Encuesta de ceguera y deficiencia visual evitable en Panamá / Survey on avoidable blindness and visual impairment in Panama

OBJETIVO: Determinar la prevalencia de ceguera y deficiencia visual en adultos de 50 años o más de Panamá, identificar sus principales causas y caracterizar la oferta de servicios de salud ocular. MÉTODOS: Estudio poblacional transversal mediante la metodología estándar de evaluación rápida de ceguera evitable. Se seleccionaron 50 personas de 50 años o más de cada uno de 84 conglomerados escogidos mediante muestreo aleatorio representativo de todo el país. Se evaluó la agudeza visual (AV) mediante una cartilla de Snellen y el estado del cristalino y del polo posterior por oftalmoscopía directa. Se calculó la cobertura de cirugía de catarata y se evaluó su calidad, así como las causas de tener AV < 20/60 y las barreras para acceder al tratamiento quirúrgico. RESULTADOS: Se examinaron 4 125 personas (98,2% de la muestra calculada). La prevalencia de ceguera ajustada por la edad y el sexo fue de 3,0% (intervalo de confianza de 95%: 2,3-3,6). La principal causa de ceguera fue la catarata (66,4%), seguida del glaucoma (10,2%). La catarata (69,2%) fue la principal causa de deficiencia visual (DV) severa y los errores de refracción no corregidos fueron la principal causa de DV moderada (60,7%). La cobertura quirúrgica de catarata en personas fue de 76,3%. De todos los ojos operados de catarata, 58,0% logró una AV < 20/60 con la corrección disponible. CONCLUSIONES: La prevalencia de ceguera en Panamá se ubica en un nivel medio con respecto a la encontrada en otros países de la Región. Es posible disminuir este problema, ya que 76,2% de los casos de ceguera y 85,0% de los casos de DV severa corresponden a causas evitables.

OBJECTIVE: Determine prevalence of blindness and visual impairment in adults aged > 50 years in Panama, identify their main causes, and characterize eye health services. METHODS: Cross-sectional population study using standard Rapid Assessment of Avoidable Blindness methodology. Fifty people aged > 50 years were selected from each of 84 clusters chosen through representative random sampling of the entire country. Visual acuity was assessed using a Snellen chart; lens and posterior pole status were assessed by direct ophthalmoscopy. Cataract surgery coverage was calculated and its quality assessed, along with causes of visual acuity < 20/60 and barriers to access to surgical treatment. RESULTS: A total of 4 125 people were examined (98.2% of the calculated sample). Age- and sex-adjusted prevalence of blindness was 3.0% (95% CI: 2.3-3.6). The main cause of blindness was cataract (66.4%), followed by glaucoma (10.2%). Cataract (69.2%) was the main cause of severe visual impairment and uncorrected refractive errors were the main cause of moderate visual impairment (60.7%). Surgical cataract coverage in individuals was 76.3%. Of all eyes operated for cataract, 58.0% achieved visual acuity < 20/60 with available correction. CONCLUSIONS: Prevalence of blindness in Panama is in line with average prevalence found in other countries of the Region. This problem can be reduced, since 76.2% of cases of blindness and 85.0% of cases of severe visual impairment result from avoidable causes.

[Survey on avoidable blindness and visual impairment in Panama]. / Encuesta de ceguera y deficiencia visual evitable en Panamá

OBJECTIVE: Determine prevalence of blindness and visual impairment in adults aged ≥ 50 years in Panama, identify their main causes, and characterize eye health services. METHODS: Cross-sectional population study using standard Rapid Assessment of Avoidable Blindness methodology. Fifty people aged ≥ 50 years were selected from each of 84 clusters chosen through representative random sampling of the entire country. Visual acuity was assessed using a Snellen chart; lens and posterior pole status were assessed by direct ophthalmoscopy. Cataract surgery coverage was calculated and its quality assessed, along with causes of visual acuity < 20/60 and barriers to access to surgical treatment. RESULTS: A total of 4 125 people were examined (98.2% of the calculated sample). Age- and sex-adjusted prevalence of blindness was 3.0% (95% CI: 2.3-3.6). The main cause of blindness was cataract (66.4%), followed by glaucoma (10.2%). Cataract (69.2%) was the main cause of severe visual impairment and uncorrected refractive errors were the main cause of moderate visual impairment (60.7%). Surgical cataract coverage in individuals was 76.3%. Of all eyes operated for cataract, 58.0% achieved visual acuity ≤ 20/60 with available correction. CONCLUSIONS: Prevalence of blindness in Panama is in line with average prevalence found in other countries of the Region. This problem can be reduced, since 76.2% of cases of blindness and 85.0% of cases of severe visual impairment result from avoidable causes.

