Panstrongylus rufotuberculatus (Champion, 1899) naturalmente infectados con Trypanosoma cruzi en el estado Miranda, Venezuela / Panstrongylus rufotuberculatus (Champion, 1899) naturally infected with Trypanosoma cruzi in Miranda state, Venezuela

Dos ejemplares de Panstrongylus rufotuberculatus fueron capturados en una vivienda de El Hatillo, estado Miranda. En ambos se confirma la presencia de Trypanosoma cruzi. Se estudian algunos parámetros biológicos para estimar el comportamiento de uno de los aislados (Pr), encontrándose que tanto el cultivo en medios acelulares como la inoculación en ratones fueron exitosos. Así mismo, 73,3% de los Rhodnius de laboratorio se infectaron y 30,6% de los parásitos presentaron metaciclogénesis, mientras que in vitro se obtuvo 25,5%. La identificación molecular correspondió a T. cruzi. Este hallazgo es importante debido a la posible emergencia de esta especie silvestre que por alteración antrópica de sus hábitats naturales puede estar en proceso de dispersión, penetración y domiciliación de las viviendas, implicando la posibilidad de transmisión del parásito al ser humano y animales domésticos.

Two specimens of Panstrongylus rufotuberculatus were captured in a house in El Hatillo, Estado Miranda. In both specimens the presence of Trypanosoma cruzi was confirmed. We studied some biological parameters for estimating the behavior of the isolates, finding in both that cell-free culture media as inoculation in mice were successful. Also, 73.3% of Rhodnius prolixus fed on infected mice became infected and 30.6% of the parasites developed to metacyclic forms whereas in vitro only 25.5% was obtained. Furthermore, the molecular identification corresponded to T. cruzi. This finding is important due to the possible emergence of wild species by anthropogenic alteration of their natural habitats, and this may become a process of dispersion, penetration and clearance of houses, implying the possibility of transmitting the parasite to humans and pets.

Distribution of Lymnaeidae (Mollusca: Pulmonata), intermediate snail hosts of Fasciola hepatica in Venezuela

An extensive malacological survey was carried out between 2005-2009 in order to clarify the exact number of lymnaeid species which may be intermediate hosts of Fasciola hepatica in Venezuela. Four species were discovered during this survey, including two local species: Lymnaea cubensis and Lymnaea cousini and two exotic species: Lymnaea truncatula and Lymnaea columella. The most common local species was L. cubensis which was found at 16 out of the 298 sampling sites. This species has a large distribution area throughout the Northern part of Venezuela and was encountered from sea level to an altitude of 1,802 m in state of Trujillo. The second local species L. cousini was collected at only two sites of the Andean Region at altitudes of 3,550 m and 4,040 m, respectively. The European L. truncatula was found at 24 sites all located in the states of Mérida and Táchira at an altitude varying between 1,540-4,000 m. The respective distribution areas of L. cubensis and L. truncatula do not appear to overlap, but more detailed malacological surveys are needed. The fourth lymnaeid species, L. columella was collected in a canal from Mérida at an altitude of 1,929 m and in an irrigation canal from the state of Guárico, at an altitude of 63 m. The role of these four lymnaeid species in the transmission of fascioliasis in Venezuela is discussed.

Laboratory diagnosis of Schistosomiasis in areas of low transmission. A review of a line of research

After 57 years of successful control of schistosomiasis in Venezuela, the prevalence and intensity of infection have declined. Approximately 80 percent of the individuals eliminate less than 100 eggs/g of stools, therefore morbidity is mild and the majority are asymptomatic. The sensitivity of Kato-Katz decreases to approximately 60 percent. Available serological methods for the detection of circulating antigens only reach a 70 percent of sensitivity. Tests based on the detection of antibodies by immunoenzymatic assays have been improved. The circumoval precipitine test has shown a high sensitivity (97 percent), specificity (100 percent), and correlation with oviposition, being considered the best confirmatory diagnostic test. Additionally to the classical immunoenzymatic assays, the development of the alkaline phosphatase immunoassay, allowed to reach a 100 percent specificity with an 89 percent sensitivity. Recently, we have developed a modified ELISA in which the soluble egg antigen is treated with sodium metaperiodate (SMP-ELISA) in order to eliminate the glycosilated epitopes responsible for the false positive reactions. The specificity and sensitivity reaches 97 percent and 99 percent, respectively. Synthetic peptides from the excretory-secretory enzymes, cathepsin B (Sm31) legumain (Sm32) and cathepsin D (Sm45), have been synthesized. The combination of two peptides derived from the Sm31 have been evaluated, reaching a sensitivity of 96 percent when analyzed independently and with a 100 percent specificity. Antibodies raised in rabbits against peptides derived from the Sm31 and Sm32 are currently evaluated in two different antigen-capture-based assays. The development of a simple, cheap and reliable test that correlates with parasite activity is a major goal

