey in subjects aged 20-44 years was performed in urban areas in Argentina. The European Community Respiratory Health Survey questionnaire was used. Asthma was defined as an exacerbation in the last year or use of asthma medications., Results: In total, 1,521 subjects responded (62.4% females, mean age 33 years), of whom 91 were classified as asthmatics (5.9%, 95% CI 4.7-7.1). Prevalence adjusted for age, sex and education level was 6.4% (95% CI 5.1-7.7). Wheezing was reported by 13.9% (95% CI 15.6-12.2) and a diagnosis of asthma by 9.5% (95% CI 8.0-11.0). Among individuals with a diagnosis of asthma (n=154), 71.3% had undergone spirometry. Among those treated (n=77), 51.9% used medications daily and 46.8% as a rescue measure. Of those reporting an exacerbation in the last year (n=60), 55% had attended an emergency department and 23% were admitted. Asthma was associated with rhinitis (OR 11.1, 95% CI 6.2-19.9) and family history (OR 3.6, 95% CI 2.3-5.5)., Conclusion: Asthma prevalence in young adults in Argentina is similar to Europe. Although attacks and admissions were common, regular use of medications was reported by half of those treated. These results may be useful for other Latin American countries., (Copyright © 2017 SEPAR. Publicado por Elsevier España, S.L.U. All rights reserved.)

Introduction: The increased availability of influenza surveillance data in recent years justifies an actual and more complete overview of influenza epidemiology in Latin America. We compared the influenza surveillance systems and assessed the epidemiology of influenza A and B, including the spatio-temporal patterns of influenza epidemics, in ten countries and sub-national regions in Latin America., Methods: We aggregated the data by year and country and characteristics of eighty-two years were analysed. We calculated the median proportion of laboratory-confirmed influenza cases caused by each virus strain, and compared the timing and amplitude of the primary and secondary peaks between countries., Results: 37,087 influenza cases were reported during 2004-2012. Influenza A and B accounted for a median of 79% and, respectively, 21% of cases in a year. The percentage of influenza A cases that were subtyped was 82.5%; for influenza B, 15.6% of cases were characterized. Influenza A and B were dominant in seventy-five (91%) and seven (9%) years, respectively. In half (51%) of the influenza A years, influenza A(H3N2) was dominant, followed by influenza A(H1N1)pdm2009 (41%) and pre-pandemic A(H1N1) (8%). The primary peak of influenza activity was in June-September in temperate climate countries, with little or no secondary peak. Tropical climate countries had smaller primary peaks taking place in different months and frequently detectable secondary peaks., Conclusions: We found that good influenza surveillance data exists in Latin America, although improvements can still be made (e.g. a better characterization of influenza B specimens); that influenza B plays a considerable role in the seasonal influenza burden; and that there is substantial heterogeneity of spatio-temporal patterns of influenza epidemics. To improve the effectiveness of influenza control measures in Latin America, tropical climate countries may need to develop innovative prevention strategies specifically tailored to the spatio-temporal patterns of influenza in this region.

Tuberculosis (TB) remains a cause of illness and death across the world, especially in developing countries and vulnerable population groups. In 2013, 1.5 million died from the disease worldwide. In Argentina, the largest proportion of TB-related deaths occurred in the northern provinces. Several international studies reported that TB mortality was related to the presence of certain comorbidities and socio-demographic characteristics. Our aim was to investigate the main risk factors associated with TB mortality in adults from six provinces in Argentina, especially those with higher TB mortality rates. A retrospective case-control study was conducted. It included all patients of =18 years with clinical and/or bacteriological TB diagnosis who underwent treatment from January 1st, 2012 to June 30th, 2013. Socio-demographic, clinical and bacteriological variables were surveyed. Information on 157 cases and 281 controls was obtained. Patients reported as deceased to the TB Control Program were considered cases, and those whose treatment result was reported as successful in the same time period were considered controls. For 111 deaths, the average time elapsed between the start of treatment and death was 2.3 months; median: 1. TB-related mortality was associated with poor TB treatment adherence (OR: 3.7 [1.9-7.3], p: 0.000), AIDS (OR: 5.29 [2.6-10.7], p: 0.000), male gender (OR: 1.7 [1.1-2.5], p: 0.009), belonging to indigenous people (OR: 7.2 [2.8-18.9], p:0. 000) and age = 50 (OR: 2.2 [1.4-3.3], p: 0.000). By multivariate analysis the two first associations were confirmed. This study sets up the basis for planning inter-program and inter-sector work to accelerate the decline in the inequitable TB mortality.

