Una Sola Salud. Un Enfoque Multisectorial y Transdisciplinario / One Health. A Multisectoral and Transdisciplinary Health Approach

Una sola salud (USS), es un enfoque integral y unificador diseñado para equilibrar y optimizar la salud tanto de seres humanos, animales y ecosistemas, aprovechando la interrelación entre estos ámbitos para establecer nuevas metodologías de vigilancia y control de enfermedades. Es así como, la forma en que se utiliza el suelo puede influir en el número de casos de malaria; las condiciones meteorológicas y controles artificiales del agua pueden afectar enfermedades como el dengue; el comercio de animales salvajes vivos puede aumentar la probabilidad de que ciertas enfermedades infecciosas se transmitan de animales a humanos (zoonosis), entre otros ejemplos. Es decir, un esfuerzo integrador de múltiples disciplinas que trabajan de manera colaborativa a nivel local, nacional y global en todos los aspectos del cuidado de la salud de los seres humanos, los animales y el medio ambiente. El objetivo de este manuscrito fue reportar y discutir el concepto USS, como nuevo enfoque sanitario inter y transdisciplinario. Debemos adoptar la filosofía de USS desde el nivel global hasta el más local para reducir entre otras, los riesgos de pandemias que pueden ocurrir con mayor frecuencia considerando el crecimiento exponencial de la población mundial y la urbanización.

SUMMARY: One Health (OH) represents a comprehensive and unifying approach designed to balance and optimize the health of humans, animals, and ecosystems. By leveraging the interdependent links among these domains, OH establishes new methodologies for disease surveillance and control. The manner in which land is utilized can influence the incidence of malaria; meteorological conditions and artificial water controls can impact diseases such as dengue, and the trade of live wildlife can escalate the likelihood of certain infectious diseases being transmitted from animals to humans (zoonoses), among other interconnected factors. That is, an integrative effort of multiple disciplines working collaboratively and locally, nationally, and globally in all aspects of health care for humans, animals, and the environment. The aim of this manuscript was to elucidate and discuss the OH concept as an interdisciplinary and transdisciplinary paradigm in healthcare. In conclusion,it is imperative to embrace the OH philosophy from a global to local scale in order to mitigate, among other concerns, the heightened risks of pandemics. This consideration is especially pertinent given the exponential growth of the global population and urbanization trends, which may contribute to an increased frequency of pandemic occurrences.

El enfoque Una Salud y la resistencia a los antimicrobianos: Implementación en el Perú / The One Health Approach and Antimicrobial Resistance: Implementation in Peru

RESUMEN La Resistencia a los Antimicrobianos (RAM) es un problema de salud pública de alcance global. De no lograrse contener su propagación, para el año 2050 se convertiría en la primera causa de muerte a nivel mundial, con un serio impacto en la economía mundial. Esta situación ha determinado la aplicación del enfoque «Una Salud¼ para su contención. Este enfoque reconoce que la salud de las personas, los animales, las plantas y el medio ambiente están estrechamente relacionados y son interdependientes. Desde el año 2015, la Organización Mundial de la Salud, en coordinación con otras organizaciones aprobaron el Plan de Acción Mundial para enfrentar la RAM, esto determinó que los estados miembros elaboraran e implementaran sus planes nacionales. El Perú inició el abordaje para la contención de la RAM aplicando el enfoque «Una Salud¼ desde el año 2017. Se registran algunos avances en la implementación de Plan nacional pero también los retos y acciones pendientes de alcanzar.

ABSTRACT Antimicrobial Resistance (AMR) is a public health problem of global scope, whose projections if its spread is not contained indicate that by the year 2050 it would become the leading cause of death worldwide with a serious impact on the world economy. This situation has determined the application of the "One Health" approach for its containment. The approach recognizes that the health of people, animals, plants and the environment are closely related and interdependent. Since 2015, the WHO, in coordination with other organizations, approved the Global Action Plan to face AMR, this determined that the Member States elaborate and implement their national plans. Peru began the approach to contain AMR applying the "One Health" approach since 2017. Some progress has been made in the implementation of the National Plan but also the challenges and actions pending to be achieved.

Whitehead, Tansley, Sen, Bobbio e a abordagem One Health / Whitehead, Tansley, Sen, Bobbio and the One Health approach / Whitehead, Tansley, Sen, Bobbio y el enfoque One Health

Objetivo: traçar parâmetros para estruturar conceitos da abordagem One Health através dos pensamentos de Alfred North Whitehead, Arthur George Tansley, Amartya Sen e Norberto Bobbio. Metodologia: tratou-se de pesquisa original, com abordagem dedutiva e viés hermenêutico, baseada nos pensamentos selecionados e na orientação de Saúde Única. Resultados: One Health estrutura-se na afirmativa holística e integrada que a saúde humana, animal e ambiental estão interligadas. Sob a perspectiva de Whitehead, a abordagem One Health pode ser considerada um processo dinâmico e relacional, onde humanos, animais e meio ambiente interagem constantemente, interconectando-se por relações e processos, formando um todo. Pela perspectiva de Tansley, a ideia de One Health pode alinhar-se ao conceito de ecossistema, não podendo a saúde ser analisada isoladamente em indivíduos, mas, necessariamente, pelas interações complexas entre seres humanos, animais e o ambiente. Sob o prisma de desenvolvimento (direitos e liberdades), proposto por Sen, a abordagem One Health pode ser considerada um meio para alcançá-lo, através da interrelação de mecanismos, sistemas e instituições focados na promoção da saúde e do bem-estar. Na visão de Bobbio, direitos fundamentais, democracia e a paz, são formas éticas e primordiais para assegurar direitos, especialmente um novo direito da natureza (humanos, animal e ambiente) na busca conjunta de garantias para a convivência pacífica. Conclusão: a abordagem One Health não é apenas uma estratégia prática, mas também uma visão renovada da antiga percepção que reconhecia a interconexão de todas as formas de vida.

