Toxoplasma gondii exposure in felines: an alarming factor to public health from mineiros, Goiás / Exposição ao toxoplasma gondii em felinos: um fator alarmante para a saúde pública de Mineiros, Goiás / Exposición a toxoplasma gondii en felinos: un factor alarmante para la salud pública de Mineiros, Goiás

Toxoplasmosis is a cosmopolitan disease caused by Toxoplasma gondii, an obligate protozoan that affects endothermic animals, including man. Being a zoonosis that can cause abortions, fetal malformations and blindness. Cats are the definitive hosts, acting as a source of dissemination. In order to collect epidemiological data on the distribution of T. gondii in Mineiros, Goiás, samples of domestic cats were analyzed to verify the circulation of the protozoan and reinforce preventive measures. Ninety-four samples of domestic cats, regardless of gender, age and breed, were randomly processed in the neighborhoods of Mineiros, Goiás. They were submitted to the indirect fluorescent antibody test for antibodies against T. gondii, using tachyzoites as antigens and anti-cat IgG conjugate (1:16 were positive). Of the 94 samples analyzed, 35 (37.2%) were reagents, of which four had a titration of 1:16, ten of 1:32, eleven of 1:64, eight of 1:128 and two of 1:256. All cats were semi-domiciled, but lifestyle and diet were not assessed. T. gondii infection is rarely symptomatic and the severity depends on the pathophysiological state. Brazil has high prevalence rates and requires effective care in the management of cats. In Mineiros, 29 reports of infected pregnant women were identified. Although infection in humans occurs primarily through consumption of undercooked meat, ingestion of oocysts in feces of cats is a possibility. Therefore, state public health institutions and veterinarians should promote health education, highlighting food hygiene. Since, when symptomatic, the disease presents severe clinical conditions and, in some cases, irreversible.

A toxoplasmose é uma doença cosmopolita causada pelo Toxoplasma gondii, um protozoário obrigatório que afeta animais endotérmicos, incluindo o homem. Sendo uma zoonose que pode causar abortos, malformações fetais e cegueira. Os gatos são os hospedeiros definitivos, atuando como fonte de disseminação. Para coletar dados epidemiológicos sobre a distribuição do T. gondii em Mineiros, Goiás, amostras de gatos domésticos foram analisadas para verificar a circulação do protozoário e reforçar as medidas preventivas. Noventa e quatro amostras de gatos domésticos, independente de sexo, idade e raça, foram processadas aleatoriamente nos bairros de Mineiros, Goiás. Foram submetidos ao teste de anticorpo fluorescente indireto para pesquisa de anticorpos contra T. gondii, utilizando como antígenos taquizoítos e conjugado anti-cat IgG (1:16 foram positivos). Das 94 amostras analisadas, 35 (37,2%) eram reagentes, das quais quatro tiveram titulação de 1:16, dez de 1:32, onze de 1:64, oito de 1:128 e duas de 1:256. Todos os gatos eram semi-domiciliados, mas o estilo de vida e a dieta não foram avaliados. A infecção por T. gondii raramente é sintomática e a gravidade depende do estado fisiopatológico. O Brasil possui altas taxas de prevalência e requer cuidados efetivos no manejo dos gatos. Em Mineiros, foram identificadas 29 notificações de gestantes infectadas. Embora a infecção em humanos ocorra principalmente pelo consumo de carne mal cozida, a ingestão de oocistos nas fezes de gatos é uma possibilidade. Portanto, as instituições estaduais de saúde pública e os médicos veterinários devem promover a educação em saúde, destacando a higiene alimentar. Já que, quando sintomática, a doença apresenta quadros clínicos graves e, em alguns casos, irreversíveis.

La toxoplasmosis es una enfermedad cosmopolita causada por Toxoplasma gondii, un protozoario obligado que afecta a animales endotérmicos, incluido el hombre. Ser una zoonosis que puede provocar abortos, malformaciones fetales y ceguera. Los gatos son los huéspedes definitivos, actuando como fuente de diseminación. Con el fin de recolectar datos epidemiológicos sobre la distribución de T. gondii en Mineiros, Goiás, se analizaron muestras de gatos domésticos para verificar la circulación del protozoario y reforzar las medidas preventivas. Noventa y cuatro muestras de gatos domésticos, independientemente de género, edad y raza, fueron procesadas al azar en los barrios de Mineiros, Goiás. Se sometieron a la prueba de anticuerpos fluorescentes indirectos contra T. gondii, utilizando como antígenos taquizoítos e IgG anti-cat conjugada (1:16 fueron positivos). De las 94 muestras analizadas, 35 (37,2%) fueron reactivos, de los cuales cuatro tuvieron una titulación de 1:16, diez de 1:32, once de 1:64, ocho de 1:128 y dos de 1:256. Todos los gatos tenían domicilio parcial, pero no se evaluó el estilo de vida ni la dieta. La infección por T. gondii rara vez es sintomática y la gravedad depende del estado fisiopatológico. Brasil tiene altas tasas de prevalencia y requiere una atención eficaz en el manejo de los gatos. En Mineiros se identificaron 29 casos de mujeres embarazadas infectadas. Aunque la infección en los seres humanos se produce principalmente a través del consumo de carne poco cocida, la ingestión de ovoquistes en las heces de los gatos es una posibilidad. Por lo tanto, las instituciones estatales de salud pública y los veterinarios deben promover la educación sanitaria, destacando la higiene alimentaria. Dado que, cuando sintomática, la enfermedad presenta cuadros clínicos severos y, en algunos casos, irreversibles.

Loop-Mediated Isothermal Amplification of Trypanosoma cruzi DNA for Point-of-Care Follow-Up of Anti-Parasitic Treatment of Chagas Disease.

A loop-mediated isothermal amplification assay was evaluated as a surrogate marker of treatment failure in Chagas disease (CD). A convenience series of 18 acute or reactivated CD patients who received anti-parasitic treatment with benznidazole was selected-namely, nine orally infected patients: three people living with HIV and CD reactivation, five chronic CD recipients with reactivation after organ transplantation and one seronegative recipient of a kidney and liver transplant from a CD donor. Fifty-four archival samples (venous blood treated with EDTA or guanidinium hydrochloride-EDTA buffer and cerebrospinal fluid) were extracted using a Spin-column manual kit and tested by T. cruzi Loopamp kit (Tc-LAMP, index test) and standardized real-time PCR (qPCR, comparator test). Of them, 23 samples were also extracted using a novel repurposed 3D printer designed for point-of-care DNA extraction (PrintrLab). The agreement between methods was estimated by Cohen's kappa index and Bland-Altman plot analysis. The T. cruzi Loopamp kit was as sensitive as qPCR for detecting parasite DNA in samples with parasite loads higher than 0.5 parasite equivalents/mL and infected with different discrete typing units. The agreement between qPCR and Tc-LAMP (Spin-column) or Tc-LAMP (PrintrLab) was excellent, with a mean difference of 0.02 [CI = -0.58-0.62] and -0.04 [CI = -0.45-0.37] and a Cohen's kappa coefficient of 0.78 [CI = 0.60-0.96] and 0.90 [CI = 0.71 to 1.00], respectively. These findings encourage prospective field studies to validate the use of LAMP as a surrogate marker of treatment failure in CD.

