Cytokine expression and mortality risk among COVID-19 hospitalized patients over 60 years of age in a referral hospital in Cartagena, Colombia.

Background: Cytokine dysregulation in COVID-19 patients aged over 60 has been associated to adverse outcomes. While serum levels have been studied, cellular expression, particularly in Afro-Colombians, remains understudied. This research aims to describe cytokine expression in peripheral blood leukocytes and its association with adverse outcomes in COVID-19 patients aged over 60 at Cartagena's referral hospital. Methods: A cohort study was conducted, encompassing severe and critical cases of COVID-19 between November 2021 and February 2022. At baseline, the cellular expression level of cytokines IL-2, IL-4, IL-6, IL-10, TNF-α and IFN-γ was assessed using flow cytometry. Additionally, various biochemical, hematological, and coagulation markers were evaluated. The main outcome was time to death. Results: Among the 50 enrolled participants, the median age was 76.5 years, 60% were male, 60% were admitted to the ICU, and 42% died. Lactate dehydrogenase and hemoglobin were the only markers that differed between fatal and surviving cases. Regarding cytokines, the level of IL-6 expression was associated with an increased risk of death. Specifically, a one percent increase in the expression was associated with a 7.3% increase in the risk of death. Stratifying the analysis by death and ICU admission, the median expression level remained high in fatal cases who were admitted to the ICU. Conclusions: Our findings revealed a significant association between high cellular expression levels of IL-6 and an increased risk of mortality. These results provide valuable scientific insights that could inform the prioritization of case management, providing especially advantageous for the vulnerable Afro-Colombian group.

Clinical, paraclinical, and genetic profile of patients with cystic fibrosis from Colombian Caribbean.

Background: Cystic fibrosis (CF) is a serious autosomal recessive disorder. Early diagnosis, comorbidity prevention, and control are cornerstones for a quality life and for improving life expectancy. In Colombian Caribbean, where there is a genetically admixed population, CF is an orphan disease affecting children and adults, and it remains a challenging issue to be addressed carefully. This work describes the genetic, clinical, and paraclinical profiles of CF patients from Cartagena de Indias, Colombia. Methods: Thirty-six patients were included in the study. The subjects were identified and evaluated through the Regional Program for CF patients. CFTR gene mutations, anthropometric parameters, microbiological infections, and pulmonary function were analyzed. Data on demographic parameters, pharmacological treatments, and comorbidities were reported. Frequency and percentages were established for the categorical variables and mean or median for the quantitative variables. In addition, comparisons were made by sex. Results: The average age of the patients was 11.9 ± 5.3 years and the median age at diagnosis was 14 months. 55.5% were women and 44.5% were men. The mean values for weight, height, and body mass index were 35 ± 17.6 kg, 139.9 ± 28 cm, and 16.5 ± 2.9 kg/m2, respectively. The clinical manifestations that occurred more frequently were steatorrhea (65.4%) and recurrent pneumonia (46.2%). Chronic airway infection with Pseudomonas aeruginosa was identified in 71.4% of the cases and the p.F508del mutation was found in 47.2% of the subjects. Conclusion: The current profile of CF patients from the Colombian Caribbean showed some concerning features, such as nutritional status; however, progress in early diagnosis and clinical follow-up could contribute to improve the general conditions of patients. It is necessary to continue efforts to increase the life expectancy and quality of life of the patients.

Climatic factors and the incidence of dengue in Cartagena, Colombian Caribbean Region.

BACKGROUND: The influence of climate on the epidemiology of dengue has scarcely been studied in Cartagena. METHODS: The relationship between dengue cases and climatic and macroclimatic factors was explored using an ecological design and bivariate and time-series analyses during lag and non-lag months. Data from 2008-2017 was obtained from the national surveillance system and meteorological stations. RESULTS: Cases correlated only with climatic variables during lag and non-lag months. Decreases in precipitation and humidity and increases in temperature were correlated with an increase in cases. CONCLUSIONS: Our findings provide useful information for establishing and strengthening dengue prevention and control strategies.