Objective: draw parameters to structure concepts of the One Health approach through the thoughts of Alfred North Whitehead, Arthur George Tansley, Amartya Sen, and Norberto Bobbio. Methodology: this was original research, with a deductive approach, hermeneutic bias based on the selected thoughts and the One Health. Results: One Health is structured on the holistic and integrated assertion that human, animal, and environmental health are interconnected. From Whitehead's perspective, the One Health approach can be considered a dynamic and relational process, where humans, animals, and the environment constantly interact, interconnecting through relationships and processes, forming a whole. From Tansley's perspective, the idea of One Health can align with the ecosystem concept, where health cannot be analyzed in isolation in individuals, but necessarily through the complex interactions between humans, animals, and the environment. From Sen's development prism (rights and freedoms), the One Health approach can be seen to achieve it, through the interrelation of mechanisms, systems, and institutions focused on promoting health and well-being. In Bobbio's view, fundamental rights, democracy, and peace are ethical and primary ways to ensure rights, especially a right of nature (humans, animals, and the environment) in the joint pursuit of guarantees for peaceful coexistence. Conclusion: the One Health approach is not just a practical strategy, but also a renewed vision of the old perception that recognized the interconnection of all forms of life.

Objetivo: establecer parámetros para estructurar conceptos del enfoque One Health a través de los pensamientos de Alfred North Whitehead, Arthur George Tansley, Amartya Sen y Norberto Bobbio. Metodología: se trató de una investigación original, con un enfoque deductivo, sesgo hermenéutico basado en los pensamientos seleccionados y el Salud Única. Resultados: One Health se estructura en la afirmación holística e integrada de que la salud humana, animal y ambiental están interconectadas. Desde la perspectiva de Whitehead, el enfoque One Health puede considerarse un proceso dinámico y relacional, donde humanos, animales y el medio ambiente interactúan constantemente, interconectándose a través de relaciones y procesos, formando un todo. Desde la perspectiva de Tansley, la idea de One Health puede alinearse con el concepto de ecosistema, donde la salud no puede analizarse aisladamente en individuos, sino necesariamente a través de interacciones complejas entre seres humanos, animales y el ambiente. Desde el prisma del desarrollo (derechos y libertades) propuesto por Sen, el enfoque One Health puede considerarse un medio para alcanzarlo, a través de la interrelación de mecanismos, sistemas e instituciones enfocados en la promoción de la salud y el bienestar. Desde la visión de Bobbio, los derechos fundamentales, la democracia y la paz son formas éticas y primordiales para asegurar derechos, especialmente un derecho de la naturaleza (humanos, animales y ambiente) en la búsqueda conjunta de garantías para la convivencia pacífica. Conclusión: el enfoque One Health no es solo una estrategia práctica, sino también una visión renovada de la antigua percepción que reconocía la interconexión de todas las formas de vida.

Feral pigs as a reservoir for zoonotic and transboundary diseases in the Western Pacific Region

@#Feral pigs are known as triple-threat pests due to their impact on health, agriculture and the ecosystem. Recent emerging infectious disease outbreaks have emphasized their role as reservoirs and amplifiers of disease and highlight the need for increased surveillance in the Western Pacific Region.

Promoting implementation research and One Health approach to respond the four global health challenges: an interpretation of the Special Programme for Research and Training in Tropical Diseases (TDR) Strategy 2024—2029 / 中国血吸虫病防治杂志

Tropical diseases, notably neglected tropical diseases and infectious diseases of poverty, remain major health problems endangering the poorest and most-marginalized people in the world. The Special Programme for Research and Training in Tropical Diseases (TDR), which is co-sponsored by the World Health Organization, the United Nations Children’s Fund (UNICEF), the United Nations Development Programme (UNDP) and the World Bank, is an important programme that helps facilitate, support, guide and coordinate global efforts to combat tropical diseases. On July 2023, TDR formally issued its 2024—2029 strategy, which proposed the direction and proprieties of global tropical disease prevention and control in the next six years. Based on its original focus on supporting researchers and research institutions from low and middle-income countries to conduct research on tropical diseases and building their research capabilities, this strategy proposed some new developments, which mainly included incorporating tropical disease prevention and control into the overall framework of addressing major global health challenges and achieving the health goals set by the United Nations Sustainable Development Goals (SDGs) to combat tropical diseases and contribute to achieving health goals of SDGs in a collaborative and integrated manner; supporting implementation research and encouraging practitioners and social innovators to participate in research to enable generation of solutions that may be used to solve local health problems; promoting and encouraging the One Health concept and interdisciplinary and cross-departmental collaboration; shifting gradually its focus from disease prevention and control to addressing the health needs of the poorest and most-marginalized populations. These new developments deserve the attention of personnel and institutions in China dedicated to the prevention and control of tropical diseases in order to help their future researches and activities.