Natural History of Congenital Cytomegalovirus Infection in Highly Seropositive Populations.

Maternal preconceptional cytomegalovirus (CMV) immunity does not protect the fetus from acquiring congenital CMV infection (cCMV). Nonprimary infections due to recurrence of latent infections or reinfection with new virus strains during pregnancy can result in fetal infection. Because the prevalence of cCMV increases with increasing maternal CMV seroprevalence, the vast majority of the cases of cCMV throughout the world follow nonprimary maternal infections and is more common in individuals of lower socioeconomic background. Horizontal exposures to persons shedding virus in bodily secretions (young children, sexual activity, household crowding, low income) probably increase the risk of acquisition of an exogenous nonprimary CMV infection and fetal transmission. In addition, more frequent acquisition of new antibody reactivities in transmitter mothers suggest that maternal reinfection by new viral strains could be a major source of congenital infection in such populations. However, the exact frequency of CMV nonprimary infection in seroimmune women during pregnancy and the rate of intrauterine transmission in these women are yet to be defined. Usually, the birth prevalence of cCMV is high (≥7:1000) in highly seropositive populations. There is increasing evidence that the frequency and severity of the clinical and laboratory abnormalities in infants with congenital CMV infection born to mothers with nonprimary CMV infection are similar to infants born after a primary maternal infection. This is particularly true for sensorineural hearing loss, which contributes to one third of all early-onset hearing loss in seropositive populations. This brief overview will discuss the need for more research to better clarify the natural history of cCMV in highly seropositive populations, which, in almost all populations, remains incompletely defined.

Evaluation of the euthanasia of seropositive dogs for canine visceral leishmaniasis as the only method of controling the disease in the enzootic area in the Midwestern Minas Gerais / Avaliação da eutanásia de cães soro reagentes para leishmaniose visceral canina como único método de controle da doença em área enzoótica no Centro Oeste de Minas Gerais

Human Visceral Leishmaniasis (VL) is expanding, and it is distributed in the five geographic regions of Brazil, with the Northeast being the region that presents the most significant number of registered cases. The main urban reservoir of the etiological agent of VL is the domestic dog, and it is known that canine cases precede human cases. One of the control actions of VL, recommended by the Ministry of Health, is performing the euthanasia of seropositive dogs. In 2013, in the municipality of Iguatama/MG, the first canine serological survey was carried out in the city, with a prevalence of 8.3% of seropositive dogs for Leishmania infantum. Of the seropositive animals for Canine Visceral Leishmaniasis (CVL) in this survey, 84% were euthanized, and 16% died within two years after diagnosis. No other control measures for CVL were taken in the municipality. The objectives of the present study were to determine the current prevalence of seropositive dogs for CVL in the municipality of Iguatama and to observe the impact of euthanasia of seropositive dogs to VL as the only control measure performed in this municipality, which is considered an enzootic area of the disease. For this, a new canine epidemiological survey was carried out in the municipality of Iguatama, following the guidelines of the Manual of Surveillance and Control of Visceral Leishmaniasis. Blood samples were collected from 270 dogs and tested by DPP® immunochromatographic test and by Enzyme-Linked Immunosorbent Assay (ELISA). The animals that presented inconclusive results had new blood samples collected and analyzed. The only animal that showed a positive result in DPP® and undetermined in the ELISA, in the first evaluation, became seropositive four months later, so this study reinforces the recommendation of the Ministry of Health to reassess dogs that present inconclusive results for CVL. From a total of 270 samples, 21 (7.8%) were reagents in both tests. Thus, the prevalence of seropositive dogs for CVL, in 2017, in the urban area of the municipality of Iguatama was 7.8%. The Polymerase Chain Reaction-Restriction Fragment Length Polymorphism (PCR-RFLP) molecular technique confirmed infection by L. infantum in the ten dogs sampled with CVL-positive serology. The comparison between the current prevalence (after euthanasia) with that found in 2013 (8.3%), there was no significant difference (p=0.764). The prevalence of CVL in the urban area of the municipality of Iguatama is still high, making it possible to presume that the euthanasia of seropositive dogs for CVL, and the absence of monitoring or other interventions measures, did not contribute to decrease the transmission of the parasite and was not sufficient for the control of CVL in the municipality of Iguatama, an area considered as non-endemic to CVL until 2013.(AU)

A Leishmaniose visceral humana (LV) está em franca expansão e distribuída nas cinco regiões geográficas do Brasil, o Nordeste sendo a região em que há o maior número de casos registrados. O principal reservatório urbano do agente etiológico da LV é o cão doméstico e sabe-se que casos caninos antecedem o aparecimento de casos humanos. Uma das ações de controle da LV, preconizada pelo Ministério da Saúde, é a eutanásia dos cães soro reagentes. Em 2013, no município de Iguatama/MG, foi realizado o primeiro inquérito sorológico canino na cidade, sendo constatada uma prevalência de 8,3% de cães soro reagentes para Leishmania infantum. Dos animais com sorologia positiva para Leishmaniose visceral canina (LVC), neste inquérito, 84% foram eutanasiados e 16% foram a óbito em, no máximo, dois anos após o diagnóstico. Nenhuma outra medida de controle para LVC foi realizada no município. Os objetivos deste estudo foram determinar a prevalência atual de cães soro reagentes para LVC no município de Iguatama e observar o impacto das eutanásias de cães soro reagentes para LV como única medida de controle realizada neste município, considerado área enzoótica para a doença. Para isso, foi realizado um novo inquérito epidemiológico canino no município de Iguatama, seguindo as normas do Manual de Vigilância e Controle da Leishmaniose Visceral. Foram colhidas amostras sanguíneas de 270 cães que foram examinadas pelo teste imunocromatográfico DPP® e pelo ensaio imunoenzimático (ELISA). Os animais que apresentaram resultados inconclusivos tiveram novas amostras de sangue coletadas e analisadas. O único animal que apresentou resultado positivo no DPP® e indeterminado no ELISA, na primeira avaliação, soro converteu quatro meses depois, o que reforça a recomendação do Ministério da Saúde de reavaliar os cães que apresentam resultado inconclusivo para LVC. Do total das 270 amostras, 21 foram reagentes nos dois testes. Portanto, a prevalência de cães soro reagentes para LVC, em 2017, na área urbana do município de Iguatama foi igual a 7,8%. A infecção pela espécie Leishmania infantum foi confirmada através da técnica molecular de PCR-RFLP em 10 cães amostrados com sorologia positiva para LVC. A comparação entre a prevalência atual (depois das eutanásias) com a encontrada em 2013 (8,3%), não mostrou diferença significativa (p=0,764). Uma vez que a soro prevalência de LVC na área urbana do município de Iguatama ainda é alta, pode-se supor que a eutanásia dos cães soro reagentes para LVC, somada à ausência de monitoramento e de outras medidas de intervenção, não contribuiu para a diminuição da transmissão do parasito, e não foi suficiente para o controle de LVC no município de Iguatama, uma área considerada, até 2013, indene para LVC.(AU)