Introduction: Determining the optimal time to vaccinate is important for influenza vaccination programmes. Here, we assessed the temporal characteristics of influenza epidemics in the Northern and Southern hemispheres and in the tropics, and discuss their implications for vaccination programmes., Methods: This was a retrospective analysis of surveillance data between 2000 and 2014 from the Global Influenza B Study database. The seasonal peak of influenza was defined as the week with the most reported cases (overall, A, and B) in the season. The duration of seasonal activity was assessed using the maximum proportion of influenza cases during three consecutive months and the minimum number of months with ≥80% of cases in the season. We also assessed whether co-circulation of A and B virus types affected the duration of influenza epidemics., Results: 212 influenza seasons and 571,907 cases were included from 30 countries. In tropical countries, the seasonal influenza activity lasted longer and the peaks of influenza A and B coincided less frequently than in temperate countries. Temporal characteristics of influenza epidemics were heterogeneous in the tropics, with distinct seasonal epidemics observed only in some countries. Seasons with co-circulation of influenza A and B were longer than influenza A seasons, especially in the tropics., Discussion: Our findings show that influenza seasonality is less well defined in the tropics than in temperate regions. This has important implications for vaccination programmes in these countries. High-quality influenza surveillance systems are needed in the tropics to enable decisions about when to vaccinate.

Objective: To evaluate if the use of the 19 Leptospira strains panel suggested by the International Leptospirosis Society of World Health Organization for microagglutination allows confirmation of more cases that the 12 strains panel used in Argentina., Materials and Methods: Cross-sectional observational study. We studied 441 serum samples corresponding to Argentinean patients with suspected leptospirosis derived during from July to December, 2009 and from January to October, 2013., Results: The same number of positive samples was obtained using the MAT with the 19 or 12 strains. In six cases a serovar of the expanded collection was presumably infecting, but always coagglutinated with strains of the reduced panel., Conclusion: In Argentina, the diagnosis of leptospirosis by MAT could be made using the reduced 12 strains panel, obtaining the same result in case detection as using the 19 strains panel. Additional information provided by the use of all strains could be the presumably infecting serogroup.

Introduction: Literature on influenza focuses on influenza A, despite influenza B having a large public health impact. The Global Influenza B Study aims to collect information on global epidemiology and burden of disease of influenza B since 2000., Methods: Twenty-six countries in the Southern (n = 5) and Northern (n = 7) hemispheres and intertropical belt (n = 14) provided virological and epidemiological data. We calculated the proportion of influenza cases due to type B and Victoria and Yamagata lineages in each country and season; tested the correlation between proportion of influenza B and maximum weekly influenza-like illness (ILI) rate during the same season; determined the frequency of vaccine mismatches; and described the age distribution of cases by virus type., Results: The database included 935 673 influenza cases (2000-2013). Overall median proportion of influenza B was 22·6%, with no statistically significant differences across seasons. During seasons where influenza B was dominant or co-circulated (>20% of total detections), Victoria and Yamagata lineages predominated during 64% and 36% of seasons, respectively, and a vaccine mismatch was observed in ≈25% of seasons. Proportion of influenza B was inversely correlated with maximum ILI rate in the same season in the Northern and (with borderline significance) Southern hemispheres. Patients infected with influenza B were usually younger (5-17 years) than patients infected with influenza A., Conclusion: Influenza B is a common disease with some epidemiological differences from influenza A. This should be considered when optimizing control/prevention strategies in different regions and reducing the global burden of disease due to influenza., (© 2015 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons Ltd.)