Characterization of stable fly (Diptera: Muscidae) larval developmental habitat at round hay bale feeding sites.

In this study, we examined the stable fly, Stomoxys calcitrans (L.) (Diptera: Muscidae), larval developmental habitat within the round hay bale feeding sites on cattle pastures, and we identified three zones with distinct characteristics around two types of hay feeders (ring and cone). The parameters monitored in each zone included stable fly emergence, substrate temperature, moisture, pH, thickness of hay-manure layer, and concentration of fecal coliform bacteria (Escherichia coli and Klebsiella oxytoca) as indicators of fecal material. All measurements were conducted during the period of high stable fly prevalence (HSF) in May-June and low stable fly prevalence (LSF) in July-August to better understand the environmental factors influencing stable fly seasonality. Substrate temperature and fecal coliform concentration were the only two significantly different factors between HSF and LSF. Temperatures ranged from 21 to 25 degrees C during HSF versus 25-30 degrees C in LSF but all were within the range for successful stable fly development. Fecal coliform concentrations ranged from 4.2 x 10(3) to 4.1 x 10(4) colony-forming units (CFU)/g of the substrate during HSF and from undetectable (<10) to 100 CFU/g during LSF. Furthermore, we evaluated the effect of different hay:manure ratios (0:1, 1:1, 2:1, and 5:1) on stable fly development (egg to adult). Temperature was significantly higher and stable fly developmental time significantly shorter in all substrates containing hay when compared with that of manure alone, but no significant differences were detected in stable fly emergence among the substrates. These results strongly indicate that the fecal microbial community plays an important role in stable fly larval development in hay feeding sites and that it is the main factor behind stable fly developmental seasonality on pastures. Our results also demonstrate that animal manure mixed with hay provides conditions for faster stable fly development than manure alone; however, hay does not significantly affect overall stable fly emergence.

An insight into the transcriptome and proteome of the salivary gland of the stable fly, Stomoxys calcitrans.

Adult stable flies are blood feeders, a nuisance, and mechanical vectors of veterinary diseases. To enable efficient feeding, blood sucking insects have evolved a sophisticated array of salivary compounds to disarm their host's hemostasis and inflammatory reaction. While the sialomes of several blood sucking Nematocera flies have been described, no thorough description has been made so far of any Brachycera, except for a detailed proteome analysis of a tabanid (Xu et al., 2008). In this work we provide an insight into the sialome of the muscid Stomoxys calcitrans, revealing a complex mixture of serine proteases, endonucleases, Kazal-containing peptides, anti-thrombins, antigen 5 related proteins, antimicrobial peptides, and the usual finding of mysterious secreted peptides that have no known partners, and may reflect the very fast evolution of salivary proteins due to the vertebrate host immune pressure. Supplemental Tables S1 and S2 can be downloaded from http://exon.niaid.nih.gov/transcriptome/S_calcitrans/T1/Sc-tb1-web.xls and http://exon.niaid.nih.gov/transcriptome/S_calcitrans/T2/Sc-tb2-web.xls.

High prevalence of West Nile virus: a continuing risk in acquiring infection from a mosquito bite.

The prevalence of West Nile Virus (WNV) was evaluated by diplex real-time RT-PCR assay for the years 2001-2005 in Culex species of mosquitoes, several species of dead birds, and clinically suspected mammals collected in Kansas. The analysis was performed using a TaqMan-based diplex real-time RT-PCR assay targeted against two regions of the WNV genome, envelope glycoprotein gene and 3' untranslated region. The assay aided in the accurate detection of WNV in mosquitoes at high prevalence for the years 2002-2005. Similarly, high incidence of birds that tested positive for WNV was detected in 2002-2004. WNV positives in mammals by the diplex real time RT-PCR assay included horses, squirrels, mules, sheep and a mountain goat. Majority of the equine WNV positives were detected only in the year 2002. Sequence analysis of a segment of the envelope glycoprotein gene from 31 randomly selected WNV positive samples revealed variations in six samples at one or two nucleotide positions. The identity of high levels of WNV positives in Kansas parallels the recent reports on the widespread distribution of the virus in the United States. The continued detection of WNV in the mosquitoes is of significant public health concern and calls for continued surveillance and public health activities.