Evaluation of the euthanasia of seropositive dogs for canine visceral leishmaniasis as the only method of controling the disease in the enzootic area in the Midwestern Minas Gerais / Avaliação da eutanásia de cães soro reagentes para leishmaniose visceral canina como único método de controle da doença em área enzoótica no Centro Oeste de Minas Gerais

Human Visceral Leishmaniasis (VL) is expanding, and it is distributed in the five geographic regions of Brazil, with the Northeast being the region that presents the most significant number of registered cases. The main urban reservoir of the etiological agent of VL is the domestic dog, and it is known that canine cases precede human cases. One of the control actions of VL, recommended by the Ministry of Health, is performing the euthanasia of seropositive dogs. In 2013, in the municipality of Iguatama/MG, the first canine serological survey was carried out in the city, with a prevalence of 8.3% of seropositive dogs for Leishmania infantum. Of the seropositive animals for Canine Visceral Leishmaniasis (CVL) in this survey, 84% were euthanized, and 16% died within two years after diagnosis. No other control measures for CVL were taken in the municipality. The objectives of the present study were to determine the current prevalence of seropositive dogs for CVL in the municipality of Iguatama and to observe the impact of euthanasia of seropositive dogs to VL as the only control measure performed in this municipality, which is considered an enzootic area of the disease. For this, a new canine epidemiological survey was carried out in the municipality of Iguatama, following the guidelines of the Manual of Surveillance and Control of Visceral Leishmaniasis. Blood samples were collected from 270 dogs and tested by DPP® immunochromatographic test and by Enzyme-Linked Immunosorbent Assay (ELISA). The animals that presented inconclusive results had new blood samples collected and analyzed. The only animal that showed a positive result in DPP® and undetermined in the ELISA, in the first evaluation, became seropositive four months later, so this study reinforces the recommendation of the Ministry of Health to reassess dogs that present inconclusive results for CVL. From a total of 270 samples, 21 (7.8%) were reagents in both tests. Thus, the prevalence of seropositive dogs for CVL, in 2017, in the urban area of the municipality of Iguatama was 7.8%. The Polymerase Chain Reaction-Restriction Fragment Length Polymorphism (PCR-RFLP) molecular technique confirmed infection by L. infantum in the ten dogs sampled with CVL-positive serology. The comparison between the current prevalence (after euthanasia) with that found in 2013 (8.3%), there was no significant difference (p=0.764). The prevalence of CVL in the urban area of the municipality of Iguatama is still high, making it possible to presume that the euthanasia of seropositive dogs for CVL, and the absence of monitoring or other interventions measures, did not contribute to decrease the transmission of the parasite and was not sufficient for the control of CVL in the municipality of Iguatama, an area considered as non-endemic to CVL until 2013.(AU)

A Leishmaniose visceral humana (LV) está em franca expansão e distribuída nas cinco regiões geográficas do Brasil, o Nordeste sendo a região em que há o maior número de casos registrados. O principal reservatório urbano do agente etiológico da LV é o cão doméstico e sabe-se que casos caninos antecedem o aparecimento de casos humanos. Uma das ações de controle da LV, preconizada pelo Ministério da Saúde, é a eutanásia dos cães soro reagentes. Em 2013, no município de Iguatama/MG, foi realizado o primeiro inquérito sorológico canino na cidade, sendo constatada uma prevalência de 8,3% de cães soro reagentes para Leishmania infantum. Dos animais com sorologia positiva para Leishmaniose visceral canina (LVC), neste inquérito, 84% foram eutanasiados e 16% foram a óbito em, no máximo, dois anos após o diagnóstico. Nenhuma outra medida de controle para LVC foi realizada no município. Os objetivos deste estudo foram determinar a prevalência atual de cães soro reagentes para LVC no município de Iguatama e observar o impacto das eutanásias de cães soro reagentes para LV como única medida de controle realizada neste município, considerado área enzoótica para a doença. Para isso, foi realizado um novo inquérito epidemiológico canino no município de Iguatama, seguindo as normas do Manual de Vigilância e Controle da Leishmaniose Visceral. Foram colhidas amostras sanguíneas de 270 cães que foram examinadas pelo teste imunocromatográfico DPP® e pelo ensaio imunoenzimático (ELISA). Os animais que apresentaram resultados inconclusivos tiveram novas amostras de sangue coletadas e analisadas. O único animal que apresentou resultado positivo no DPP® e indeterminado no ELISA, na primeira avaliação, soro converteu quatro meses depois, o que reforça a recomendação do Ministério da Saúde de reavaliar os cães que apresentam resultado inconclusivo para LVC. Do total das 270 amostras, 21 foram reagentes nos dois testes. Portanto, a prevalência de cães soro reagentes para LVC, em 2017, na área urbana do município de Iguatama foi igual a 7,8%. A infecção pela espécie Leishmania infantum foi confirmada através da técnica molecular de PCR-RFLP em 10 cães amostrados com sorologia positiva para LVC. A comparação entre a prevalência atual (depois das eutanásias) com a encontrada em 2013 (8,3%), não mostrou diferença significativa (p=0,764). Uma vez que a soro prevalência de LVC na área urbana do município de Iguatama ainda é alta, pode-se supor que a eutanásia dos cães soro reagentes para LVC, somada à ausência de monitoramento e de outras medidas de intervenção, não contribuiu para a diminuição da transmissão do parasito, e não foi suficiente para o controle de LVC no município de Iguatama, uma área considerada, até 2013, indene para LVC.(AU)

Optimal dengue vaccination strategies of seropositive individuals.

The dengue vaccine, CYD-TDV (Dengvaxia), has been licensed in 20 countries in Latin America and Southeast Asia beginning in 2015. In April 2018, the World Health Organization (WHO) advised that CYD-TDV should only be administered to individuals with a history of previous dengue virus infection. Using literature-based parameters, a mathematical model of dengue transmission and vaccination was developed to determine the optimal vaccination strategy while considering the effect of antibody-dependent enhancement (ADE). We computed the optimal vaccination rates under various vaccination costs and serological profiles. We observe that the optimal dengue vaccination rates for seropositive individuals are highest at the initial phase of a vaccination program, requiring intense effort at the early phase of an epidemic. The model shows that even in the presence of ADE, vaccination could reduce dengue incidence and provide population benefits. Specifically, optimal vaccination rates increase with a higher proportion of monotypic seropositive individuals, resulting in a higher impact of vaccination. Even in the presence of ADE and with limited vaccine efficacy, our work provides a population-level perspective on the potential merits of dengue vaccination.