Bibliometric analysis of ESKAPE drug‑resistant bacteria / 上海预防医学

ObjectiveTo conduct a bibliometric visual analysis of studies on Enterococcus faecium， Staphylococcus aureus， Klebsiella pneumoniae， Acinetobacter baumannii， Pseudomonas aeruginosa and Enterobacter species （ESKAPE） in the past 10 years at home and abroad， and to analyze current research status and future research directions in this field based on the concept of “One health”. MethodsRelated literature on ESKAPE drug resistant bacteria from 2013 to 2022 was searched on CNKI and WoS， respectively. Furthermore， a metrological visualization analysis of authors， source of agencies， countries， and keywords was conducted by the CiteSpace 6.1.R6 software. ResultsA total of 2 991 pieces of Chinese-language and 24 497 pieces of English-language literature were included in this study. Although the number and growth rate of English-language publications were higher than those of Chinese-language publications， the number of English-language papers authored by Chinese scholars showed a significant upward trend. The level of collaboration between authors and institutions in Chinese-language publications was weaker than that in English-language publications. Overall， the country with the highest number of publications was the United States （6 623）， followed by China （3 776）. However， China’s annual publication volume （851） exceeded that of the United States （600） in 2022. China had collaborations with 25 countries， indicating good global cooperation， but its level of international cooperation was still slightly weaker than that of the United States. High-frequency keywords in Chinese-language literature mainly included drug resistance， nosocomial infection， and antibiotics， while high-frequency keywords in English-language literature included Staphylococcus aureus， Klebsiella pneumoniae， and methicillin-resistant. ConclusionCarbapenem-resistant Klebsiella pneumoniae， carbapenem-resistant Enterobacteriaceae， and "One health" are research hotspots. In the future， cross-sectoral and multi-regional collaboration should be deepened to strengthen the control of infections of important drug-resistant bacteria， and infection treatment strategies should be optimized as well.

The present and future research agenda of sporotrichosis on the silver anniversary of zoonotic sporotrichosis in Rio de Janeiro, Brazil

Twenty-five years have passed since the initial observation of endemic zoonotic sporotrichosis in Rio de Janeiro, Brazil. Since then, this disease has spread throughout South America. Accompanying the emergence of this mycosis, some progress has been made, including the expansion of a research network in this field and higher visibility of sporotrichosis within government authorities and funding agencies. However, there are still some challenges to curbing the expansion of this disease in the coming years. These include the development of rapid and accurate diagnostic tests, new antifungal drugs, particularly for the treatment of extracutaneous manifestations of sporotrichosis, and more comprehensive care for cats with sporotrichosis. Including these actions in the sporotrichosis research agenda is required so as to change the development of this disease in the years to come.

Absence of Leishmania spp. DNA in road-killed wild mammals in Southern Brazil / Ausência de DNA de Leishmania spp. em mamíferos silvestres atropelados no Sul do Brasil

Abstract Leishmaniasis are neglected diseases transmitted by vectors that affect domestic and wild animals, including humans. Due to its incidence and lethality, this zoonosis is a worrying public health problem, making it essential to identify all links in the transmission chain. Infection of wild mammals by Leishmania spp. remains poorly understood, especially in southern Brazil. Therefore, the objective was to research, using the PCR technique, the presence of Leishmania spp. DNA in road-killed wild mammals in Southern Brazil. Carcasses of 96 animals were collected from highways in the Pelotas microregion, Rio Grande do Sul, southern Brazil and subjected to necropsies. Tissue fragments (spleen, skin, liver, kidney, heart, lung, lymph nodes, bone marrow and blood) were collected and genomic DNA was extracted. PCR protocols targeting the ITS1, kDNA and 18S genes were tested. We found no evidence of Leishmania spp. circulation in the studied population. However, epidemiological studies like this one are of great relevance, as they allow monitoring of the occurrence of pathogens and help identify possible risk areas. As these animals act as epidemiological markers for the presence of the microorganism, studies must be carried out continuously to understand whether there are sources of infection in the region.

Resumo As leishmanioses são doenças negligenciadas, transmitidas por vetores que acometem animais domésticos e silvestres, incluindo os humanos. Devido a sua incidência e letalidade, essa zoonose consiste em um problema de saúde pública preocupante, sendo fundamental a identificação de todos os elos da cadeia de transmissão. A infecção de mamíferos silvestres por Leishmania spp. permanece pouco compreendida, especialmente no sul do Brasil. Portanto, objetivou-se pesquisar, por meio da técnica de PCR, a presença de DNA de Leishmania spp. em mamíferos silvestres atropelados no Sul do Brasil. Carcaças de 96 animais foram coletadas, em rodovias da microrregião de Pelotas, Rio Grande do Sul, sul do Brasil e submetidas a necropsias. Fragmentos de tecidos (baço, pele, fígado, rim, coração, pulmão, linfonodos, medula óssea e sangue) foram coletados e o DNA genômico foi extraído. Protocolos de PCR visando os genes ITS1, kDNA e 18S foram testados. Não foram encontradas evidências de circulação de Leishmania spp. na população estudada. Porém, estudos epidemiológicos como este são de grande relevância, pois permitem monitorar a ocorrência de patógenos e auxiliam na identificação de possíveis áreas de risco. Como esses animais atuam como marcadores epidemiológicos da presença do microrganismo, estudos devem ser realizados continuamente, para entender se existem fontes de infecção na região.

First whole genome sequencing of Escherichia coli carrying mcr-1 from pig in Argentina

The objective of this study is to communicate the findings of the first whole genome sequencing of a colistin-resistant Escherichia coli isolate harboring mcr-1 gene obtained from a pig in Argentina. Genomic DNA was sequenced using the MinION Oxford Nanopore platform. The libraries were prepared using a SQK-RBK110-96 protocol. The sequencing process was conducted on a MinION Mk1C MIN 101-C, utilizing a FLO-MIN106 flow cell. The quality of the reads was evaluated using NanoPlot. De novo assembly was conducted using Canu 1.6 and the quality of contigs was evaluated using QUAST. Annotation was performed using Prokka. The CBC20 strain exhibited a colistin MIC of 4 µg/mL. The genome size was 5178653 bp with a GC content of 50,31%. The N50 value was 133,250, while the L50 value was 21. A total of 11,620 genes, 11,518 coding sequences, 77 transfer RNAs and 24 ribosomal RNAs were identified. A serotype O9:H37 with sequence type ST-297 was observed. A total of seven antimicrobial resistance genes were identified, including mcr-1.5, bla TEM-1B, bla EC-18, bla TEM-70, aph(3')-Ia, mph(A) and sul3. The presence of punctual mutations was observed in the genes encoding the proteins GyrA (S83L, D87N) and ParC (S80I). Five distinct plasmid replicon types were identified, including IncFII, IncY, IncFIB, IncX1 and Col440II. Our findings may assist in the comprehension of the mechanisms of antimicrobial resistance, genomic epidemiology and dissemination of mcr-1 gene among animals and environment, which could potentially impact human health.

