Mercurio en cabello de diferentes grupos ocupacionales en una zona de minería aurifera en el Norte de Colombia

Análisis de mercurio en cabello fue realizado a 219 personas que habitan en la principal zona de minería del oro en Colombia, tomando 27 personas de la ciudad de Cartagena, como muestra Control. Para el análisis de los datos, la muestra estudiada se dividió de acuerdo con la ocupación de las personas, encontrándose concentraciones medias (±DE) de 5,23±5,78, 2,83±3,27, 2,40±2,02 y 1,33±0,74 µg/g de mercurio en cabello, para pescadores, mineros, personas dedicadas a otras actividades y grupo control respectivamente. De acuerdo con el análisis de varianza y el test de Newman Keuls, existe diferencia significativa (p<0,01) para las concentraciones de mercurio observadas entre pescadores y los demás grupos. No se presentaron diferencias significativas de mercurio en cabello de acuerdo con el sexo, tampoco se detectó correlación con la edad, no obstante se observó una ligera correlación positiva (R=0,15, p<0,01) con la frecuencia en el consumo de pescado. Los principales síntomas de intoxicación mercurial encontrados entre la población expuesta fueron cefalea, náuseas, lesiones orales, gusto metálico, pérdida de memoria e irritabilidad.

Prevención en fonoaudiólogos de la Universidad del Valle en Cali, Colombia

INTRODUCCIÓN: Un curriculo de formación en fonoaudiología, idealmente, contempla fundamentación teórica-prática para el abordaje preventivo de desordenes de comunicación humana presentes en usuarios de serviços profesionales. Para explorar la coherencia de lo propuesto por un plan de estudios y las prácticas preventivas en el ejercicio profesional, se vinculó a los graduados del programa de estudios en fonoaudiologia de la Universidad del Valle con sede en la ciudad de Cali - Colombia. METODOLOGÍA: Se formuló un estudio descriptivo; 45 profisionales que cumplieron criterios de graduación, residencia y con ejercicio comprobado en la ciudad al momento del estudio, respondieron entre enero y abril de 1995 a un cuestionario autoadministrado de 13 items, formulados y validados según objetivos del estudio; referidos a variable laborales, ocupacionales y profesionales para describir y analizar la distribución del grupo según campo de ocupación, lugar de trabajo, tipo de institución a la que estam vinculados, grupo etáreo y área de comunicación humana en la que ejercían su prática professional; abordar el origen intra o extracurricular de sus conocimientos en prevención y la utilización-frequencia de estrategias y acciones específicas de prevención en las áreas de voz-habla, audición, lenguaje y aprendizaje. RESULTADOS: El 67% reconoció el plan de estudios como fuente relevante de sus conocimientos preventivos. Un 47% de profesionales usaba solo una entre nueve estrategias preventivas viables; un 29% afirmó haber usado maximo dos de tales alternativas de intervencíon. Para todas las areas de comunicación, en media, cerca del 60% de fonoaudiólogos nunca incorporó acciones preventivas de ninguna categoría. CONCLUSIÓN: La mayoría del grupo estudiado no incorpora en su ejercicio profesional estrategias ni acciones preventivas de desordenes de comunicación del modo propuesto en el perfil curricular, como es socialmente esperado, a pesar de reconocer los aportes teorico-praticos preventivos recibidos durante su formación académica. Se sugiere que determinantes del mercado laboral y de la demanda de servicios fonoaudiológicos impiden la incorporación de práticas preventivas habituales.

Infestación por triatominos en comunidades indígenas de Valledupar, Colombia

OBJETIVO: Calcular los índices infestación por triatominos en comunidades indígenas en Colombia. MÉTODOS: Se realizó estudio descriptivo en 19 comunidades indígenas del municipio de Valledupar Departamento de Cesar, Colombia. Durante junio a diciembre de 2007 se recolectaron triatominos por búsqueda activa en las viviendas de los indígenas. Los insectos luego fueron identificados por las claves de Lent & Wygodzinsky. Se desarrolló estudio del proceso infectivo en modelo animal y análisis enzimático de cepas de Trypanosoma cruzi, detectadas en heces de triatominos. RESULTADOS: Rhodnius prolixus presentó índice de densidad en las viviendas de 154,7%, Triatoma dimidiata de 102,45%, Triatoma maculata de 109,25% y Panstrogylus geniculatus de 0,3%. El índice promedio de infestación de las cuatro especies fue de 40,54% y, el de infección con T. cruzi de 9,4%. De cinco hemocultivos positivos para T. cruzi, tres se caracterizaron por isoenzimas, clasificándose en T. cruzi grupo I. El estudio de las biopsias reveló pocas características patológicas durante el proceso de infección con las cepas de T. cruzi aisladas de triatominos domiciliados. CONCLUSIÓN: Los altos índices de infestación por triatominos en las viviendas y el índice de infección por T. cruzi, evidencian la transmisión activa de la enfermedad de Chagas, situación que amerita la aplicación de medidas de control vectorial y el estudio seroepidemilógico de la población en riesgo. La identificación de las cepas de T. cruzi como grupo I concuerda con otros estudios realizados en esta región colombiana.