Access to sexual and reproductive health services for women living with HIV in Latin America and the Caribbean: systematic review of the literature.

INTRODUCTION: Systematic reviews show that women living with HIV (WLHIV) have high unmet sexual and reproductive health (SRH) needs due to barriers to access sexual and reproductive health services (SRHS). In Latin America and the Caribbean (LAC), as of 2016, there were nearly one million WLHIV, but the existing evidence of their SRH needs comes from a few individual studies. This systematic review provides an overview of these women's needs to help define new and/or adapt existing public health strategies to the local context. This review synthesizes the evidence from the literature on the use of and access to SRHS related to family planning, antenatal care, abortion services and violence against WLHIV in LAC. METHODS: Using a systematic review of mixed studies, a search was performed in MEDLINE, EMBASE, LILACS, INASP, POPLINE, SCOPUS, for studies conducted in LAC, from 2004 to 2017, as well as contact with authors and hand search as needed. Two independent reviewers evaluated the quality of the studies using the Mixed Methods Appraisal Tool; inclusion was conducted according to the PRISMA flow diagram. An exploratory narrative synthesis followed by quantitative synthesis data was undertaken. Group analysis or meta-analysis was not considered appropriate given the level of heterogeneity of the studies. RESULTS: A total of 18 studies in 13 LAC countries for a population of 5672 WLHIV were included. Data from individual studies reported unmet family planning needs; higher, but inconsistent use of condom as the sole contraceptive method OR=1.46 [1.26 to 1.69]; lesser use of other non-permanent contraceptive methods OR=0.26 [0.22 to 0.31]; more unplanned pregnancies OR=1.30 [1.02 to 1.66]; more induced abortions OR=1.96 [1.60 to 2.39]; higher risk of immediate postpartum sterilization; and higher exposure to sexual and institutional violence by WLHIV when compared with women without HIV. CONCLUSIONS: This review presents evidence from LAC about the SRH unmet needs of WLHIV that must be addressed by decreasing institutional and structural barriers, facilitating services and reducing stigma, and discrimination among healthcare providers to improve access to SRHS based on human rights, so women independently of their HIV status can make their own reproductive decisions, free of violence and coercion.

Mortality and Kidney Transplantation Outcomes Among Hepatitis C Virus-Seropositive Maintenance Dialysis Patients: A Retrospective Cohort Study.

RATIONALE & OBJECTIVE: Hepatitis C virus (HCV) infection is common among maintenance dialysis patients. Few studies have examined both dialysis survival and transplantation outcomes for HCV-seropositive patients because registry data sets lack information for HCV serostatus. STUDY DESIGN: Retrospective cohort study. SETTING & PARTICIPANTS: Adult long-term dialysis patients treated by a US national dialysis provider between January 1, 2004, and December 31, 2014. EXPOSURE: HCV antibody serostatus obtained as part of clinical data from a national dialysis provider. OUTCOMES: Mortality on dialysis therapy, entry onto the kidney transplant waiting list, kidney transplantation, and estimated survival benefit from kidney transplantation versus remaining on the waitlist. ANALYTICAL APPROACH: After linking clinical data with data from the Organ Procurement and Transplantation Network, Cox and cause-specific hazards regression were implemented to estimate the associations between HCV seropositivity and mortality, as well as entry onto the kidney transplant waitlist. Cox regression was also used to estimate the survival benefit from transplantation versus dialysis among HCV-seropositive individuals. RESULTS: Among 442,171 dialysis patients, 31,624 (7.2%) were HCV seropositive. HCV seropositivity was associated with a small elevation in the rate of death (adjusted HR [aHR], 1.09; 95% CI, 1.07-1.11) and a substantially lower rate of entry onto the kidney transplant waitlist (subdistribution HR [sHR], 0.67; 95% CI, 0.61-0.74). Once wait-listed, the kidney transplantation rate was not different for HCV-seropositive (sHR 1.10; 95% CI, 0.96-1.27) versus HCV-seronegative patients. HCV-seropositive patients lived longer with transplantation (aHR at 3 years, 0.42; 95% CI, 0.27-0.63). Receiving an HCV-seropositive donor kidney provided a survival advantage at the 2-year posttransplantation time point compared to remaining on dialysis therapy waiting for an HCV-negative kidney. LIMITATIONS: No data for HCV viral load or liver biopsy. CONCLUSIONS: HCV-seropositive patients experience reduced access to the kidney transplantation waitlist despite deriving a substantial survival benefit from transplantation. HCV-seropositive patients should consider foregoing HCV treatment while accepting kidneys from HCV-infected donors to facilitate transplantation and prolong survival.

Occurrence of antibodies against Neospora caninum in cattle and dogs from dairy farms from the central northern region of Paraná State / Ocorrência de anticorpos contra Neospora caninum em bovinos e cães oriundo de propriedades produtoras de leite do Norte Central do Estado do Paraná

Neosporosis is one of the principal causes of reproductive problems in cattle worldwide. The aim of this study was to evaluate the occurrence of anti-Neospora caninum antibodies in cattle and dogs from dairy farms from the central northern region of Paraná state. Blood samples with and without EDTA were collected from 400 cattle and 46 dogs from 20 properties. Nested polymerase chain reaction (n-PCR) was performed on whole blood samples and indirect immunofluorescence reaction (IFR) on the serum samples (after clot retraction). Cattle and dogs with titers ? 100 and ? 50, respectively, were considered positive. Anti-N. caninum was detected in 20,1% (80/400) of cattle, with titers ranging from 100 to 1600. The n-PCR presented only two cattle positives (0.5%). Anti-N. caninum was detected in 19,6% (9/46) of the dogs, with titers ranging from 50 to 6400. The occurrence of antibodies against N. caninum obtained in the present study was similar to those in studies performed in other regions of Paraná and Brazil. The probability of detecting parasitemia in epidemiological studies is a rare event.(AU)

A neosporose é uma das principais causas de abortamentos em bovinos no mundo todo. O objetivo do presente estudo foi avaliar a ocorrência de anticorpos contra Neospora caninum em soros de bovinos de leite e cães provenientes de propriedades da região centro norte do estado do Paraná. Sangue com e sem EDTA foram colhidos de 400 bovinos e de 46 cães provenientes de 20 propriedades. Para detecção de anticorpos contra N. caninum a Reação de Imunofluorescência Indireta (RIFI) foi realizada, e bovinos e cães foram considerados positivos quando apresentaram títulos ? 100 e ? 50, respectivamente. Anticorpos contra-N. caninum foram detectados em 20,1% (80/400) dos bovinos, cujos títulos variaram de 100 a 1600. A n-PCR apresentou apenas dois animais positivos (0,5%) para os bovinos. Dos 46 cães estudados 19,6% (9/46) foram considerados positivos na RIFI, com títulos variando de 50 a 6400. Os resultados permitem concluir que a ocorrência de anticorpos contra N. caninum em bovinos e cães na mesorregião centro norte do Paraná foram semelhantes aos observados em outras mesorregiões do Paraná. A n-PCR de sangue total revelou uma baixa positividade em bovinos e cães, mostrando que a probabilidade de se detectar parasitemia em estudos epidemiológicos é baixa.(AU)

