Latin American and the Caribbean Code Against Cancer 1st edition: Infections and cancer.

About 13% of all cancers around the world are associated with infectious agents, particularly in low-resource settings. The main infectious agents associated with cancer are Helicobacter pylori (H. pylori), that causes gastric cancer, human papillomavirus (HPV) that causes cervical, vulvar, vaginal, penile, anal, and oropharyngeal cancer, hepatitis B and C viruses that cause liver cancer, and human immunodeficiency virus (HIV), associated with cancers of the cervix, Kaposi sarcoma (KS) and non-Hodgkin´s lymphoma. In Latin America and the Caribbean (LAC), about 150,000 cancer cases are caused annually by infections. The LAC Cancer Code Against Cancer consists of a set of 17 evidence-based and individual-level cancer prevention recommendations targeted to the general population, suited to the epidemiological, socioeconomic, and cultural conditions of the region, and tailored to the availability and accessibility of health-care systems. The recommendations with respect to infection-driven malignancies include testing and treating for H. pylori in the context of specific public health programs, vaccination against HPV and Hepatitis B Virus (HBV) and detection and treatment of chronic infections with HBV, Hepatitis C virus (HCV) and HIV, in addition to the promotion of safe sex and use of condoms to prevent sexually transmitted infections (STI). Countries, policy makers, health care systems and individuals should consider the adoption of these recommendations to help reduce the incidence and mortality of infection-related cancers in LAC, to improve quality of life of individuals and reduce the costs of cancer care in the region.

Bats in ecosystems and their Wide spectrum of viral infectious potential threats: SARS-CoV-2 and other emerging viruses.

Bats have populated earth for approximately 52 million years, serving as natural reservoirs for a variety of viruses through the course of evolution. Transmission of highly pathogenic viruses from bats has been suspected or linked to a spectrum of potential emerging infectious diseases in humans and animals worldwide. Examples of such viruses include Marburg, Ebolavirus, Nipah, Hendra, Influenza A, Dengue, Equine Encephalitis viruses, Lyssaviruses, Madariaga and Coronaviruses, involving the now pandemic Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Herein, we provide a narrative review focused in selected emerging viral infectious diseases that have been reported from bats.

MERS-CoV and SARS-CoV infections in animals: a systematic review and meta-analysis of prevalence studies.

INTRODUCTION: Coronaviruses are zoonotic viruses that include human epidemic pathogens such as the Middle East Respiratory Syndrome virus (MERS-CoV), and the Severe Acute Respiratory Syndrome virus (SARS-CoV), among others (e.g., COVID-19, the recently emerging coronavirus disease). The role of animals as potential reservoirs for such pathogens remains an unanswered question. No systematic reviews have been published on this topic to date. METHODS: We performed a systematic literature review with meta-analysis, using three databases to assess MERS-CoV and SARS-CoV infection in animals and its diagnosis by serological and molecular tests. We performed a random-effects model meta-analysis to calculate the pooled prevalence and 95% confidence interval (95%CI). RESULTS: 6,493articles were retrieved (1960-2019). After screening by abstract/title, 50 articles were selected for full-text assessment. Of them, 42 were finally included for qualitative and quantitative analyses. From a total of 34 studies (n=20,896 animals), the pool prevalence by RT-PCR for MERS-CoV was 7.2% (95%CI 5.6-8.7%), with 97.3% occurring in camels, in which pool prevalence was 10.3% (95%CI 8.3-12.3). Qatar was the country with the highest MERS-CoV RT-PCR pool prevalence: 32.6% (95%CI 4.8-60.4%). From 5 studies and 2,618 animals, for SARS-CoV, the RT-PCR pool prevalence was 2.3% (95%CI 1.3-3.3). Of those, 38.35% were reported on bats, in which the pool prevalence was 14.1% (95%CI0.0-44.6%). DISCUSSION: A considerable proportion of infected animals tested positive, particularly by nucleic acid amplification tests (NAAT). This essential condition highlights the relevance of individual animals as reservoirs of MERS-CoV and SARS-CoV. In this meta-analysis, camels and bats were found to be positive by RT-PCR in over 10% of the cases for both; thus, suggesting their relevance in the maintenance of wild zoonotic transmission.

Genomic Epidemiology and its importance in the study of the COVID-19 pandemic.

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Clinical, laboratory and imaging features of COVID-19: A systematic review and meta-analysis.

INTRODUCTION: An epidemic of Coronavirus Disease 2019 (COVID-19) began in December 2019 in China leading to a Public Health Emergency of International Concern (PHEIC). Clinical, laboratory, and imaging features have been partially characterized in some observational studies. No systematic reviews on COVID-19 have been published to date. METHODS: We performed a systematic literature review with meta-analysis, using three databases to assess clinical, laboratory, imaging features, and outcomes of COVID-19 confirmed cases. Observational studies and also case reports, were included, and analyzed separately. We performed a random-effects model meta-analysis to calculate pooled prevalences and 95% confidence intervals (95%CI). RESULTS: 660 articles were retrieved for the time frame (1/1/2020-2/23/2020). After screening, 27 articles were selected for full-text assessment, 19 being finally included for qualitative and quantitative analyses. Additionally, 39 case report articles were included and analyzed separately. For 656 patients, fever (88.7%, 95%CI 84.5-92.9%), cough (57.6%, 95%CI 40.8-74.4%) and dyspnea (45.6%, 95%CI 10.9-80.4%) were the most prevalent manifestations. Among the patients, 20.3% (95%CI 10.0-30.6%) required intensive care unit (ICU), 32.8% presented with acute respiratory distress syndrome (ARDS) (95%CI 13.7-51.8), 6.2% (95%CI 3.1-9.3) with shock. Some 13.9% (95%CI 6.2-21.5%) of hospitalized patients had fatal outcomes (case fatality rate, CFR). CONCLUSION: COVID-19 brings a huge burden to healthcare facilities, especially in patients with comorbidities. ICU was required for approximately 20% of polymorbid, COVID-19 infected patients and hospitalization was associated with a CFR of >13%. As this virus spreads globally, countries need to urgently prepare human resources, infrastructure and facilities to treat severe COVID-19.