El objetivo de este estudio es comunicar la primera secuenciación de genoma completo de un aislamiento de Escherichia coli resistente a colistina mediada por el gen mcr-1 obtenido de un cerdo en Argentina. El ADN genómico se secuenció utilizando la plataforma MinION Oxford Nanopore. Las bibliotecas se prepararon utilizando un protocolo SQK-RBK110-96. El proceso de secuenciación se realizó en un MinION Mk1C MIN 101-C, utilizando una flow cell FLO-MIN106. La calidad de las lecturas se evaluó mediante NanoPlot. El ensamblaje de novo se realizó utilizando Canu 1.6 y la calidad de los contigs se evaluó utilizando QUAST. La anotación se realizó utilizando Prokka. CBC20 exhibió una CIM de colistina de 4 µg/mL. El tamaño del genoma fue de 5.178.653 pb con un contenido de GC del 50.31 %. El valor N50 fue 133.250, mientras que el valor L50 fue 21. Se identificaron un total de 11.620 genes, 11.518 secuencias codificantes, 77 ARN de transferencia y 24 ARN ribosómicos. Se observó el serotipo O9:H37 con un secuenciotipo ST-297. Se identificaron siete genes de resistencia, incluyendo mcr-1.5, bla TEM-1B, bla EC-18, bla TEM-70, aph(3')-Ia, mph(A) y sul3. Se observó la presencia de mutaciones puntuales en los genes que codifican las proteínas GyrA (S83L, D87N) y ParC (S80I). Se identificaron cinco tipos distintos de plásmidos, incluidos IncFII, IncY, IncFIB, IncX1 y Col440II. Nuestros hallazgos podrían ayudar a comprender los mecanismos de resistencia antimicrobiana, la epidemiología genómica y la diseminación del gen mcr-1 entre animales y el medio ambiente, lo que potencialmente podría afectar la salud humana.

Entomological indicators and food sources of triatomines in the Brazilian semi-arid region

ABSTRACT Background: Triatomines are biological vectors of Trypanosoma cruzi, the etiological agent of Chagas Disease (CD) and have various mammalian hosts. This study evaluated the entomological indicators and food sources of triatomines in Petrolina in the semi-arid region of Brazil, where CD is endemic. Methods: Triatomines were captured indoors and outdoors through an active search and entomological indices (household and natural infections) were calculated. Parasitological analyses were performed through microscopic visualization using Giemsa-stained insect feces, and DNA sequencing was employed to identify food sources from the gut contents of 82 insects (9.05%) that were better preserved. Results: We captured triatomines (906) in peridomicile (807) and intradomicile (99): Triatoma brasiliensis (84.7%, 767 specimens), Triatoma spp. (8.2%, 74 specimens), T. pseudomaculata (6.5%, 59 specimens), Rhodnius spp. (0.4%, four specimens), R. nasutus (0.1%, one specimen), and T. sordida (0.1%, one specimen). The household infestation index is 11.8%. Thirty-five triatomines were infected (33 T. brasiliensis and two T. pseudomaculata), corresponding to a natural infection index of 3.8%. The identified food sources were human T. pseudomaculata and T. brasiliensis, dogs for T. brasiliensis and rodents (Mus musculus) for T. brasiliensis. Conclusions: The results reinforce the need to intensify CD diagnosis, surveillance, and control actions, as an increase in entomological indices was recorded. Blood from humans and domestic and synanthropic animals was detected in the infected triatomines, suggesting a risk of CD vector transmission in Petrolina. As CD is a zoonosis, multidisciplinary and intersectoral CD surveillance must be conducted in the context of the One Health.

Evaluation of medical professionals' knowledge about Q fever / Avaliação do conhecimento de profissionais médicos sobre a febre Q

Aims: evaluate the medical professionals' knowledge about Q fever, seeking integrative contributions to public health that may favor the formulation of policies and the development of strategies based on a One Health approach. Methods: this is a cross-sectional and quantitative study with data collection through a structured questionnaire applied face-to-face to physicians from various clinical specialties working at the three levels of health care in Brazil. The questionnaire consisted of 25 questions, seven of which were specific to assessing knowledge about Q fever. Univariate and multivariate logistic regression analyses were conducted to assess whether the variables medical specialty, level of health care in which they work, age range and gender were associated with a correct answer to at least one specific question about Q fever. Results: among the 254 physicians included, 236 (92.9%) were unaware of Q fever. Only three (16.6%) of the 18 who correctly answered at least one specific question about the disease had a score of more than 50%. The highest rates of correct answers for at least one question (p < 0.0001) occurred among the me-dical specialties most related to clinical signs and symptoms or the differential diagnosis of Q fever and among males. It is highlighted that 85.8% of physicians consider Q fever a neglected and underreported disease in Brazil. Additionally, all physicians responded that they were not aware of the One Health approach.Conclusions: the almost total lack of knowledge among medical professionals regarding Q fever reinforces the need for greater disclosure for this zoonosis with a One Health approach in Medical Schools, in Residency Programs and for physicians in general. In addition, the inclusion of Q fever in the national list of notifiable diseases becomes relevant, allowing a better understanding of its epidemiological situation in Brazil. Finally, effective public health actions must be carried out to avoid underdiagnosis and the development of severe cases of the disease