Occurrence of antibodies against Neospora caninum in cattle and dogs from dairy farms from the central northern region of Paraná State / Ocorrência de anticorpos contra Neospora caninum em bovinos e cães oriundo de propriedades produtoras de leite do Norte Central do Estado do Paraná

Neosporosis is one of the principal causes of reproductive problems in cattle worldwide. The aim of this study was to evaluate the occurrence of anti-Neospora caninum antibodies in cattle and dogs from dairy farms from the central northern region of Paraná state. Blood samples with and without EDTA were collected from 400 cattle and 46 dogs from 20 properties. Nested polymerase chain reaction (n-PCR) was performed on whole blood samples and indirect immunofluorescence reaction (IFR) on the serum samples (after clot retraction). Cattle and dogs with titers ? 100 and ? 50, respectively, were considered positive. Anti-N. caninum was detected in 20,1% (80/400) of cattle, with titers ranging from 100 to 1600. The n-PCR presented only two cattle positives (0.5%). Anti-N. caninum was detected in 19,6% (9/46) of the dogs, with titers ranging from 50 to 6400. The occurrence of antibodies against N. caninum obtained in the present study was similar to those in studies performed in other regions of Paraná and Brazil. The probability of detecting parasitemia in epidemiological studies is a rare event.

A neosporose é uma das principais causas de abortamentos em bovinos no mundo todo. O objetivo do presente estudo foi avaliar a ocorrência de anticorpos contra Neospora caninum em soros de bovinos de leite e cães provenientes de propriedades da região centro norte do estado do Paraná. Sangue com e sem EDTA foram colhidos de 400 bovinos e de 46 cães provenientes de 20 propriedades. Para detecção de anticorpos contra N. caninum a Reação de Imunofluorescência Indireta (RIFI) foi realizada, e bovinos e cães foram considerados positivos quando apresentaram títulos ? 100 e ? 50, respectivamente. Anticorpos contra-N. caninum foram detectados em 20,1% (80/400) dos bovinos, cujos títulos variaram de 100 a 1600. A n-PCR apresentou apenas dois animais positivos (0,5%) para os bovinos. Dos 46 cães estudados 19,6% (9/46) foram considerados positivos na RIFI, com títulos variando de 50 a 6400. Os resultados permitem concluir que a ocorrência de anticorpos contra N. caninum em bovinos e cães na mesorregião centro norte do Paraná foram semelhantes aos observados em outras mesorregiões do Paraná. A n-PCR de sangue total revelou uma baixa positividade em bovinos e cães, mostrando que a probabilidade de se detectar parasitemia em estudos epidemiológicos é baixa.

Anti-Neospora caninum antibodies among dairy cattle in a rural settlement, Paraná, Brazil / Prevalência de anticorpos anti-Neospora caninum em bovinos leiteiros de um assentamento rural, Paraná, Brazil

The aim of the present study was to evaluate the seroprevalence of antibodies against Neospora caninum, obtained two years apart, among dairy cattle in a rural settlement in southern Brazil. Blood samples from 734 dairy cattle on 41 farms were collected at two different times: in 2012, 406 animals on 30 farms were used; and in 2014, 329 animals on 31 farms. Serum samples were obtained and were used to detect antibodies against N. caninum, by means of the indirect fluorescence assay (IFA). Animals with titers ≥ 100 were considered positive. The total serum prevalence of anti-N. caninum antibodies was 19.7% (145/736) among all the dairy cattle, comprising 23.1% (94/406) in 2012 and 15.5% (51/329) in 2014. Serum from 91 animals was tested in both trials: 11(12.1%) showed positivity in 2012 and 10 (11%) in 2014. The variables of age, sex and breed did not show any associations with seropositivity. Thus, we showed that the cattle in this settlement presented high levels of antibodies against N. caninum, and that IFA showed good efficacy for epidemiological studies.(AU)

O objetivo deste estudo foi avaliar a soroprevalência de anticorpos contra Neospora caninum em bovinos de leite de um assentamento rural, região sul do Brasil. Participaram do estudo um total de 734 bovinos de leite, 406 animais de 30 propriedades coletados em 2012, e 329 animais de 31 propriedades em 2014. Amostras de soro foram analisadas por meio da Reação de Imunofluorescência Indireta (RIFI), animais com títulos ≥100 foram considerados positivos. A soroprevalência total para anticorpos contra N. caninum foi 19,7% (145/736), 23,1 % (94/406) e 15,5% (51/329) em 2012 e 2014, respectivamente. Noventa e um animais tiveram amostras analisadas em ambos estudos, 11(12,1%) evidenciaram positividade em 2012 e 10 (11%) em 2014. Não houveram associações entre as variáveis estudadas (idade, sexo e raças) com a soropositividade para neosporose. Evidenciou-se com o presente estudo um alto nível de anticorpos contra N. caninum nos bovinos desse assentamento rural, bem como, a RIFI utilizada mostrou boa eficácia para estudos epidemiológicos.(AU)

Anti-Neospora caninum antibodies among dairy cattle in a rural settlement, Paraná, Brazil / Prevalência de anticorpos anti-Neospora caninum em bovinos leiteiros de um assentamento rural, Paraná, Brazil

The aim of the present study was to evaluate the seroprevalence of antibodies against Neospora caninum, obtained two years apart, among dairy cattle in a rural settlement in southern Brazil. Blood samples from 734 dairy cattle on 41 farms were collected at two different times: in 2012, 406 animals on 30 farms were used; and in 2014, 329 animals on 31 farms. Serum samples were obtained and were used to detect antibodies against N. caninum, by means of the indirect fluorescence assay (IFA). Animals with titers ? 100 were considered positive. The total serum prevalence of anti-N. caninum antibodies was 19.7% (145/736) among all the dairy cattle, comprising 23.1% (94/406) in 2012 and 15.5% (51/329) in 2014. Serum from 91 animals was tested in both trials: 11(12.1%) showed positivity in 2012 and 10 (11%) in 2014. The variables of age, sex and breed did not show any associations with seropositivity. Thus, we showed that the cattle in this settlement presented high levels of antibodies against N. caninum, and that IFA showed good efficacy for epidemiological studies.