Epidemiology of COVID-19 in Individuals under 18 Years Old in Cartagena, Colombia: An Ecological Study of the First 14 Months of the Pandemic.

The epidemiology of the coronavirus disease (COVID-19) has been scarcely described in individuals under 18 years old, particularly during the first months of the pandemic. The study aimed to describe the COVID-19 epidemiology in the Colombian department of Bolívar from March 2020 to April 2021 among individuals under 18 years. Furthermore, we explored whether the use of data generated by a Bolívar reference laboratory captures the departmental epidemiology. Two information sources were used; the national COVID-19 surveillance system and the Bolívar COVID-19 reference laboratory. In using a population-based ecological approach and information from confirmed symptomatic cases, epidemic curves and heat maps were constructed to assess the COVID-19 dynamics and patterns by sex, age, and residence (Cartagena vs. 45 other municipalities). The COVID-19 incidence was comparable between males and females but varied by age group, being higher in children aged 10 years and older. Cartagena had a significantly higher number of cases and experienced early epidemic peaks. Our analyses suggest that information generated by the reference laboratory does not capture the COVID-19 departmental epidemiology, despite conducting population-based surveillance across Bolívar. The study provides a retrospective characterization of the COVID-19 epidemiology in an understudied population and information that may be useful for future evidence-based responses.

Demographic, clinical, and radiological characteristics of cleidocranial dysplasia: A systematic review of cases reported in south America.

Introduction: Cleidocranial dysplasia (CCD) is a rare disease characterized by craniofacial, skeletal, and oral anomalies. The disease prevalence is estimated to be 1 per million inhabitants; thus, only a few studies have described large cohorts of CCD patients. This study reviewed the clinical-radiological and demographic characteristics of patients with CCD in South America. Methods: We conducted a systematic review of all cases of CCD reported in South America following the PRISMA guidelines. Demographic information (sex, age at diagnosis, origin, reason for consultation, and family history) was also recorded. CCD signs were divided into "craniofacial" and "skeletal" categories. Results: A total of 72 cases were included. We found that oral anomalies were the most common reason for consultation leading to a diagnosis in patients, with a median age at diagnosis of 14 years. Fifty percent of the patients were women. Open fontanels or cranial sutures, the presence of at least one of the typical CCD facies (frontal bossing, brachycephaly, hypertelorism, or depression of the nasal bridge), and supernumerary teeth were reported in 92%, 85%, and 88% of cases, respectively. Clavicular dysplasia was present in 98.6% of cases, and other skeletal abnormalities such as scoliosis, pubic symphysis diastasis, and flat feet were found; short stature was present in 71% of cases, and one case presented cognitive deficits. Conclusion: Although the phenotypic spectrum of CCD is variable, clavicular dysplasia, open fontanels or cranial sutures, dental anomalies, and at least one of the typical CCD facies are present in at least 80% of cases.

Prevalence of Mosquito Populations in the Caribbean Region of Colombia with Important Public Health Implications.

Mosquito studies are important for understanding their role in the transmission of pathogens including arboviruses, parasites, and protozoa. This study characterized the prevalence of Culicidae fauna in rural and peri-urban areas with human populations in the Colombian Caribbean region to establish the risk of transmission of mosquito-borne pathogens. From 2016 to 2017, adult mosquitos were collected in Turbaco (Bolívar), Sabanalarga (Atlántico) and Pueblo Bello (Cesar). The collections in rural areas were in the forest fragments using CDC, Shannon, and human bait traps. In peri-urban areas, Prokopack aspirator collections were used inside households. Entomological and ecological indicators were also calculated. A total of 11,566 mosquito specimens, from 13 genera and 63 species, were collected. The forests fragments of Sabanalarga and Turbaco had the highest species abundance and richness. Turbaco had the highest adult Aedes aegypti index. Arbovirus vectors were among the identified species, including Ae. aegypti, Culex quinquefasciatus, Haemagogus janthinomys, Sabethes chloropterus, Aedes angustivittatus, Mansonia titillans, Coquillettidia venezuelensis and the subgenera Culex Melanoconion. Overall, the diversity and abundance of mosquitoes present in these municipalities establish a potential disease transmission risk by these vectors.