Objetivos: avaliar o conhecimento dos profissionais médicos sobre a febre Q, visando contribuições integrativas para saúde pública que possam favorecer a formulação de políticas e o desenvolvimento de estratégias baseadas na abordagem de Saúde Única.Métodos: trata-se de um estudo transversal e quantitativo com coleta de dados por meio de questionário estruturado aplicado presencialmente a médicos de diversas especialidades clínicas que atuam nos três níveis de atenção à saúde no Brasil. O questionário foi composto por 25 questões, sendo sete específicas de avaliação de conhecimento sobre a febre Q. Foram realizadas análises de regressão logística univariada e multivariada para avaliar se as variáveis especialidade médica, nível de assistência à saúde em que atua, faixa etária e sexo estavam associadas ao acerto de pelo menos uma questão específica sobre a febre Q.Resultados: dos 254 médicos incluídos, 236 (92,9%) desconheciam a febre Q. Apenas três (16,6%) dos 18 que acertaram pelo menos uma questão específica sobre a doença obtiveram um aproveitamento superior a 50%. As maiores taxas de acerto de pelo menos uma questão (p < 0,0001) ocorreram entre as especialidades médicas mais relacionadas aos sinais e sintomas clínicos ou ao diagnóstico diferencial da febre Q e entre os do sexo masculino. Destaca-se que 85,8% dos médicos consideram a febre Q uma doença negligenciada e subnotificada no Brasil. Além disso, todos os médicos responderam que não conheciam a abordagem de Saúde Única.Conclusões: o quase total desconhecimento dos profissionais médicos sobre a febre Q reforça a necessidade de maior divulgação desta zoonose com abordagem de Saúde Única nas Faculdades de Medicina, nos Programas de Residência e para os médicos em geral. Além disso, torna-se relevante a inclusão da febre Q na lista nacional de doenças de notificação compulsória, permitindo uma melhor compreensão da sua situação epidemiológica no Brasil. Por fim, devem ser realizadas ações eficazes de saúde pública para evitar o subdiagnóstico e o desenvolvimento de casos graves da doença

Panorama clínico, epidemiológico e espacial da ocorrência de Leishmaniose visceral no estado do Pará, Amazônia brasileira / Clinical, epidemiological and spatial overview of visceral Leishmaniasis in the state of Pará, brazilian amazonia / Panorama clínico, epidemiológico y espacial de la Leishmaniasis visceral en el estado de Pará, amazonia brasileña

Objetivo: Essa pesquisa teve como objetivo determinar o perfil clínico, epidemiológico e espacial daLeishmaniose Visceral, bem como, sua associação com o desmatamento nos municípios pertencentesao 12º centro regional de saúde no Sudeste do Estado do Pará, Brasil de 2016 a 2020. Método: Trata-se de um estudo analítico ecológico, realizado com dados provenientes de 15 municípios do 12º Centro Regional de Saúde, obtidos por meio do banco de dados do Data-SUS-TABNET, através do SINAN. Resultados: Para o período do estudo foram notificados 415 casos de LV nos municípios analisados, o que correspondeu a uma média anual de 83 casos. O ano com maior número de notifi- cações foi 2017, apresentando 34,7%, sendo o município de Redenção com o maior número de casos.Conclusões: Portanto, há necessidade de ampliação das medidas de controle e vigilância da LV, comfoco na notificação de casos, a fim de realizar a obtenção do panorama fidedigno da LV e elaborar estratégias mais assertivas para seu controle e mitigação.

Objective: This research aimed to determine the clinical, epidemiological and spatial profile of Vis- ceral Leishmaniasis, as well as its association with deforestation in the municipalities belonging to the 12th regional health center in the Southeast of Pará State, Brazil from 2016 to 2020. Method: Thisis an ecological analytical study, conducted with data from 15 municipalities of the 12th Regional Health Center, obtained through the Data-SUS-TABNET database, through SINAN. Results: For thestudy period, 415 cases of VL were reported in the analyzed municipalities, corresponding to an an-nual average of 83 cases. The year with the highest number of notifications was 2017, present- ing 34.7%, being the municipality of Redenção with the highest number of cases. Conclu- sion: Therefore,there is a need to expand VL control and surveillance measures, focusing on the notification of casesin order to obtain a reliable picture of VL and develop more assertive strategies for its control and mitigation.

Objetivo: Esta investigación tuvo como objetivo determinar el perfil clínico, epidemiológico y espacial de la Leishmaniasis Visceral, así como su asociación con la deforestación en municipios pertenecientes al 12º Centro Regional de Salud del Sudeste del Estado de Pará, Brasil, de 2016 a 2020. Método: Trata-se de um estudo analítico ecológico, realizado com dados provenientes de 15 municípios do 12º Centro Regional de Saúde, obtidos por meio do banco de dados do Data-SUS-TABNET, através do SINAN. Resultados: Durante el período de estudio, fueron notificados 415 casos de LV en los municipios analizados, correspondiendo a una media anual de 83 casos. El año con mayor número de notificaciones fue 2017, 34,7%, y el municipio de Redenção presentó el mayor número de casos. Conclusiones: Por lo tanto, es necesario ampliar las medidas de control y vigilancia de la LV, centrándose en la notificación de casos con el fin de obtener una imagen fiable de la LV y desarrollar estrategias más asertivas para su control y mitigación.

