ABSTRACT
We herein described a case of acute infection by Coxiella burnetii (acute Q fever) that started with a short incubation period and showed prominent dermatological manifestations and unusual serological behavior. The infection was confirmed by molecular detection through real-time polymerase chain reaction using genomic DNA collected from peripheral blood.
ABSTRACT
Coxiella burnetii causes Q fever in humans and coxiellosis in animals. In humans, it causes acute febrile illnesses like influenza, pneumonia, hepatitis, and chronic illnesses such as endocarditis, vascular infection, and post-infectious fatigue syndrome. It is widely distributed worldwide, and its main reservoirs are sheep, goats, and cattle. This study aimed to determine the frequency of C. burnetii infection using molecular detection and to identify the associated factors in livestock farmers and cattle from the Magdalena Medio region of Antioquia, Colombia. Using real-time polymerase chain reaction (PCR), molecular detection was performed for the IS1111 insertion sequence of C. burnetii using genomic DNA collected from the peripheral blood of 143 livestock farmers and 192 cattle from 24 farms located in Puerto Berrío, Puerto Nare, and Puerto Triunfo. To confirm the results, bidirectional amplicon sequencing of 16S rRNA was performed in four of the positive samples. Additionally, factors associated with C. burnetii were identified using a Poisson regression with cluster effect adjustment. Real-time PCR showed positive results in 25.9% and 19.5% of livestock farmer samples and cattle samples, respectively. For livestock farmers, factors associated with C. burnetii were the area where the farm was located [Puerto Berrío, adjusted prevalence ratio (aPR): 2.13, 95% confidence interval (CI): 1.10-4.11], presence of hens (aPR: 1.47, 95% CI: 1.21-1.79), horses (aPR: 1.61, 95% CI: 1.54-1.67), and ticks (aPR: 2.36, 95% CI: 1.03-5.42) in the residence, and consumption of raw milk (aPR: 1.47, 95% CI: 1.26-1.72). For cattle, the factors associated with Coxiella genus were municipality (Puerto Nare; aPR: 0.39, 95% CI: 0.37-0.41) and time of residence on the farm (≥49 months; aPR: 2.28, 95% CI: 1.03-5.20). By analyzing sequences of the 16S rRNA molecular marker, C. burnetii infection was confirmed in livestock farmers. However, in cattle, only the presence of Coxiella-type bacteria was identified. Further research is necessary to determine the potential role that these types of bacteria have as etiological agents for disease in livestock farmers and cattle from the study area.
Subject(s)
Coxiella burnetii/genetics , Coxiella burnetii/isolation & purification , Q Fever/diagnosis , Adult , Animals , Antibodies, Bacterial/blood , Cattle , Cattle Diseases/diagnosis , Cattle Diseases/microbiology , Colombia/epidemiology , Coxiella burnetii/pathogenicity , DNA, Bacterial/genetics , Farmers , Female , Humans , Livestock/genetics , Male , Middle Aged , Prevalence , Q Fever/blood , Q Fever/epidemiology , RNA, Ribosomal, 16S/genetics , Real-Time Polymerase Chain Reaction/methods , Zoonoses/diagnosis , Zoonoses/geneticsABSTRACT
Introducción: El estigma en las personas con VIH/SIDA por parte de los estudiantes y profesionales de la salud obstaculiza el diagnóstico precoz, el tratamiento oportuno e incrementa el riesgo de expansión de la pandemia. Objetivo: Describir el estigma social en la atención de personas con VIH/SIDA según condiciones socioeconómicas, demográficas y académicas. Materiales y Métodos: Estudio transversal en 1253 individuos. Se aplicó una escala de estigma social validada con los criterios de apariencia, contenido, constructo, consistencia interna, fiabilidad y utilidad. Los análisis incluyeron correlaciones de Pearson, α de Cronbach, análisis factorial, frecuencias, medidas de resumen, U de Mann Whitney, Anova y regresión lineal multivariante, en SPSS 21.0®. Resultados: Las mayores frecuencias de estigma correspondieron al trato diferencial que brindarían a personas con VIH/SIDA (57,2 %), el considerar necesario crear hospitales exclusivos para este grupo (52,5%), el que la atención de estos pacientes incrementa el riesgo de infección (49,7%) y la necesidad de aislar a los seropositivos (43,3%). Los principales predictores del estigma social fueron el programa académico, la realización de la prueba presuntiva y el semestre de estudio. Conclusión: El estigma social fue mayor en los primeros ciclos de formación, quienes no se han realizado la tamización e individuos de medicina; se corrobora la necesidad de mejorar las estrategias de comunicación, información y educación en salud para combatir el estigma.
Introduction: The social stigma in people with HIV/AIDS by students and health professionals hinders early diagnosis, timely treatment and increases the spread risk of the pandemic. Objective: To describe the social stigma in the care of people with HIV/AIDS by socioeconomic, demographic and academic conditions. Materials and methods: A cross-sectional study in 1,253 individuals. The scale of social stigma was validated with criteria of appearance, content, construct, internal consistency, reliability and usefulness. The analyzes included Pearson correlations, α Cronbach, factor analysis, frequencies, summary measures, Mann Whitney U, Anova and multivariate linear regression in SPSS 21.0 ®. Results: The highest frequencies for stigma were related to the differential treatment delivered to people with HIV/AIDS (57.2 %), accounting necessary to create exclusive hospitals for this group (52.5 %), the attention of these patients increases the risk of infection (49.7 %), and the need to isolate HIV-positive (43.3 %). The main predictors of social stigma were the academic program, performing the presumptive test and semester of study. Conclusion: Social stigma attitudes were higher in individuals of the first cycle of formation, without performing the test screening, and medical students; this corroborates the need to improve communication, information and health education strategies to combat stigma.
Introdução: o estigma das pessoas com VIH/SIDA por parte dos estudantes e profissionais da saúde obstaculiza o diagnóstico precoce, o tratamento oportuno e incrementa o risco de expansão da pandemia. Objetivo: descrever o estigma social na atenção de pessoas com VIH/SIDA segundo condições socioeconômicas, demográficas e académicas. Materiais e métodos: estudo transversal em 1.253 indivíduos.Aplicou-se uma escala de estigma social validada com os critérios de aparência, conteúdo, constructo, consistência interna, fiabilidade e utilidade.As análises incluíram correlações de Pearson α de Cronbach, análise fatorial, frequências, medidas de resumo, U de Mann Whitney, Anova e regressão linear multivariada, em SPSS 21.0®. Resultados: as maiores frequências de estigma corresponderam ao trato diferencial que brindariam a pessoas com VIH/SIDA (57,2%), o considerar necessário criar hospitais exclusivos para este grupo (52,5%), o que a atenção destes pacientes incrementa o risco de infeção (49,7%) e a necessidade de isolar aos soropositivos (43,3%). Os principais preditores do estigma social foram o programa académico, a realização do teste presuntivo e o semestre de estudo. Conclusão: o estigma social foi maior nos primeiros ciclos de formação, onde não se têm realizado a tamisação de indivíduos de medicina; corrobora-se a necessidade de melhorar as estratégias de comunicação, informação e educação em saúde para combater o estigma.