O objetivo deste estudo foi avaliar a soroprevalência de anticorpos contra Neospora caninum em bovinos de leite de um assentamento rural, região sul do Brasil. Participaram do estudo um total de 734 bovinos de leite, 406 animais de 30 propriedades coletados em 2012, e 329 animais de 31 propriedades em 2014. Amostras de soro foram analisadas por meio da Reação de Imunofluorescência Indireta (RIFI), animais com títulos ?100 foram considerados positivos. A soroprevalência total para anticorpos contra N. caninum foi 19,7% (145/736), 23,1 % (94/406) e 15,5% (51/329) em 2012 e 2014, respectivamente. Noventa e um animais tiveram amostras analisadas em ambos estudos, 11(12,1%) evidenciaram positividade em 2012 e 10 (11%) em 2014. Não houveram associações entre as variáveis estudadas (idade, sexo e raças) com a soropositividade para neosporose. Evidenciou-se com o presente estudo um alto nível de anticorpos contra N. caninum nos bovinos desse assentamento rural, bem como, a RIFI utilizada mostrou boa eficácia para estudos epidemiológicos.

Anti-Neospora caninum antibodies among dairy cattle in a rural settlement, Paraná, Brazil / Prevalência de anticorpos anti-Neospora caninum em bovinos leiteiros de um assentamento rural, Paraná, Brazil

The aim of the present study was to evaluate the seroprevalence of antibodies against Neospora caninum, obtained two years apart, among dairy cattle in a rural settlement in southern Brazil. Blood samples from 734 dairy cattle on 41 farms were collected at two different times: in 2012, 406 animals on 30 farms were used; and in 2014, 329 animals on 31 farms. Serum samples were obtained and were used to detect antibodies against N. caninum, by means of the indirect fluorescence assay (IFA). Animals with titers ≥ 100 were considered positive. The total serum prevalence of anti-N. caninum antibodies was 19.7% (145/736) among all the dairy cattle, comprising 23.1% (94/406) in 2012 and 15.5% (51/329) in 2014. Serum from 91 animals was tested in both trials: 11(12.1%) showed positivity in 2012 and 10 (11%) in 2014. The variables of age, sex and breed did not show any associations with seropositivity. Thus, we showed that the cattle in this settlement presented high levels of antibodies against N. caninum, and that IFA showed good efficacy for epidemiological studies.

O objetivo deste estudo foi avaliar a soroprevalência de anticorpos contra Neospora caninum em bovinos de leite de um assentamento rural, região sul do Brasil. Participaram do estudo um total de 734 bovinos de leite, 406 animais de 30 propriedades coletados em 2012, e 329 animais de 31 propriedades em 2014. Amostras de soro foram analisadas por meio da Reação de Imunofluorescência Indireta (RIFI), animais com títulos ≥100 foram considerados positivos. A soroprevalência total para anticorpos contra N. caninum foi 19,7% (145/736), 23,1 % (94/406) e 15,5% (51/329) em 2012 e 2014, respectivamente. Noventa e um animais tiveram amostras analisadas em ambos estudos, 11(12,1%) evidenciaram positividade em 2012 e 10 (11%) em 2014. Não houveram associações entre as variáveis estudadas (idade, sexo e raças) com a soropositividade para neosporose. Evidenciou-se com o presente estudo um alto nível de anticorpos contra N. caninum nos bovinos desse assentamento rural, bem como, a RIFI utilizada mostrou boa eficácia para estudos epidemiológicos.

Peru-15 (Choleragarde(®)), a live attenuated oral cholera vaccine, is safe and immunogenic in human immunodeficiency virus (HIV)-seropositive adults in Thailand.

BACKGROUND: Many areas with endemic and epidemic cholera report significant levels of HIV transmission. According to the World Health Organization (WHO), over 95% of reported cholera cases occur in Africa, which also accounts for nearly 70% of people living with HIV/AIDS globally. Peru-15, a promising single dose live attenuated oral cholera vaccine (LA-OCV), was previously found to be safe and immunogenic in cholera endemic areas. However, no data on the vaccine's safety among HIV-seropositive adults had been collected. METHODS: This study was a double-blinded, individually randomized, placebo-controlled trial enrolling HIV-seropositive adults, 18-45 years of age, conducted in Bangkok, Thailand, to assess the safety of Peru-15 in a HIV-seropositive cohort. RESULTS: 32 HIV infected subjects were randomized to receive either a single oral dose of the Peru-15 vaccine with a buffer or a placebo (buffer only). No serious adverse events were reported during the follow-up period in either group. The geometric mean fold (GMF) rise in V. cholerae O1 El Tor specific antibody titers between baseline and 7 days after dosing was 32.0 (p<0.001) in the vaccine group compared to 1.6 (p<0.14) in the placebo group. Among the 16 vaccinees,14 vaccinees (87.5%) had seroconversion compared to 1 of 16 placebo recipients (6.3%). V. cholerae was isolated from the stool of one vaccinee, and found to be genetically identical to the Peru-15 vaccine strain. There were no significant changes in HIV viral load or CD4 T-cell counts between vaccine and placebo groups. CONCLUSION: Peru-15 was shown to be safe and immunogenic in HIV-seropositive Thai adults.

Representações Sociais do HIV/AIDS e da morte produzidos por idosos soropositivos e de seus cuidadores

A população idosa encontrava-se “imune” ao HIV/AIDS. No entanto, com o surgimento de medicamentos que devolvem ao homem idoso sua potência sexual, aliado ao conceito de envelhecimento ativo, notou-se que o comportamento sexual havia se alterado e com isso a HIV/AIDS chegou à terceira idade. Outro aspecto a ser considerado é a demora dos cuidadores formais em detectar indícios de que o idoso apresenta HIV/AIDS, sendo este diagnóstico realizado depois de descartada uma lista de outras enfermidades que mais acometem essa faixa etária. Diante do exposto, e tendo como aporte teórico-metodológico as Representações Sociais (RS), o objetivo deste estudo foi apreender as RS que pessoas idosas soropositivas, cuidadores formais e cuidadores informais produzem sobre o viver, o conviver e a morte no contexto do HIV/AIDS. Método: Utilizou-se amostragem não probabilística, tipo acidental, na qual foram analisadas nove pessoas idosas; dez cuidadores formais que lidam diretamente com pacientes soropositivos e, por fim, três cuidadores informais. A coleta dos dados foi realizada utilizando-se entrevistas semiestruturadas que foram gravadas. A análise foi realizada com o software ALCEST. Resultados e discussão: A RS trazida pelas pessoas idosas soropositivas foi de um HIV/AIDS que traz um sentimento negativo, principalmente no momento da descoberta, onde a questão da morte é levantada como uma possibilidade de desenrolar da doença. A morte é associada ao diagnóstico e também traz um sentimento de tristeza e de estranhamento. Para o cuidador formal a RS do HIV/AIDS está atrelada ao conhecimento científico vigente. Já sobre a morte os cuidadores formais a retratam como um evento de sofrimento intenso e difícil de se aceitar, mesmo ela se fazendo presente em sua vida quase diariamente. Os cuidadores informais trazem o HIV/AIDS como marco para o cuidado ao idoso e com esse cuidado uma mudança em suas vidas que agora precisa se dividir entre o cuidado e as outras atividades. (AU)