Seropositividad de Chlamydia psittaci en trabajadores expuestos a aves y revisión de la literatura: evidencia de circulación en Antioquia / Chlamydia psittaci seropositivity in workers exposed to birds and review of the literature: Evidence of circulation in Antioquia

Introducción. La psitacosis es una enfermedad zoonótica causada por Chlamydia psittaci. Esta bacteria es catalogada como un agente con potencial bioterrorista y ha causado múltiples brotes en trabajadores con exposición laboral a aves en diferentes lugares del mundo. En Colombia, no se hace seguimiento epidemiológico de la infección y existe una gran brecha en el conocimiento. Objetivos. Determinar la frecuencia de anticuerpos contra C. psittaci en trabajadores con exposición laboral a aves y sus factores asociados. Además, revisar la literatura en relación con los estudios sobre el tema realizados en Colombia. Materiales y métodos. Se llevó a cabo un estudio descriptivo, transversal, con intención analítica, en trabajadores en contacto con aves y se revisó la literatura científica relacionada en Colombia. Se detectaron anticuerpos IgM e IgG contra C. psittaci en suero por microinmunofluorescencia. La descripción de las características sociodemográficas y de exposición se hizo con frecuencias y medidas de resumen. Se exploraron factores asociados por análisis bivariados y multivariados. La revisión de la literatura científica y gris se hizo con búsqueda estructurada. Resultados. Se analizaron 54 trabajadores en contacto con aves y se encontró una prevalencia de anticuerpos del 31,5 %. El ejercer funciones de sacrificio y faenado de las aves sin ser médico veterinario fue un factor de riesgo para la presencia de anticuerpos. Solo se encontraron cuatro estudios previos sobre C. psittaci hechos en Colombia. Conclusiones. Este estudio constituye la primera evidencia de la circulación de C. psittaci en trabajadores en contacto con aves en Antioquia y el segundo reporte en el país. Estos hallazgos aportan desde la salud pública a la estrategia One Health.

Introduction. Psittacosis is a zoonotic disease caused by Chlamydia psittaci, a bacterium classified as an agent with bioterrorist potential. It has caused multiple outbreaks in exposed poultry workers around the world. Colombia has no epidemiological follow-up of the infection and a big knowledge gap. Objectives. To determine the antibodies' frequency against C. psittaci in workers with occupational exposure to birds and to review the literature on studies conducted in Colombia. Materials and methods. We conducted a cross-sectional descriptive study with analytical intent on workers in contact with birds and reviewed the related literature in Colombia. IgM and IgG serum antibodies against C. psittaci were detected by microimmunofluorescence. The sociodemographic and exposure characteristics were expressed as frequencies and summary measures. Associated factors were explored by bivariate and multivariate analysis. The scientific and gray literature review was done with a structured search. Results. We analyzed 54 workers in contact with birds. Antibody prevalence was 31.5%. Slaughtering and evisceration by non-veterinarians was a risk factor for antibody presence. There are only four previous studies on C. psittaci in Colombia. Conclusions. Here, we present the first evidence of C. psittaci circulation among workers exposed to birds in Antioquia and the second report in the country. These findings contribute to the "One Health" public health strategy.

Epidemiological Determinants of Depression among the Geriatric Population Residing in a Slum of Urban India: A Cross-sectional Study

Background: Mental health is important at every stage of life, from childhood and adolescence through adulthood. Worldwide interest in geriatric depression has increased but studies to assess the depression among the elderly population in urban slums has hardly been done. So this study would shed light on the risk factors of depression among geriatrics in urban slums. Aim & Objective: To study the epidemiological determinants such as age, marital status, education, financial dependency, economic status and chronic illness in relation to of depression among the geriatric population (60–80 years). Settings and Design: Community-based, cross-sectional study for 24 months with a samplesize of 209. Methods & Material: Urban slum area represented by one health post was selectedas the study area which caters to around 96,630 slum residents. Pre-tested semi-structuredinterviews were conducted after selecting households by systematic random sampling. Statistical analysis: Data was analyzed using SPSS version 21. A chi-square test was applied. Result: The present study shows overall prevalence of depression among the elderly above 60 years of age to be 48.6%. Depression is found to been significantly associated with an increase in age, living alone (72.7%), lower class economic status (100%), financial dependency (54%), history of chronic family illness (54.7%) and with no formal education (62.1%) among elderly dwelling in slums. Conclusions: There is a high prevalence of depression in the community and hence, a need to sensitize Primary level Health Care Services to institute screening tests considering the association of these determinants with depression and link them to specialized services for further management.

Seropositividad a Chlamydophila psittaci en cotorras argentinas (Myiopsitta monachus) invasoras de la ciudad de Santiago de Chile / Seropositivity to zoonotic Chlamydophila psittaci in invasive monk parakeets (Myiopsitta monachus) from Santiago, Chile

INTRODUCCIÓN: Chlamydophila psittaci es una bacteria zoonótica e intracelular estricta, que provoca la psitacosis humana y su principal hospedero son las aves psitácidas. La cotorra argentina es un ave psitácida nativa de Sudamérica y actualmente considerada una especie invasora en 19 países, incluyendo Chile. OBJETIVO: Determinar positividad contra C. psittaci en muestras de suero y torulados de cotorras argentinas de vida libre capturadas en la Región Metropolitana de Chile. MÉTODOS: Se analizaron 95 muestras de suero de pichones e individuos adultos de cotorras argentinas, a través de una prueba de ELISA indirecto utilizando un kit comercial. Posteriormente, se analizaron 40 tórulas nasotraqueales y cloacales de individuos adultos a través de una RPC en tiempo real específica para C. psittaci. RESULTADOS: Se detectaron anticuerpos en muestras de suero de cinco individuos adultos de cotorras argentinas (n = 68), mientras que ninguno de los pichones analizados fue seropositivo (n = 27). Todas las muestras analizadas a través de RPC en tiempo real fueron negativas. CONCLUSIÓN: Estos resultados demuestran por primera vez en Chile la exposición a C. psittaci en cotorras argentinas de vida libre, lo cual puede representar un riesgo importante para la transmisión de este patógeno a poblaciones humanas y animales.