Schistosomiasis mansoni in low transmission areas. Abdominal ultrasound

In endemic areas with low prevalence and low intensity of infection, the diagnosis of hepatic pathology due to the Schistosoma mansoni infection is very difficult. In order to establish the hepatic morbidity, a double-blind study was achieved in Venezuelan endemic areas, with one group of patients with schistosomiasis and the other one of non-infected people, that were evaluated clinically and by abdominal ultrasound using the Cairo classification. Schistosomiasis diagnosis was established based on parasitologic and serological tests. The increase of the hepatic size at midclavicular and midsternal lines (in hepatometry) and the hard liver consistency were the clinical parameters able to differentiate infected persons from non infected ones, as well as the presence of left lobe hepatomegaly detected by abdominal ultrasound. The periportal thickening, especially the mild form, was frequent in all age groups in both infected and uninfected patients. There was not correlation between the intensity of infection and ultrasound under the current circumstances. Our data suggest that in Venezuela, a low endemic area of transmission of schistosomiasis, the hepatic morbidity is mild and uncommon. The Cairo classification seems to overestimate the prevalence of periportal pathology. The specificity of the method must be improved, especially for the recognition of precocious pathology. Other causes of hepatopathies must be investigated

Schistosomiasis mansoni in areas of low transmission. Epidemiological characterization of Venezuelan foci

Severe schistosomiasis is a rare event in Venezuela nowadays, after a successful national campaign by the Schistosomiasis Control Program. Unfortunately, this program has practically disappeared, and snail surveillance in field is not a priority, anymore. Thus, schistosomiasis has become a neglected disease in this country. However, surveys in different populations from the endemic area have shown particular epidemiological features described herein. In five communities we evaluated 2,175 persons and searched for the presence of Biomphalaria glabrata snails. Some markers were used for classifying schistosomiasis foci: mean age of the persons with Schistosoma mansoni eggs in the stools, serological tests, presence of B. glabrata snails, and intensity of infection. Places without B. glabrata snails and with few schistosomiasis cases were defined as "past transmission sites"; a site with abundant snails but few cases was defined as "potential risk"; "new transmission" foci were characterized by the presence of infected snails and young people passing eggs in the stools. A "re-emergent" focus has shared these last features, showing in addition a place where schistosomiasis had been reported before. Recent evidences of active transmission with the increasing dispersion of B. glabrata snails, point out the necessity for the re-establishment of the Schistosomiasis Control Program in Venezuela

Antigenic community between Schistosoma mansoni and Biomphalaria glabrata: on the search of candidate antigens for vaccines

We have previously confirmed the presence of common antigens between Schistosoma mansoni and its vector, Biomphalaria glabrata. Cross-reactive antigens may be important as possible candidates for vaccine and diagnosis of schistosomiasis. Sera from outbred mice immunized with a soluble Biomphalaria glabrata antigen (SBgA) of non-infected B. glabrata snails recognized molecules of SBgA itself and S. mansoni AWA by Western blot. Recognition of several molecules of the SBgA were inhibited by pre-incubation with AWA (16, 30, 36, 60 and 155 kDa). The only specific molecule of AWA, inhibited by SBgA, was a 120 kDa protein. In order to determine which epitopes of SBgA were glycoproteins, the antigen was treated with sodium metaperiodate and compared with non-treated antigen. Molecules of 140, 60 and 24 kDa in the SBgA appear to be glycoproteins. Possible protective effects of the SBgA were evaluated immunizing outbred mice in two different experiments using Freund's Adjuvant. In the first one (12 mice/group), we obtained a significant level of protection (46 percent) in the total worm load, with a high variability in worm recovery. In the second experiment (22 mice/group), no significant protection was observed, neither in worm load nor in egg production per female. Our results suggest that SBgA constitutes a rich source of candidate antigens for diagnosis and prophylactic studies