Evaluation of dengue fever reports during an epidemic, Colombia

OBJECTIVE To assess the validity of dengue fever reports and how they relate to the definition of case and severity. METHODS Diagnostic test assessment was conducted using cross-sectional sampling from a universe of 13,873 patients treated during the fifth epidemiological period in health institutions from 11 Colombian departments in 2013. The test under analyses was the reporting to the National Public Health Surveillance System, and the reference standard was the review of histories identified by active institutional search. We reviewed all histories of patients diagnosed with dengue fever, as well as a random sample of patients with febrile syndromes. The specificity and sensitivity of reports were estimated for this purpose, considering the inverse of the probability of being selected for weighting. The concordance between reporting and the findings of the active institutional search was calculated using Kappa statistics. RESULTS We included 4,359 febrile patients, and 31.7% were classified as compatible with dengue fever (17 with severe dengue fever; 461 with dengue fever and warning signs; 904 with dengue fever and no warning signs). The global sensitivity of reports was 13.2% (95%CI 10.9;15.4) and specificity was 98.4% (95%CI 97.9;98.9). Sensitivity varied according to severity: 12.1% (95%CI 9.3;14.8) for patients presenting dengue fever with no warning signs; 14.5% (95%CI 10.6;18.4) for those presenting dengue fever with warning signs, and 40.0% (95%CI 9.6;70.4) for those with severe dengue fever. Concordance between reporting and the findings of the active institutional search resulted in a Kappa of 10.1%. CONCLUSIONS Low concordance was observed between reporting and the review of clinical histories, which was associated with the low reporting of dengue fever compatible cases, especially milder cases.

Clinical and laboratory findings of Plasmodium vivax malaria in Colombia, 2001

A descriptive study was carried out in 104 patients with Plasmodium vivax malaria, from the region of Turbo (Antioquia, Colombia). Clinical features and levels of hemoglobin, glycemia, serum bilirubin, alanine-aminotransferase (ALT), aspartate-aminotransferase (AST), creatinine and complete blood cell profile were established. 65% of the studied individuals were men and their mean age was 23. Of all individuals 59% had lived in the region for > 1 year and 91% were resident in the rural area. 42% were farmers and 35% had a history of malaria. The mean parasitaemia was 5865 parasites/mm³. The evolution of the disease was short (average of 4.0 days). Fever, headache and chills were observed simultaneously in 91% of the cases while the most frequent signs were palmar pallor (46%), jaundice (15%), hepatomegaly (17%), and spleen enlargement (12%). Anemia was found in 39% of the women and in 51% of the men, 8% of individuals had thrombocytopaenia and 41% had hypoglycemia.

Fatal septicemia caused by Chromobacterium violaceum in a child from Colombia

A 4-year old child living in Colombia presented with a history of fever and severe abdominal pain for four days. The patient developed pneumonia, septic shock, multiple organ failure and died on the fifth day of hospitalization. Chromobacterium violaceum was isolated from admission blood cultures and was resistant to ampicillin, cephalosporins, carbapenems and aminoglycosides.

Giardia intestinalis and nutritional status in children participating in the complementary nutrition program, Antioquia, Colombia, May to October 2006

Giardia intestinalis infection is prevalent throughout the world and widely distributed in developing countries. In general, children display serious consequences to their state of health, including slow height-weight development; therefore, the main aim of this study was to determine the association between Giardia infection and the nutritional status of children who participate in the program of complementary feeding (Mejoramiento Alimentario y Nutricional de Antioquia (MANA) - Instituto Colombiano de Bienestar Familiar (ICBF)). A cross-sectional study examining the association of giardiasis with nutritional status was conducted. A total of 2035 children aged eight months to six years-old were studied. Data were collected using structured questionnaires, anthropometric measurements and laboratory analysis of blood and stool samples. Analysis of the results showed that 27.6% of children were infected with G. intestinalis, while 8.1% and 1.9% were mildly and significantly underweight, respectively, and 14.1% presented stunting. Giardiasis was statistically identified as a strong predictor of stunting in this study population.