History is repeating itself: Probable zoonotic spillover as the cause of the 2019 novel Coronavirus Epidemic

Pathogen transmission from a vertebrate animal to a human, also known as zoonotic spillover, represents a global public health burden, which while associated with multiple outbreaks, still remains a poorly understood phenomenon. Coronaviruses, like influenza viruses, circulate in nature in various animal species. Alpha-coronaviruses and beta-coronaviruses can infect mammals and gamma-coronaviruses and delta-coronaviruses tend to infect birds, but some of them can also be transmitted to mammals. Although still preliminary, current data suggest that bats are the most probable initial source of the current 2019 novel CoV (2019nCoV) outbreak, that begun on December 2019 in Wuhan, China, apparently spreading from a "wet market" to multiple cities and provinces in China. This epidemic of 2019nCoV, already reaching more than 6,000 cases to-day (end of January 2020) (>90% in China), will not be the last one linked to zoonotic spillover events.

Evaluación de la calidad metodológica de las guías de práctica clínica relacionadas a enfermedad hipertensiva vigentes en Brasil, Chile, Colombia, Peru y del Reino Unido / Assessment of methodological quality of clinical practice guidelines related to existing hypertensive disease in Brazil, Chile, Colombia, Peru and the United Kingdom

Se trata de un estudio cuyo interés es conocer la calidad metodológica de las Guías de Práctica Clínica (GPC) que se encuentran vigentes, relacionadas a enfermedad hipertensiva de Países como Brasil, Colombia, Chile , Perú y de La agencia del Reino Unido National Institute for Clinical Excellence (NICE).La importancia de este estudio se basó en la amplia cantidad de Guías publicadas en Latinoamérica en la actualidad, por lo que era relevante conocer si esas guías que supuestamente nos guían son de adecuada calidad metodológica. Así mismo resultó de interés compararlas con aquellas guías que son elaboradas por una agencia europea como NICE que tienen una amplia experiencia en la elaboración de las mismas.Dentro de los objetivos del estudio principalmente fue conocer si son o no recomendables el uso de dichas guías de práctica clínica vigentes y de patologías similares en países sudamericanos como los ya precisados así como de una agencia europea de Inglaterra, y luego hacer un análisis comparativo entre ellos. En cuanto a la metodología, se trata de un estudio transversal en el cual se analizaron las guías de práctica clínica según los criterios de elegibilidad usando un instrumento de evaluación de la calidad metodológica: AGREE II (Appraisal of Guidelines for Research and Evaluation). Se encontraron 9 guías, 4 guías peruanas, una colombiana, una chilena, una brasileña y 2 del NICE a ser evaluadas. Solo una Guía de Práctica Clínica de Colombia fue Recomendada a nivel Latinoamericano junto con las GPC del NICE. Las Guías de Práctica Clínica de Brasil y Chile fueron recomendadas con modificaciones y ninguna GPC de Perú fue recomendada. Solo la GPC de Colombia sobrepasó el 60 por ciento de puntaje en lo que es Rigor en la elaboración y Aplicabilidad...

This research was developed to recognize the methodological quality of Clinical Practice Guidelines (CPGs) that are currently in force, related to hypertensive disease in countries such as Brazil, Colombia, Chile, Peru and the United Kingdom agency National Institute for Clinical Excellence (NICE).The importance of this study was based on the large amount of guidelines published in Latin America nowadays; therefore it was necessary to know if those guidelines, that are supposed to guide us, have a suitable methodological quality. Moreover, it was interesting to compare them with those guidelines developed by a European agency like NICE, which has wide experience in preparing thereof.Among the objectives of the study, the main one was to know whether or not it is recommended the use of these clinical practice guidelines in force and similar diseases in South American countries such as those already identified, as well as the European agency from England, and then make a comparative analysis between them.In terms of methodology, it is a cross-sectional study in which clinical practice guidelines were analyzed according to the eligibility criteria using an instrument for assessing the methodological quality: AGREE II (Appraisal of Guidelines for Research and Evaluation).A total of 9 guidelines; four guidelines from Peru, one from Colombia, one from Chile, one from Brazil and two from NICE, were evaluated. Only one Colombian CPG was recommended in Latin American with the NICE Clinical Practice Guidelines. The Clinical Practice Guidelines from Brazil and Chile were recommended with modifications and none Peruvian GPC was recommended. Only the Colombian GPG exceeded 60 percent score related to rigor in the development and applicability. All domains of the NICE Clinical Practice Guidelines exceeded 60 percent of score. It is advisable to develop a methodological guide for developing clinical practice guidelines at national and Latin American level...