Climatic factors and the incidence of dengue in Cartagena, Colombian Caribbean Region

ABSTRACT Background: The influence of climate on the epidemiology of dengue has scarcely been studied in Cartagena. Methods: The relationship between dengue cases and climatic and macroclimatic factors was explored using an ecological design and bivariate and time-series analyses during lag and non-lag months. Data from 2008-2017 was obtained from the national surveillance system and meteorological stations. Results: Cases correlated only with climatic variables during lag and non-lag months. Decreases in precipitation and humidity and increases in temperature were correlated with an increase in cases. Conclusions: Our findings provide useful information for establishing and strengthening dengue prevention and control strategies.

Clinical-radiological approach for the diagnosis of cleidocranial dysplasia in adults: A familial cases series.

Cleidocranial dysplasia is a rare disease with an autosomal-dominant inheritance that mainly affects the bones of the axial skeleton. In this report, we discuss the clinical and radiological signs of a case series comprising three sisters and the son of one of the sisters, all with suspected bone dysplasia.

Climatic Variability and Human Leptospirosis Cases in Cartagena, Colombia: A 10-Year Ecological Study.

Leptospirosis is an acute febrile disease that mainly affects developing countries with tropical climates. The complexity and magnitude of this disease is attributed to socioeconomic, climatic, and environmental conditions. In this study, in a 10-year period from 2008 to 2017, the relationship between human leptospirosis cases and climatic factors in Cartagena de Indias, Colombia were evaluated. Monthly leptospirosis cases, climatic variables, and macroclimatic phenomena (El Niño and La Niña) were obtained from public datasets. Local climatic factors included temperature (maximum, average, and minimum), relative humidity, precipitation, and the number of precipitation days. Time series graphs were drawn and correlations between cases of leptospirosis and climatic variables considering lags from 0 to 10 months were examined. A total of 360 cases of leptospirosis were reported in Cartagena during the study period, of which 192 (53.3%) were systematically notified between October and December. Several correlations were detected between the number of cases, local climatic variables, and macroclimatic phenomena. Mainly, the increase of cases correlated with increased precipitation and humidity during the La Niña periods. Herein, seasonal patterns and correlations suggest that the climate in Cartagena could favor the incidence of leptospirosis. Our findings suggest that prevention and control of human leptospirosis in Cartagena should be promoted and strengthened, especially in the last quarter of the year.

Clinical, histopathological, and molecular characterization of leprosy in an endemic area of the colombian caribbean.

Background: Mycobacterium leprae was considered the only causal agent of leprosy until Mycobacterium lepromatosis was identified' which it has been suggested has greater pathogenicity and is linked to diffuse lepromatous leprosy (DLL) and Lucio's phenomenon (LPh). Our objective is to identify Mycobacterium spp. in an endemic area of leprosy in Colombia. Methods: The study included cases with a diagnosis of leprosy by clinical and histopathological analysis. DNA extraction and two specific rounds of semi-nested polymerase chain reaction (PCR) were performed in paraffin biopsies skin to identify M. leprae and M. lepromatosis. Demographic, clinical, and histopathological data were extracted and tabulated for analysis. Results: Forty-one cases of leprosy were analyzed. The most frequent clinical diagnosis was lepromatous leprosy (36.6%); there was one case with DLL and two with LPh. The most common histopathological finding was tuberculoid leprosy (36.59%); three cases had negative histopathology. M. lepromatosis was not detected; all cases corresponded to M. leprae including cases with negative histopathology' DLL, and LPh. Conclusion: In this study, M. leprae was the causative agent of leprosy, encompassing even its most severe phenotypic forms. It is appropriate to consider PCR as an indispensable tool for the diagnosis of leprosy and to continue to carry out the active search for M. lepromatosis.