Análisis de la situación del personal docente de la Facultad de Medicina de la UCV / Analysis of the situation of the docents personnel of the Schools Medical at the UCV

La Facultad de Medicina de la Universidad Central de Venezuela tiene una misión principal como es la formación de recursos humanos para atender la salud del pueblo venezolano en el sentido más amplio e integral de salud y bienestar. Sus actividades de extensión e investigación y la docencia de pre postgrado la llevan a tener presencia en casi todo el territorio nacional. Esta responsabilidad reposa en el binomio docente-estudiante con el apoyo de los empleados administrativos. Se analizan las distribuciones de profesores de acuerdo a sus escalafones y dedicación por dependencia, la dinámica de jubilaciones en los últimos cinco años, las reposiciones de docentes, así como la expectativa para los próximos 5 años. Se presentan propuestas a corto y mediano plazo basadas en los reglamentos, la integración horizontal y vertical, la optimización de recursos humanos y materiales, con el convencimiento de que mejorando el proceso de enseñanza-aprendizaje transformaremos la Universidad elevando a la excelencia su nivel académico

Evaluación del IEFA como Técnica de inmunodiagnóstico en el programa de lucha contra la bilharziosis / Evaluation of IEFA as inmunodiagnosis technique in the program of struggle againt the schtomiasis

El inmunoensayo para la Fosfatasa Alcalina (IEFA) detecta la presencia de anticuerpos antifosfatasa alcalina de la membrana de los vermes adultos de schistosoma mansoni. Su valor disgnóstico fue probado con 1514 sueros de personas de tres comunidades diferentes del área endémica del interior de Venezuela y 322 sueros de personas del área capitalina de Caracas, encontrandose una sensibilidad de 91,1 por ciento-96,8 por ciento con respecto a la Elisa (con antígenos de huevo). El IEFA fue 100 por cierto específico con sueros de sujetos residentes en localidades no endémicas. Esta metodología mostró menor 84 por cierto de concordancia (Prueba "kappa" de cohen) con "western blot" de antígenos de membrana del adulto y concordancia positiva con la PPCO (40, 6-77,1 por ciento) y la ELISA (51,4-69,1 por ciento) en las poblaciones endémicas estudiadas. Los resultados indican que IEFA es aplicable a la pesquisa epidemiológica de la esquistosomiasis mansoni en zonas endémicas y que la prueba es muy sensible para la detección de casos con baja carga parasitaria (au)

Comunidad antigénica y reactividad cruzada: su repercusión en el diagnóstico y tratamiento de enfermedades parasitarias especial referencia a esquistosomiasis / Community antigenic and cross reaction: repercussion in the diagnosis and treatment parasitic of disease special reference e schistosomiasis

Las condiciones geográficas, ambientales, culturales y económicas facilitan en algunas áreas las infecciones simultaneas por varios agentes. Parásitos de un mismo género o de diferentes familias o phyla, entre parásitos y sus hospederos, comparten moléculas capaces de despertar respuestas inmunes comunes. Este fenómeno permitiría la reactividad cruzada entre parásitos, que tendría como ventaja la eficacia de un producto de amplio espectro (vacuna o medicamento) al poder atacar varios agentes parasitarios en una población poliparasitada. Por el contrario, como desventaja se destaca la inespecificidad del inmunodiagnóstico reflejada como falsos positivos por reactividad cruzada, detectándose anticuerpos o antígenos compartidos que no pertenecen propiamente al agente sospechado. Adicionalmente, la respuesta inmune a un agente patógeno puede dirigirse contra tejidos del propio huésped, desencadenando fenómenos de autoinmunidad. En esquistosomiasis se han desarrollado técnicas de inmunoensayo de mejor especificidad que las tradicionales. Sin embargo, siendo Venezuela un país en el cual coexisten áreas endémicas donde se solapan infecciones parasitarias tales como esquitosomiasis, nematodes intestinales y cisticercosis, se presentan inconvenientes de sobreestimación de prevalencias ocasionando limitaciones en el tratamiento masivo con praziquantel y confusión en la definición de verdaderos casos de esquistosomiasis o cisticercosis. Investigaciones tendientes a mejorar el inmunodiagnóstico disminuyendo los falsos positivos, mediante ensayos de captura de anticuerpos y antígenos para ambos parasitosis, se desarrollan en la actualidad