Evaluation of significance of bacteria in larval development of Cochliomyia macellaria (Diptera: Calliphoridae).

Bacteria were isolated and identified from the digestive tract of the secondary screwworm, Cochliomyia macellaria (F.) (Diptera: Calliphoridae), and their role in the larval development of this insect was assessed in laboratory bioassays. The analysis of 16S rDNA sequences revealed that the bacterial isolates represented four species: Providencia sp., Escherichia coli O157:H7 (Escherich), Enterococcus faecalis (Orla-Jensen), and Ochrobactrum sp. (Holmes). Developmental assays demonstrated that C. macellaria larvae are able to develop on a sterile blood agar, and no bacteria are required to complete larval development. Indeed, developmental times were shorter and survival rates of C. macellaria on a sterile blood agar and the modified Harris rearing diet were greater compared with that on the blood agar inoculated with individual and mixed bacterial isolates. The cultures of Ochrobactrum sp. and E. faecalis supported larval development to a significantly greater extent than those of Providencia sp. and E. coli O157:H7. The presence of bacteria in newly emerged C. macellaria adults also was assessed and revealed that the bacteria in the gut of larvae can survive pupation and colonize the gut of adult flies. This study shows that development of larvae of C. macellaria does not depend on bacteria and that some bacterial isolates negatively impact larval development.

Ectoparasite control.

The severity of damage that insects, ticks, and mites may have on their bovine hosts ranges from undetectable effects on energy expenditure to the death of the host. These pest insects can cause direct damage to their hosts by their annoyance, irritation, blood feeding, modification of host behavior, and invasion of tissues. This direct damage can result in such direct losses as dermatitis, anemia,reduction in weight gain performance, devaluation of carcass,injury during pest avoidance, injury by chemical control of pests,necrosis, and death. The main flies that affect cattle performance and specifically, stockers, are discussed in this article.

Pyemotes herfsi (Acari: Pyemotidae), a mite new to North America as the cause of bite outbreaks.

High incidences of red, itching, and painful welts on people in the midwestern United States led to the discovery of a European species of mite, Pyemotes herfsi (Oudemans) (Acari: Pyemotidae), preying on gall-making midge larvae on oak leaves. The mites' great reproductive potential, small size, and high capacity for dispersal by wind make them difficult to control or avoid.

Relative efficiency of biological transmission of Anaplasma marginale (Rickettsiales: Anaplasmataceae) by Dermacentor andersoni (Acari: Ixodidae) compared with mechanical transmission by Stomoxys calcitrans (Diptera: Muscidae).

Anaplasma marginale Theiler is a tick-borne intraerythrocytic rickettsial pathogen of cattle that also can be mechanically transmitted by biting flies. Rickettsemia during the acute phase of infection may reach as high as 10(9) infected erythrocytes (IEs) per milliliter of blood. Animals that survive acute infection develop a life-long persistent infection that cycles between 10(2.5) and 10(7) IE/ ml of blood. We compared stable fly Stomoxys calcitrans (L.) -borne mechanical transmission during acute infection with Rocky Mountain wood tick, Dermacentor andersoni Stiles-borne biological transmission in the persistent phase of infection to demonstrate quantitatively that biological transmission by ticks is considerably more efficient than mechanical transmission by biting flies. Stable flies that partially fed on an acutely infected calf and were immediately transferred to susceptible calves to complete their bloodmeals failed to transmit A. marginale. Ticks that fed on the original acquisition host after it reached the persistent phase of infection (>300-fold lower rickettsemia) successfully transmitted A. marginale after transfer to the same calves that failed to acquire infection after fly feeding. Failure of fly-borne mechanical transmission at a rickettsemia >300-fold higher than that from which ticks transmit with 100% efficiency demonstrates that tick-borne biological transmission is at least 2 orders of magnitude more efficient than direct stable fly-borne mechanical transmission.