BACKGROUND: Chlamydophila psittaci is a zoonotic obligate intracellular bacterium that causes the human psittacosis, and its main host are psittacine birds. The monk parakeet is a psittacine bird native to South America, currently being considered an invasive species in 19 countries, including Chile. AIM: To determine positivity to C. psittaci in serum samples and swabs from free-ranging monk parakeets captured in the Metropolitan Region of Chile. METHODS: Ninety-five serum samples from nestling chicks and adult monk parakeets were tested using an indirect ELISA test kit. Cloacal and nasotracheal swabs from 40 adult parakeets were further analyzed by C. psittaci-specific real-time PCR. RESULTS: We found antibody titers in sera of five adult monk parakeets (n = 68) while none of the nestlings were seropositive (n = 27). All samples tested with real-time PCR were negative. CONCLUSIONS: Our results demónstrate for the first time in Chile the exposure to C. psittaci in free-ranging monk parakeets which may represent a significant risk of pathogen transmission to human and animal populations.

Perfil Epidemiológico de Gatos com Esporotricose no Município de São Paulo (SP), 2011 a 2022 / Epidemiological Profile of Cats with Sporotrichosis in the City of São Paulo (SP), 2011 to 2022

Objetivo: este estudo se propôs a caracterizar o perfil epidemiológico da esporotricose felina no município de São Paulo (SP) no período de 2011 a 2022. Métodos: estudo descritivo dos casos de esporotricose felina registrados entre 2011 e 2022. Foram utilizados dados secundários, provenientes dos bancos de dados da vigilância do município. Resultados: o perfil predominante dos animais é composto por machos, 71,4% (n=2.644), com idade inferior a 4 anos 70,1% (n=1.137) e com livre acesso à rua 51,0% (n=1.348). Foram registrados 811 óbitos, entre os quais foi informado o sexo para 381, sendo estes 77,4% (n=295) machos e 22,6% (n=86) fêmeas. Conclusão: diante dos achados deste estudo, compreende-se que a situação epidemiológica da doença requer ações conjuntas das vigilâncias epidemiológica e ambiental para serem desenvolvidas medidas de prevenção e controle embasadas em uma perspectiva de saúde única.

Objective: this study aimed to characterize the epidemiological profile of feline sporotrichosis in the city of São Paulo (SP) from 2011 to 2022. Methods: this is a descriptive study of feline sporotrichosis cases reported between 2011 and 2022. The data were obtained from a secondary database of the São Paulo Health Surveillance System. Results: the predominant profile of the animals is composed of males 71.4% (n=2,644), under the age of four years old 70.1% (n=1,137), and with free access to streets 51.0% (n=1,348). Furthermore, of the 811 deaths registered, 381 had the gender identified, 77.4% (n=295) were males, and 22.6% (n=86) were females. Conclusion: given the findings of this study, it is understood that the epidemiological situation of the disease requires joint actions by epidemiological and environmental surveillance in order to develop prevention and control measures based on one health perspective.

Construction of an evaluation index system for the capability of comprehensive control of mountain - type zoonotic visceral leishmaniasis based on the One Health concept / 中国血吸虫病防治杂志

Objective To construct an evaluation index system for the capability of comprehensive control of mountain-type zoonotic visceral leishmaniasis based on the One Health concept, so as to provide insights into the control and elimination of mountain-type zoonotic visceral leishmaniasis using the One Health approach. Methods A preliminary evaluation index system was constructed based on literature review, panel discussions and field surveys. Thirty-three experts were selected from 7 provincial disease control and prevention centers in Beijing Municipality, Hebei Province, Shanxi Province, Henan Province, Sichuan Province, Shaanxi Province and Gansu Province where mountain-type zoonotic visceral leishmaniasis was endemic, and two rounds of expert consultations were conducted to screen the indicators. The positive coefficient, degree of concentration, degree of coordination, and authority of the experts were calculated, and the normalized weights of each index were calculated with the analytic hierarchy process. Results The response rates of questionnaires during two rounds of expert consultation were both 100.00% (33/33), and the authority coefficients of the experts were 0.86 and 0.88, respectively. The coefficients of coordination among experts on the rationality, importance, and operability of the indicators were 0.392, 0.437, 0.258, and 0.364, 0.335, 0.263, respectively (all P values < 0.05). Following screening, the final evaluation index system included 3 primary indicators, 17 secondary indicators, and 50 tertiary indicators. The normalized weights of primary indicators “external environment”, “internal support” and “comprehensive control” were 16.98%, 38.73% and 44.29%, respectively. Among the secondary indicators of the primary indicator “external environment”, the highest weight was seen for natural environment (66.67%), and among the secondary indicators of the primary indicator “internal support”, the lowest weight was seen for the scientific research for visceral leishmaniasis control (8.26%), while other indicators had weights of 12.42% to 13.38%. Among the secondary indicators of the primary indicator “comprehensive control”, the weight was 16.67% for each indicator. Conclusions An evaluation index system has been constructed for the capability of comprehensive control of mountain-type zoonotic visceral leishmaniasis based on the One Health concept. In addition to assessment of the effect of conventional mountain-type zoonotic visceral leishmaniasis control measures, this index system integrates the importance of top-level design, organizational management, and implementation of control measures, and includes indicators related to multi-sectoral cooperation.

Current prevalence and control strategies of visceral leishmaniasis in Sichuan Province: A review / 中国血吸虫病防治杂志

Visceral leishmaniasis is a parasitic disease transmitted by Phlebotomus chinensis that poses a great threat to human health. Historically, visceral leishmaniasis was predominantly prevalent in northwestern regions of Sichuan Province. Following the founding of the People’s Republic of China, large-scale integrated interventions had been implemented in visceral leishmaniasis-endemic areas of Sichuan Province, including identification and treatment of visceral leishmaniasis patients, elimination of infected dogs, Ph. chinensis control and health education. This review summarizes the prevalence of visceral leishmaniasis, discusses the control strategy of visceral leishmaniasis and analyzes the challenges of elimination of visceral leishmaniasis based on the One Health concept in Sichuan Province, so as to provide insights into elimination of visceral leishmaniasis in the province.