The elderly population was “immune “to HIV/AIDS. However, With the emergence of drugs that return to the old man his sexual potency, Coupled with the concept of active aging, it was noted that sexual behavior had changed and with it the HIV/AIDS arrived in the elderly. Another aspect to be considered is the delay of formal caregivers to detect evidence that the elderly presents HIV/AIDS, and this diagnosis was made after discarded a list of other diseases that most affect this age group. Given the above, and with the theoretical and methodological contributions to social representations (SR) The aim of this study was to understand that SR seropositive elderly, Caregivers formal and informal caregivers have on the living, live and death in the context of HIV/AIDS. Method: We used non-probability sampling, accidental kind, where nine elderly people were analyzed, ten formal caregivers who deal directly with patients seropositive and finally, three informal caregivers. Data collection was performed using semi-structured interviews that were recorded. The analysis was performed with the software ALCEST. Results and discussion: The RS brought by seropositive elderly was an HIV/AIDS that brings a negative feeling, especially at the time of discovery, where the issue of death is raised as a possibility to conduct disease. Death is associated with the diagnosis and also brings a feeling of sadness and strangeness. For the caregiver RS HIV/AIDS is linked to current scientific knowledge. Already on death formal caregivers to portray as an event of intense and difficult to accept suffering, she even doing this in his life almost daily. (AU)

O Psicólogo no hospital e o paciente soropositivo: breve recorte do estágio profissional em um Hospital Geral no Oeste da Bahia / Psychologist and seropositive patient in hospital: brief cutout traineeship in a General Hospital in Western Bahia

Para atender às novas exigências, principalmente no que diz respeito à atuação recente do psicólogo no hospital, foi preciso que inicialmente se compreendesse o novo conceito que se tem de saúde e como esse conceito influencia a inserção no contexto hospitalar. A figura do psicólogo tornou-se importante dentro do ambiente hospitalar, desde que o conceito de saúde foi reformulado, e passou a ser visto numa perspectiva mais abrangente, incluindo também o bem-estar físico e mental. Diante do exposto, este artigo tem o objetivo de refletir sobre o ambiente hospitalar como espaço de atuação também dos psicólogos e, sobretudo,acerca do manejo clínico com pacientes soropositivos. É comum que estes pacientes neguem seu diagnóstico; assim, o psicólogo deve observar que há razões para que se utilize desta defesa e possa intervir de modo satisfatório, tanto para benefício do paciente quanto da equipe. Este artigo se desenvolveu a partir de breves recortes da experiência de estágio profissional em psicologia da saúde em um Hospital Geral no Oeste da Bahia.

To meet the new requirements, especially regarding the recent performance of the psychologist in the hospital it was initially necessary to understand the new concept of health and how this concept influences to his insertion in the hospital. The figure of the psychologist became important in the hospital environment, since the concept of health has been redesigned and is now seen in a broader perspective including also the mental and physical well being. Given the above, this article aims to reflect on the hospital as a performance space also for psychologists, and especially about the clinical management seropositive patients. It is common for these patients to deny their diagnosis so the psychologist should observe that there are reasons for them to use this defense and can intervene in a satisfactory manner, so as to benefit the patient himself and the team. This article was developed from brief excerpts from professional internship experience in health psychology in a General Hospital in Western Bahia.

O Psicólogo no hospital e o paciente soropositivo: breve recorte do estágio profissional em um Hospital Geral no Oeste da Bahia / Psychologist and seropositive patient in hospital: brief cutout traineeship in a General Hospital in Western Bahia

Para atender às novas exigências, principalmente no que diz respeito à atuação recente do psicólogo no hospital, foi preciso que inicialmente se compreendesse o novo conceito que se tem de saúde e como esse conceito influencia a inserção no contexto hospitalar. A figura do psicólogo tornou-se importante dentro do ambiente hospitalar, desde que o conceito de saúde foi reformulado, e passou a ser visto numa perspectiva mais abrangente, incluindo também o bem-estar físico e mental. Diante do exposto, este artigo tem o objetivo de refletir sobre o ambiente hospitalar como espaço de atuação também dos psicólogos e, sobretudo,acerca do manejo clínico com pacientes soropositivos. É comum que estes pacientes neguem seu diagnóstico; assim, o psicólogo deve observar que há razões para que se utilize desta defesa e possa intervir de modo satisfatório, tanto para benefício do paciente quanto da equipe. Este artigo se desenvolveu a partir de breves recortes da experiência de estágio profissional em psicologia da saúde em um Hospital Geral no Oeste da Bahia. (AU)

To meet the new requirements, especially regarding the recent performance of the psychologist in the hospital it was initially necessary to understand the new concept of health and how this concept influences to his insertion in the hospital. The figure of the psychologist became important in the hospital environment, since the concept of health has been redesigned and is now seen in a broader perspective including also the mental and physical well being. Given the above, this article aims to reflect on the hospital as a performance space also for psychologists, and especially about the clinical management seropositive patients. It is common for these patients to deny their diagnosis so the psychologist should observe that there are reasons for them to use this defense and can intervene in a satisfactory manner, so as to benefit the patient himself and the team. This article was developed from brief excerpts from professional internship experience in health psychology in a General Hospital in Western Bahia.(AU)

Comportamiento de la epidemia de VIH en Cuba / Behavior of the HIV epidemics in Cuba

Introducción: La infección por el VIH/sida es considerada un problema de la salud pública a nivel mundial. Los primeros diagnósticos ocurrieron en 1981 y desde entonces el número de infectados se ha incrementado. Cuba no está ajena a este fenómeno y se continúa trabajando para detener el avance de la epidemia en el país. Objetivo: Caracterizar el comportamiento de la epidemia de VIH en Cuba y elaborar un modelo pronóstico para los próximos años. Métodos: El universo estuvo constituido por todos los diagnósticos de personas de nacionalidad cubana infectadas por el VIH desde 1986 hasta 2010. La información fue obtenida de la base de datos de VIH/sida del Ministerio de Salud Pública de Cuba. Se analizó la epidemia tomando en cuenta los componentes de la serie cronológica. Para la modelación del pronóstico se empleó el alisamiento exponencial con dos parámetros. Para el procesamiento y análisis se utilizaron los paquetes estadísticos SPSS versión 11.5, Statistic versión 6.0, Econometric Views versión 4.0 y el programa MapInfo Profesional versión 7.5. Resultados: Se consideró que no existió aleatoriedad en la serie cronológica, pero sí que existía un patrón cíclico. La tasa de incidencia de VIH presentó una tendencia ascendente, aumentando un 90,70 % con respecto a los años extremos de la serie. La relación hombre/mujer se presentó como una mujer diagnosticada por cada 4 hombres. El 56,87 % de los diagnosticados eran homobisexuales, la mayoría del sexo masculino. El grupo de edades más afectado fue el de 20-24 años. La capital del país reportó la mayor tasa de incidencia de casos. Los municipios más afectados son urbanos y de alta densidad poblacional. Conclusiones: La incidencia del diagnóstico de personas VIH positivas mantiene una tendencia ascendente a expensas de los hombres que tienen sexo con otros hombres. El grupo de edades con mayor incidencia corresponden al de 20 a 24 años. La mayor cantidad de casos generalmente provenía de regiones urbanas y densamente pobladas.

