Seroprevalencia de la infección de Chagas y sus determinantes en población pediátrica de la región de Cochabamba, Bolívia / Seroprevalence of Chagas disease and its determinants in children and adolescents from Cochabamba, Bolivia

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Seroprevalence of hepatitis B in two period birth cohorts of Bolivian children: effect of universal vaccination.

BACKGROUND: Since 2000 universal routine immunization against the hepatitis B virus (HBV) was implemented in Bolivia. This study aimed to assess the seroprevalence of markers against HBV in two different birth cohorts (pre-universal vaccine cohort and post-universal vaccine cohort) from Cochabamba, Bolivia. METHODS: We performed a school-based seroepidemiological survey (n = 424) of HBV in 2010 in the Cochabamba region. An ELISA test was used to measure antibodies to the hepatitis B surface antigen (anti-HBs IgG) and to the hepatitis B core antigen (anti-HBc IgG). RESULTS: The prevalence of anti-HBs IgG in the pre-universal vaccine cohort was 5.8% (95% CI: 3.3-8.3%); it was higher in boys (9.1%), and those living in suburbs (9.7%). The anti-HBs IgG prevalence among post-universal vaccine cohort was 37.9% (95% CI: 28.5-48.1%), and was higher in children who spoke Quechua at home (51.0%), those living in suburbs (53.9%), and those born in 2005 (72.7%). Neither cohort showed differences relating to parental education. The prevalence of anti-HBc IgG was 1.1% among post-universal vaccine cohort and 1.2% among pre-universal vaccine cohort (p > 0.05). CONCLUSIONS: This study identified a persistent low seroprevalence of hepatitis B infection in spite of a decade of universal immunization, and low long-term humoral immunity against HBV infection in vaccinated children in Cochabamba. 

Effectiveness of the WC/rBS oral cholera vaccine in the prevention of traveler's diarrhea: a prospective cohort study.

OBJECTIVE: Traveler's diarrhea (TD) is the most frequent disease among people from industrialized countries who travel to less developed ones, especially sub-Saharan Africa, Southern Asia and South America. The most common bacteria causing TD is enterotoxigenic Escherichia coli (ETEC). The WC/rBS cholera vaccine (Dukoral) has been shown to induce cross-protection against ETEC by means of the B subunit of the cholera toxin. The aim of the study was to evaluate the effectiveness of the WC/rBS cholera vaccine in preventing TD. METHODS: Between May 1 and September 30 (2007), people seeking pre-travel advice in ten Spanish international vaccination centers were included in a prospective cohort study of travelers to cholera risk countries. The incidence rates of TD were adjusted for variables whose frequencies were statistically different (entry point 0.10) between the vaccinated and non-vaccinated cohorts. FINDINGS: The vaccinated cohort (n = 544 travelers) included people vaccinated with the WC/rBS cholera vaccine, and the non-vaccinated cohort (n = 530 travelers) by people not vaccinated. The cumulative incidence rate of TD was 1.69 in vaccinated and 2.14 in non-vaccinated subjects. The adjusted relative risk of TD in vaccinated travelers was 0.72 (95% CI: 0.58-0.88) and the adjusted vaccination effectiveness was 28% (95% CI: 12-42). CONCLUSIONS: The WC/rBS cholera vaccine prevents TD in 2 out of 7 travelers (preventive fraction: 28%). The number needed to vaccinate (NNV) to prevent 1 case of TD is 10.