The purpose of this study was to plan health education efforts that integrate the health and education sectors. From March to November 2004, an art contest was held for 7th-9th grade students in 109 schools in 11 of Argentina's provinces. The contest allowed improvements in knowledge to be measured and adjustments to be made to the curriculum. The students created works of art featuring tuberculosis. To evaluate knowledge acquired, two provinces were chosen at random. Student knowledge had increased from 67.2% to 96.4%. The administrators and teachers testified to the usefulness of the materials developed. These results show that when the efforts of health and education sectors are coordinated and the appropriate materials are leveraged, the efforts of educators can be substantially bolstered.

In order to assess laboratory resources, practices, and biosafety measures during mycobacterial testing and determine the usefulness and scope of mycobacterial techniques, a cross-sectional survey of public laboratories was conducted in Argentina using a structured questionnaire. Sputum smear analysis showed that both smear and culture testing centers are being provided at or above the WHO recommended density for such facilities. The microscopy quality assessment program covered most high-demand laboratories. Mean number of sputum smears per patient was low (1.6). The use of inadequate personal respiratory protection was identified in 25% of culture laboratories. Jurisdictions that cultured a higher proportion of their smear-tested sputa identified a higher proportion of smear-negative cases. The percentage of smear negatives among all bacteriologically confirmed pulmonary cases was 18.9%, while most extrapulmonary cases were confirmed by culture (71.3%). In conclusion, increasing the number of sputa studied by microscopy and culture (while expanding the coverage of the quality assessment program) is a priority; adequate respiratory protection and regular medical evaluation of laboratory staff is still needed in some laboratories.

The increase in both Mycobacterium tuberculosis human clinical isolates resistant to the essential drugs and cases of disseminated micobacteriosis due to Mycobacterium avium Complex, underlines the need to investigate new antimicobacterial agents. The antimicrobial peptides are a new group of active antibiotics with a particular mechanism of action. Some of them, like cecropin and melittin, isolated from insects, have demonstrated good in vitro activity against Gram-positive and Gram-negative bacteria. Synthetic hybrids of those peptides have been more active than individual peptides. In this study, the in vitro activity of two hybrid synthetic peptides from melittin and cecropin against M. tuberculosis, M. avium Complex, Mycobacterium fortuitum and Mycobacterium smegmatis has been evaluated. The minimal inhibitory concentration was determined by using the broth macrodilution technique. The minimal bactericide concentration in Lowenstein Jensen medium was then obtained. The peptides studied were active, in vitro, against M. smegmatis, but they did not show any activity against the other mycobacteria analyzed.

Tuberculous (TB) meningitis in children under 5 years of age is a serious health problem in Argentina, with a rate of 0.39/100000 inhabitants, for 2003-2004. This rate indicates recent infections. It is an operational indicator for case finding and treatment of pulmonary adult cases, and for BCG vaccination of the newborn. The object of this study was to describe epidemic and clinical variables registered in cases of TB meningitis in children less than 5 years old in Argentina, from 1999 to 2001 and to determine the real number of TB meningitis cases in our country. Fifteen cases of TB meningitis out of 32 (46.8%) were studied through epidemic records. The average age was 14 months. Six children presented BCG scars but in only one child it was proved that he had been vaccinated at birth; 11/13 (92.3%) were at the second stage of illness, the bacteriological investigation was positive in 8/11 (72.7%) and in (46.8%) chest radiography revealed abnormal findings. The tuberculin reaction was negative in all tested cases. This study showed that the diagnosis was made at an advanced stage of disease. None of these patients was cured without sequels and a high death rate (46%) was observed. In order to control this epidemic situation, it is necessary to increase case finding and directly observed treatment of smear positive pulmonary TB cases, as well as BCG vaccination given at birth.