Population characterization and parasitological assessment of the giant African snail ( Achatina fulica) in urban areas of Cartagena, Colombia.

Background: The giant African snail, Achatina fulica, is an invasive species recognized for being a serious agricultural pest and an intermediary vector for diverse parasites that cause diseases in humans. The knowledge of the state of African snail populations in urban areas is of great ecological and public health importance. Therefore, our objective was to characterize the status of giant African snail populations present in the city of Cartagena, Colombia, including the assessment of nematode parasites in the specimens. Methods. Sites were visited following information from citizens affected by the presence of the African snail. The specimens were collected and transported to the laboratory; subsequently, they were weighed, measured, and classified by size. Dissections of lung tissue and soft organs were performed to search for and identify nematode parasites. Size measurement between the sampled sites was statistically compared and density and biomass indicators were established. Results. In total, 204 snails were collected distributed among four sites within Cartagena city. Of these, 50% were juvenile specimens (10-40 mm). The size of the specimens showed significant differences between the sampling areas. The calculated density was between 0.0019-0.68 ind/m 2 and the biomass between 3.92-48.75 kg/ha. No presence of nematode parasites was observed in these specimens. Conclusions. Densities and biomasses of A. fulica in Cartagena do not reach levels considered highly harmful. On the other hand, although no parasites were found in these snails, it is relevant to continue with studies on the human health risks that represent the presence of this invasive species in urban areas of Cartagena.

Spatial Distribution of Congenital Disorders Diagnosed by the Newborn Screening Program in Ecuador

Abstract The newborn screening program in Ecuador has been operating since 2011 under the responsibility of the Ministry of Health. This program is centralized and diagnoses four diseases: congenital hypothyroidism, phenylketonuria, galactosemia, and congenital adrenal hyperplasia. This study aimed to assess the geographical distribution of newborn screening cases in Ecuador. Spatial analysis techniques were applied using the records of the National Newborn Screening Program with a congenital disease confirmed from January 2012 to December 2019. Morbidity rates per 100,000 were calculated by newborn screening disease detected and the province of birth, posteriorly, the map of its distribution was graphed and assessed using the QGIS 3.12 software. In total, 393 cases born confirmed between 2012 and 2019 were registered. The distribution of every disease tends to be different in all provinces in Ecuador; the spatial variation was significant and relative rates showed a higher incidence in some eastern provinces. In conclusion, we found a different distribution and rates of newborn screening disorders in Ecuador. The high incidence of congenital hypothyroidism, phenylketonuria, galactosemia, and congenital adrenal hyperplasia in some areas should be investigated, due could be related to ethnic, genetic, and cultural aspects of the population.

Usefulness and limitations of implementing rapid tests for the diagnosis of COVID-19 in Latin America.

Not available.

Negative Correlation between Altitude and COVID-19 Pandemic in Colombia: A Preliminary Report.

It has been suggested that high altitude can reduce the infectivity and case fatality rate of COVID-19. We investigated the relationship between altitude and the COVID-19 pandemic in Colombia. Epidemiological data included the number of positive cases, deaths, and the case fatality rate of COVID-19. In particular, we analyzed data from 70 cities with altitudes between 1 and 3,180 m. Correlations and linear regression models adjusted to population density were performed to examine the relationship and contribution of altitude to epidemiological variables. The case fatality rate was negatively correlated with the altitude of the cities. The incidence of cases and deaths from COVID-19 had an apparent correlation with altitude; however, these variables were better explained by population density. In general, these findings suggest that living at high altitude can reduce the impact of COVID-19, especially the case fatality rate.