Winter feeding sites of hay in round bales as major developmental sites of Stomoxys calcitrans (Diptera: Muscidae) in pastures in spring and summer.

The stable fly, Stomoxys calcitrans (L.), historically has been a pest of livestock in confined operations but seldom of animals on pastures or rangelands. In the past two decades, however, S. calcitrans has become a major pest of cattle and horses on pastures in the midwestern United States. Although there usually is an overabundance of diverse stable fly and house fly, Musca domestica L., larval habitats in confined livestock operations, no larval habitat for stable flies has been clearly identified in the pasture-range environment. Because the winter feeding of hay in round bales results in significant amounts of hay wastage that when mixed with manure, might develop into suitable larval habitats, this study evaluated these areas as developmental sites for the abundant stable flies in pastures. There was a trend for fly traps placed in the vicinity of hay feeding sites to catch more stable flies than those placed distant from these sites. Estimates of stable flies emerging from these sites ranged from 102 to 1225 flies per core sample (25 by 25 cm). The mean number of adult stable flies during May and June 2001 through 2004 correlated negatively with the average minimum temperatures during the preceding winter (November-February) but not with rainfall or temperatures during the spring. These results support the hypothesis that winter feeding sites of hay in round bales are the main source of stable flies in pastures.

Insecticide susceptibilities of cat fleas (Siphonaptera: Pulicidae) from several regions of the United States.

Eleven cat flea, Ctenocephalides felis (Bouchè), strains, seven field-collected and four laboratory-colonized, were assayed for susceptibilities to five insecticides (carbaryl, chlorpyrifos, malathion, permethrin, and pyrethrin) with an insecticide-treated, horizontally-oriented, Nylon 6,6 disk in a test tube. The pyrethrin was synergized using piperonyl butoxide (PBO). Flea mortality at two doses was recorded after 4 and 24 h exposures. The field strains from Texas and Florida tolerated carbaryl, chlorpyrifos, and malathion; and carbaryl and PBO-synergized pyrethrin, respectively. Tolerance was observed in a field strain from Kansas against malathion. Colonies from California and North Carolina were susceptible to malathion and PBO-synergized pyrethrin, and chlorpyrifos and permethrin, respectively, but three colonies showed tolerance. The insecticidal response of the California colony varied; when exposed to a chlorpyrifos dose of 10 mg (AI)/m2 for 24 h, at various times had mortality of 3-100%. With a PBO-synergized pyrethrin dose of 396 mg (AI)/ m2 for 4 h, the mortality ranged between 4.2 and 97%. Colonized strains were more susceptible than field strains at 4 h exposure to all insecticides except PBO-synergized pyrethrin. Colonized strains survived better in control tubes. The colony strains' susceptibility and variability are of considerable importance because these strains are used for flea product efficacy evaluations and bioassays. The differences in susceptibility between laboratory colonies and the field strains suggested development of both adaptation to colonization, and extensive, multiple cross-resistance to insecticides in field strains. Varying susceptibility of cat fleas may affect control success.

Chronological age-grading of house flies by using near-infrared spectroscopy.

The sensitivity and accuracy of near-infrared spectroscopy (NIRS) was compared with that of the pteridine fluorescence technique for estimating the chronological age of house flies, Musca domestica (L.). Although results with both techniques were significantly correlated with fly age, confidence limits on predicted ages generally were smaller with NIRS. Young flies could be readily differentiated from old flies by using NIRS. Age predictions using the pteridine method are dependent upon size, sex, and temperature at which adult flies are exposed. In contrast, those factors do not need to be determined for age-grading using NIRS. Classification accuracy using the NIRS method was similar for whole flies, fresh heads, dried heads, and ethanol-preserved heads. The NIRS method was also suitable for predicting age of stable flies, Stomoxys calcitrans (L.), and face flies, Musca autumnalis De Geer. NIRS has several advantages over the measurement of pteridine levels for age-grading field-collected flies, including speed and portability of instrumentation, and not needing to determine sex, size, and temperatures to which adult flies were exposed.