A randomised study on the clinical progress of high-risk elective major gastrointestinal surgery patients treated with olive oil-based parenteral nutrition with or without a fish oil supplement.

n-3 Fatty acids have clinical benefits. The primary aim of the present study was the assessment of infection in patients who underwent major high-risk elective gastrointestinal surgery receiving postoperatively fish oil (FO)-supplemented parenteral nutrition (PN), compared with those receiving a standard olive oil (OO) emulsion. The secondary aims were the assessment of anti-inflammatory response and evaluation of tolerance and safety of these emulsions. A prospective, randomised, double-blind study was performed in patients requiring at least 5 d of PN. An isoenergetic and isoproteic formula was administered: group A received OO alone, while group B received OO that was partially replaced with FO (16.6 %, w/w). End points were outcome measures (mortality, sepsis, infection, hospitalisation days and PN duration), inflammatory response (C-reactive protein (CRP), prealbumin and leucocytes) and safety (TAG and glucose metabolism, and liver and kidney function). Statistical analysis was done using Student's t test and Fisher's exact test (P < 0.05). Twenty-seven patients were evaluated, with thirteen patients receiving FO. In this group, a significantly lower incidence of infections was found (23.1 v. 78.6 %, P = 0.007). CRP, prealbumin and leucocytes were not significantly different between the groups. There were no differences in safety parameters. We conclude that high-risk surgical patients receiving FO-supplemented PN for 5 d present a lower incidence of infection. Emulsions were safe and well tolerated.

Efectos de la vacunación antigripal sobre el porcentaje de linfocitos T CD4 positivos en pacientes VIH 1/2 positivos: estudio de una cohorte / Effects of influenza vaccination on the percentage of CD4+ T lymphocytes in HIV 1/2 positive patients: a cohort study

ObjetivoDeterminar la incidencia del cambio inmunitario del porcentaje de linfocitos T CD4+ en pacientes VIH 1/2 positivos en el primer trimestre posvacunación antigripal (P-CIR) y secundariamente comparar las características demográficas y clínicas relacionadas con dicho cambio.MétodosSe estudiaron 105 pacientes con VIH-sida de una cohorte retrospectiva hospitalaria entre 2001 y 2006. Se consideró P-CIR una disminución >3% del porcentaje de CD4+ prevacunal, y su asociación cruda y ajustada (sexo, edad, terapia antirretroviral, estabilidad clínica, carga viral prevacunal, CD4 total prevacunal) fue evaluada por regresión logística (odds ratio [OR] con intervalo de confianza del 95% [IC95%]).ResultadosLa incidencia del P-CIR fue del 33,3%, y fue persistente en un 31,4% durante los siete meses posvacunación independientemente de una viremia alta prevacunal. Asimismo, las variables demográficas y clínicas estudiadas no se relacionaron con la presencia de P-CIR, con una OR cruda de 0,90 (0,17–4,8) y una OR ajustada de 1,09 (0,17–6,8).ConclusionesLos datos encontrados reflejan que el cambio relevante del estado inmunitario no fue despreciable en la posvacunación, aunque mayoritariamente resultó transitorio(AU)

ObjectiveTo determine the incidence of immunologic change in the percentage of CD4+ T lymphocytes in HIV 1/2 positive patients in the first quarter after influenza vaccination (P-CIR) and to compare the demographic and clinical characteristics associated with this change.MethodsWe studied 105 patients with HIV/AIDS in a retrospective hospital cohort between 2001–2006. P-CIR was considered as a decrease of >3% in the prevaccination CD4+ percentage. Crude and adjusted OR (sex, age, antiretroviral therapy, clinical stability, prevaccination viremia and prevaccination total CD4) were evaluated by logistic regression (95%CI).ResultsThe incidence of P-CIR was 33.3%. P-CIR was persistent in 31.4% for 7 months after vaccination regardless of high prevaccination viremia. No association was found between demographic and clinical variables and P-CIR [crude OR: 0.90 (0.17–4.8); adjusted OR: 1.09 (0.17–6.8)].ConclusionsThe results showed that the immunological change after vaccination was not inconsiderable. However, this change was mainly transient(AU)

Brief smoking cessation intervention in hospitalized patients with cardiovascular disease.

