RÉSUMÉ
Drug resistance is one of the principal obstacles blocking worldwide malaria control. In Colombia, malaria remains a major public health concern and drug-resistant parasites have been reported. In vitro drug susceptibility assays are a useful tool for monitoring the emergence and spread of drug-resistant Plasmodium falciparum. The present study was conducted as a proof of concept for an antimalarial drug resistance surveillance network based on in vitro susceptibility testing in Colombia. Sentinel laboratories were set up in three malaria endemic areas. The enzyme linked immunosorbent assay-histidine rich protein 2 and schizont maturation methods were used to assess the susceptibility of fresh P. falciparum isolates to six antimalarial drugs. This study demonstrates that an antimalarial drug resistance surveillance network based on in vitro methods is feasible in the field with the participation of a research institute, local health institutions and universities. It could also serve as a model for a regional surveillance network. Preliminary susceptibility results showed widespread chloroquine resistance, which was consistent with previous reports for the Pacific region. However, high susceptibility to dihydroartemisinin and lumefantrine compounds, currently used for treatment in the country, was also reported. The implementation process identified critical points and opportunities for the improvement of network sustainability strategies.
Sujet(s)
Humains , Antipaludiques , Résistance aux substances , Plasmodium falciparum , Colombie , Paludisme à Plasmodium falciparum , Tests de sensibilité parasitaire/méthodesRÉSUMÉ
Durante el desarrollo de un estudio epidemiológico para evaluar el riesgo de infección por Leishmania, se realizo una evaluación entomológica y el inventario de la fauna flebotomínea utilizando trampa Shannon y capturador bucal sobre cebo humano, en la comunidad indígena Tikuna residentes a orillas del río Pupuña, afluente del río Putumayo, departamento del Amazonas. En estemismo lugar se capturaron 560 ejemplares, de flebotomíneos pertenecientes a 20 especies, entre lascuales se identificaron por primera vez para Colombia a Lutzomyia reducta Feliciangeli, Ramirez- Pérez & Ramirez y Lutzomyia carrerai carrerai (Barreto) y Lutzomyia nocticola Young como nuevosregistros para la zona. Se presenta un inventario actualizado de las especies de flebótomos del departamento del Amazonas Colombia.
During the execution of an epidemiological study to assess the risk of Leishmania infection, an entomological evaluation and an inventory of phlebotomine fauna was made. The captures of phlebotomines were carried out with Shannon type traps and aspirators which collected the sand flies on human bait, in the Tikuna native community, on the banks of the Pupuña River an affluent of the Putumayo River among the department of Amazon. Five hundred and sixty phlebotomine specimens belonging to 20 species were captured in this place and the presence of Lutzomyia reducta Feliciangeli, Ramirez-Pérez & Ramirez recorded in Colombia for the first time and Lutzomyia carrerai carrerai(Barreto) and Lutzomyia nocticola Young were identified as new records for the zone. An updated inventory of phlebotomine species in Amazon department of Colombia is included.
RÉSUMÉ
Las intoxicaciones alimentarias son ocasionadas por consumo de alimentos en malas condiciones de preparación o de conservación o que han sufrido contaminación con agenes químicos, físicos o biológicos. La reciente incorporación de la vigilancia de este evento en el sistema de vigilancia intensificado de la Secretaría de Salud del Amazonas, ha permitido identificar la presencia de brotes de intoxicación alimentaria del departamento. En abril de 1997, se informó a la Oficina de Epidemiología de la Secretaría de Salud del Amazonas, la llegada de 30 pacientes al Hospital Empresa Social del Estado San Rafael de Leticia, con un cuadro clínico de dolor abdominal, vómito y cefalea. Las pacientes eran estudiantes adolescentes del internado indígena femenino de Nazareth que presentaban como antecedente común la ingestión de pescado recalentado el día anterior a su consulta. En la investigación del presente brote de intoxicación alimentaria se comprobó por laboratorio que el alimento implicado era la carne de caiman negro, Melanosuchus niger, contaminada con Bacillus cereus. Esta carne iba a ser vendida como pescado seco en Bogotá, por la gran demanda que tiene este alimento en la época de Semana Santa