Epidemiologic and antibiotic resistance profile and detection of meca gene in Staphylococcus spp. isolates from dog-owning veterinary students / Perfil epidemiológico e de resistência a antibióticos e detecção do gene meca em Staphylococcus spp. isolados de estudantes veterinários proprietários de cães / Perfil de resistencia epidemiológica y antibiótica y detección de género meca en Staphylococcus spp. estudiantes veterinarios aislados de perros

The maintenance of pets as reservoirs of multiresistant bacteria and the transmission of microorganisms such as Staphylococcus spp. between animals and humans can affect the effectiveness of antimicrobials in human medicine. The aim of this study was to detect risk factors, evaluate the phenotypic profile of antimicrobial resistance and detect the mecA gene in Staphylococcus spp. isolated from the nasal cavity of students of veterinary medicine who own dogs. This is a field survey where 35 nasal swab samples were collected to isolate Staphylococcus spp. The antimicrobial resistance of the isolates and the classification according to the multidrug resistance profile (MDR) were determined. The presence of the mecA gene was investigated in isolates with resistance to oxacillin. In addition, the research subjects answered a questionnaire about behavior towards the dog and hygiene habits to identify risk variables for developing antimicrobial resistance. The antimicrobials tested were ampicillin, penicillin, oxacillin, cephalothin, clindamycin, gentamicin, erythromycin, enrofloxacin, and tetracycline. 92.9% of coagulase-positive staphylococci (CoPS) and 45% of coagulase-negative staphylococci (CoNS) were resistant to the beta-lactam class, and 28.6% of CoPS and 45% of CoNS showed MDR profile. Three isolates were classified as resistant to oxacillin, and the mecA gene was detected in 100% of these isolates. About half of the individuals used antimicrobials in the last 12 months (52.9%), and 75% used amoxicillin, which could explain the high antimicrobial resistance profile. Dog owners harbor Staphylococcus spp. with high resistance to beta-lactam antimicrobials and a multi-resistance profile, representing a unique One Health problem.

A manutenção de pets como reservatórios de bactérias multirresistentes e a transmissão de microrganismos como Staphylococcus spp. entre animais e humanos podem afetar a eficácia de antimicrobianos na medicina humana. O objetivo deste estudo foi detectar fatores de risco, avaliar o perfil fenotípico de resistência antimicrobiana e detectar o gene mecA em Staphylococcus spp. isolados da cavidade nasal de estudantes de medicina veterinária proprietários de cães. Trata-se de pesquisa de campo onde 35 amostras de swab nasal foram coletadas para isolar Staphylococcus spp. A resistência antimicrobiana e a classificação segundo o perfil de multirresistência (MDR) dos isolados foram determinadas. A presença do gene mecA foi investigada em isolados resistentes à oxacilina. Os estudantes responderam a um questionário sobre comportamento em relação ao cão e hábitos de higiene para identificar variáveis de risco para o desenvolvimento de resistência antimicrobiana. Foram testados os antimicrobianos ampicilina, penicilina, oxacilina, cefalotina, clindamicina, gentamicina, eritromicina, enrofloxacina e tetraciclina. 92,9% dos estafilococos coagulase-positivos (CoPS) e 45% dos estafilococos coagulase-negativos (CoNS) foram resistentes à classe dos beta- lactâmicos e 28,6% CoPS e 45% CoNS apresentaram perfil MDR. Três isolados foram classificados como resistentes à oxacilina e o gene mecA foi detectado em 100% destes isolados. Mais da metade dos indivíduos fez uso de antimicrobiano nos últimos 12 meses (52,9%), 75% fizeram uso de amoxicilina, o que poderia explicar o alto perfil de resistência antimicrobiana. Os donos de cães abrigam Staphylococcus spp. com alta resistência aos antimicrobianos beta-lactâmicos e apresentam MDR, o que representa um problema de saúde única.

El mantenimiento de las mascotas como reservorios de bacterias multiresistentes y la transmisión de microorganismos como Staphylococcus spp. entre animales y seres humanos pueden afectar a la eficacia de los antimicrobianos en la medicina humana. El objetivo de este estudio fue detectar factores de riesgo, evaluar el perfil fenotípico de la resistencia antimicrobiana y detectar el gen meccaA en Staphylococcus spp. aislado de la cavidad nasal de estudiantes veterinarios dueños de perros. Se trata de una investigación de campo en la que se recogieron 35 muestras de hisopo nasal para aislar Staphylococcus spp. Se determinó la resistencia antimicrobiana y la clasificación de los aislados por perfil de multiresistencia (MDR). La presencia del gen de la mecaA se ha investigado en aislados resistentes a oxacilina. Los estudiantes respondieron a un cuestionario sobre comportamiento de perros y hábitos de higiene para identificar variables de riesgo para el desarrollo de resistencia antimicrobiana. Se han estudiado antimicrobianos como ampicilina, penicilina, oxacilina, cefalotina, clindamicina, gentamicina, eritromicina, enrofloxacina y tetraciclina. El 92,9% de los estafilococos coagulasa-positivos (CoPS) y el 45% de los estafilococos coagulasa- negativos (CoNS) fueron resistentes a la clase beta-lactam y el 28,6% de los CoPS y el 45% de los CoNS tenían un perfil de MDR. Se clasificaron tres aislados como resistentes a la oxacilina y se detectó el gen de la mecaA en el 100% de estos aislamientos. Más de la mitad de los individuos utilizaron antimicrobianos en los últimos 12 meses (52,9%), el 75% utilizó amoxicilina, lo que podría explicar el alto perfil de resistencia antimicrobiana. Los dueños de perros albergan Staphylococcus spp. con alta resistencia a los antimicrobianos beta-lactámicos y tienen MDR, lo que representa un único problema de salud.