The objective of this study was to determine the smoking abstinence rate after hospital discharge in cardiovascular patients who had undergone a brief smoking cessation intervention during hospitalization. The prospective cohort study involved 252 smokers who were admitted to the Hospital Universitari de Bellvitge in Catalonia, Spain. Twenty-four hours after hospital discharge, 76.6% of patients were still abstaining from smoking. At 1, 3, 9 and 12 months, the abstinence rate diminished to 71.4%, 67.2%, 64.1% and 62.2%, respectively. Patients diagnosed with ischemic cardiopathy had a significantly lower probability of a smoking relapse: hazard ratio=0.56 (95% confidence interval, 0.36-0.87). At our center, a brief smoking cessation intervention in cardiovascular patients during hospital admission was found unlikely to result in smoking abstinence following discharge.

Breve intervención de cesación tabáquica en enfermos cardiovasculares hospitalizados / Brief smoking cessation intervention in hospitalized patients with cardiovascular disease

El objetivo del estudio es estimar la tasa de abstinencia tabáquica posterior al alta hospitalaria en enfermos cardiovasculares que recibieron una intervención mínima de cesación tabáquica durante el ingreso. Se realizó un estudio prospectivo de una cohorte de 252 fumadores ingresados en el Hospital Universitari de Bellvitge. A las 24 h del alta hospitalaria se mantenía en abstinencia tabáquica el 76,6% de los pacientes. Tras 1, 3, 9 y 12 meses, las tasas de abstinencia habían disminuido al 71,4, el 67,2, el 64,1 y el 62,2%, respectivamente. Los pacientes diagnosticados de cardiopatía isquémica tenían menor probabilidad de recaída tabáquica: hazard ratio = 0,56 (intervalo de confianza del 95%, 0,36-0,87). En nuestro centro, una intervención mínima de cesación tabáquica durante la hospitalización en los enfermos cardiovasculares probablemente no sea suficiente para mantener la abstinencia tabáquica al alta (AU)

The objective of this study was to determine the smoking abstinence rate after hospital discharge in cardiovascular patients who had undergone a brief smoking cessation intervention during hospitalization. The prospective cohort study involved 252 smokers who were admitted to the Hospital Universitari de Bellvitge in Catalonia, Spain. Twenty-four hours after hospital discharge, 76.6% of patients were still abstaining from smoking. At 1, 3, 9, and 12 months, the abstinence rate diminished to 71.4%, 67.2%, 64.1%, and 62.2%, respectively. Patients diagnosed with ischemic cardiopathy had a significantly lower probability of a smoking relapse: hazard ratio =0.56 (95% confidence interval, 0.36-0.87). At our center, a brief smoking cessation intervention in cardiovascular patients during hospital admission was found unlikely to result in smoking abstinence following discharge (AU)

[Effects of influenza vaccination on the percentage of CD4+ T lymphocytes in HIV 1/2 positive patients: a cohort study]. / Efectos de la vacunación antigripal sobre el porcentaje de linfocitos T CD4 positivos en pacientes VIH 1/2 positivos: estudio de una cohorte.

OBJECTIVE: To determine the incidence of immunologic change in the percentage of CD4+ T lymphocytes in HIV 1/2 positive patients in the first quarter after influenza vaccination (P-CIR) and to compare the demographic and clinical characteristics associated with this change. METHODS: We studied 105 patients with HIV/AIDS in a retrospective hospital cohort between 2001-2006. P-CIR was considered as a decrease of >3% in the prevaccination CD4+ percentage. Crude and adjusted OR (sex, age, antiretroviral therapy, clinical stability, prevaccination viremia and prevaccination total CD4) were evaluated by logistic regression (95%CI). RESULTS: The incidence of P-CIR was 33.3%. P-CIR was persistent in 31.4% for 7 months after vaccination regardless of high prevaccination viremia. No association was found between demographic and clinical variables and P-CIR [crude OR: 0.90 (0.17-4.8); adjusted OR: 1.09 (0.17-6.8)]. CONCLUSIONS: The results showed that the immunological change after vaccination was not inconsiderable. However, this change was mainly transient.