Introduction: The HIV/AIDS infection is considered a public health problem around the world. The firsts diagnostics were made in 1981, and since that the number of infected persons has increased. Cuba is not free from to this phenomenon and we continue working to stop the advance of the epidemics in the country. Objective: Characterizing the behavior of the HIV epidemics in Cuba and making a prognostic model for the following years. Methods: The universe was formed by all the diagnoses of Cuban people infected with the HIV between 1986 and 2010. Data were obtained from the HIV/AIDS data base of the Public health Ministry of Cuba. We analyzed the epidemics taking into account the components of the chronologic series. For making the model of the prognostic we used the exponential smoothening with two parameters. For processing and analyzing data we used the statistic packages SPSS version 11.5, Statistic version 6.0, Econometric Views version 4.0 and the program MapInfo Professional Version 7.5. Results: We considered that there was not any randomization in the chronologic series, but there it was a cyclic pattern. The HIV incidence rate showed a growing tendency, increasing 90,70 % with respect of the extreme years of the series. The relation man/woman was one woman diagnosed per four men. The 56,87 % of the diagnosed people were homo-bisexual ones, most of them male. The most affected age group was the 20-24 years-old group. The capital of the country reported the biggest incidence rate of cases. The most affected municipalities were urban and had a high population density. Conclusions: The incidence of the HIV positive people's diagnosis maintains an increasing tendency due to the men having sex with other men. The age group with higher incidence is the 20-24 years-old one. The bigger quantity of the cases stems from urban and densely populated regions.

Diversity and uncommon HPV types in HIV seropositive and seronegative women attending an STI clinic

Given the causal relationship between specific types of HPV with cervical cancer and precursor lesions, it is important to identify the viral type involved. The aim of this study is to access the prevalence of HPV types in HIV seropositive and seronegative women. Accordingly, 77 HPV positive cervical samples were obtained from 284 women (seropositive (n=112) and seronegative (n=172) for HIV) who attended a Sexually Transmitted Infection clinic, in Vitoria, Southeastern Brazil. Viral DNA was amplified by PCR using MY09/MY11 degenerated primers and the genotyping was performed by Restriction Fragment Length Polymorphism. Seventy five out of the 77 HPV samples were genotyped: 6, 11, 13, 16, 18, 26, 31, 31b, 32, 33, 34, 35, 52, 53, 55, 56, 58, 59, 61, 62, 64, 66, 71, 81, 83, 84. The most prevalent type was HPV16 followed by HPV types 6, 11 and 53. Fifty five percent and 45 percent belonged to high and low risk types, respectively. High risk types corresponded to 59 percent and 54.5 percent of the HPV detected in HIV seronegative and seropositive women, respectively. The uncommon HPV 13 type in cervical samples was also observed in this study. The oncogenic types were more common in the HIV seronegative samples and the number of cases with multiple infections was similar for the two groups. HPV typing is not only important clinically for the establishment of monitoring and treatment of a patient, it also provides knowledge of the viral types circulating in a population, which is of interest in the development of prevention and treatment programs for this disease.

Niñez afectada con VIH/SIDA: información sobre VIH/SIDA en cinco ciudades colombianas / Children affected with HIV/AIDS: information of HIV/AIDS in five Colombian cities

Objectives: To describe information about HIV/AIDS in a youth population under 18 years of age affected with HIV/AIDS and caregivers in five Colombian cities: Cali, Buenaventura, Barranquilla, Santa Marta, and Cartagena. Methods: 286 personal surveys were conducted: 11 of children who were aware of their status of involvement with HIV/AIDS and 275 of caregivers of children who did not know their status of involvement with HIV/AIDS. The surveys were conducted in health institutions in the State and private sectors and private, using instruments in line with training programs from participating institutions to inquire about HIV/AIDS. Descriptive analysis was performed of the data and tabulation was done with the SPSS program. Results: Most children who knew their status of involvement with HIV/AIDS report that by acquiring the HIV virus, they may develop other diseases; however, half of these fail to recognize that AIDS weakens the body’s ability to fight infection. The children surveyed partly recognized the HIV/AIDS transmission and treatment mechanisms, while caregivers possess adequate information on the disease. We found reasons to delay the delivery of diagnosis by caregivers 96.2% (N=275) related to avoiding psychological harm to the children, and that if they were to know said status, they might inadvertently disclose this to others, probably exposing them to stigma and/or discrimination. Likewise, professionals providing health services to HIV seropositive children express lack of training regarding the proper procedure and age to reveal such information. Conclusions: It is a priority to enhance the capacity, information, and education of patients about effects, characteristics, manifestations, and treatment of the disease within the comprehensive health management processes conducive to supporting affected families.

Objetivos: Describir información sobre VIH/SIDA en población infantil afectada y menor de 18 años y cuidadores en cinco ciudades colombianas: Cali, Buenaventura, Barranquilla, Santa Marta y Cartagena. Métodos: Se realizaron 286 encuestas personales: 11 a menores que conocían su situación de afectación para VIH/SIDA y 275 a cuidadores de menores que no conocían su situación. Las encuestas se llevaron a cabo en instituciones de salud de los sectores estatal y privado. Se usaron instrumentos que estuvieran de acuerdo con programas de capacitación de las instituciones participantes para indagar sobre VIH/SIDA. Se realizó un análisis descriptivo de los datos y tabulación en SPSS. Resultados: La mayoría de los menores que conocían su situación de afectación para VIH/SIDA sostiene que al adquirir el virus del VIH pueden contraer otras enfermedades. No obstante, la mitad no reconoce que el sida debilita la capacidad del cuerpo para combatir las infecciones. Los menores reconocen parcialmente los mecanismos de transmisión y tratamiento del VIH/SIDA mientras que los cuidadores poseen información adecuada con respecto a la enfermedad. Se encontraron razones para retrasar la entrega del diagnóstico por parte de cuidadores [96.2% (N=275)] relacionadas con evitar daño psicológico al menor y que éste, al conocer su condición, la revele de manera involuntaria a otras personas, lo que probablemente lo exponga a estigma o a la discriminación. Asimismo, los profesionales que brindan servicios de salud a los menores seropositivos para VIH, expresan falta de capacitación con respecto al procedimiento y edad para revelar esta información. Conclusiones: Es prioritario fortalecer las capacidades, información y educación de los pacientes sobre efectos de la enfermedad, características, manifestaciones y tratamiento dentro del manejo integral en salud que favorezca procesos de apoyo a familias afectadas.