Thermoterapy effective and safer than miltefosine in the treatment of cutaneous leishmaniasis in Colombia

In Colombia, pentavalent antimonials and miltefosine are the drugs of choice for the treatment of cutaneous leishmaniasis; however, their toxicity, treatment duration, (treatment adherence problems), cost, and decreased parasite sensitivity make the search for alternative treatments of American cutaneous leishmaniasis necessary. Based on the results found in a controlled, open, randomized, phase III clinical trial, the efficacy and safety of miltefosine was compared to that of thermotherapy for the treatment of cutaneous leishmaniasis in Colombia. Adult patients from the Colombian army participated in the study; they received either 50 mg of miltefosine three times per day for 28 days by the oral route (n = 145) or a thermotherapy (Thermomed®) application of 50 °C for 30 seconds over the lesion and surrounding area (n = 149). Both groups were comparable with respect to their sociodemographic, clinical, and parasitological characteristics. The efficacy of miltefosine by protocol and by intention to treat was 70% (85/122 patients) and 69% (85/145 patients), respectively. The adverse effects were primarily gastrointestinal for miltefosine and pain at the lesion site after treatment for thermotherapy. No statistically significant difference was found in the efficacy analysis (intention to treat and protocol) between the two treatments. ClinicalTrials.gov: NCT00471705.

CONTRIBUTIONS TO RICKETTSIOSES RESEARCH IN COLOMBIA (1917-1943), LUIS B. PATIÑO CAMARGO

Colombian physician Luis Benigno Patiño Camargo was one of the pioneers in the study of rickettsioses in South America, demonstrating for the first time in Colombia the presence of Rickettsia rickettsii as the etiological agent of a highly deadly exanthematic febrile syndrome in the 1930s. However, Patiño-Camargo performed other investigations from 1917-1943, which represent the first descriptions and scientific evidence of the presence ofR. prowazekii and R. typhi in Colombia. Almost 60 years after the latest research conducted by Dr. Patiño-Camargo, rickettsioses were again a matter of interest and research. In the last decade over 20 research studies have been published, showing new endemic areas forR. rickettsii, as well as the description of new rickettsial species in Colombia.

Serological and parasitological study and report of the first case of human babesiosis in Colombia

A study on the presence of Babesia in humans was performed in Puerto Berrío (Latitude 6.50deg. Longitude: -74.38deg. River: Magdalena. Area: 74.410km², Colombia-South America). Indirect immunofluorescence, thin and thick blood smears were used to study 194 individuals. Patients were grouped according to their risk-factors for Babesia infection: (group 1) individuals with fever, chills, sweating and other malaria-type symptoms; (group 2) symptomatic and asymptomatic individuals from local cattle ranches, which were enrolled in an active form, and (group 3) workers from the local slaughterhouse. Seven individuals were serologically positive for Babesia: Three individuals presented IgM antibodies against B. bovis, while one had IgG against this species; one individual had IgM against B. bigemina, another had IgG and a third both IgM and IgG against this species. Only one individual was parasitologically positive for Babesiaand serologically positive for Babesia bovis (IgM 1:64)

Platelet profile is associated with clinical complications in patients with vivax and falciparum malaria in Colombia

Introduction Thrombocytopenia is a common complication in malaria patients. The relationship between abnormal platelet profile and clinical status in malaria patients is unclear. In low and unstable endemic regions where vivax malaria predominates, the hematologic profiles of malaria patients and their clinical utility are poorly understood. The aim of this study was to characterize the thrombograms of malaria patients from Colombia, where Plasmodium vivax infection is common, and to explore the relationship between thrombograms and clinical status. Methods Eight hundred sixty-two malaria patients were enrolled, including 533 (61.8%) patients infected with Plasmodium falciparum, 311 (36.1%) patients infected with Plasmodium vivax and 18 (2.1%) patients with mixed infections. Results The most frequently observed changes were low platelet count (PC) and high platelet distribution width (PDW), which were observed in 65% of patients; thrombocytopenia with <50,000 platelets/µL was identified in 11% of patients. Patients with complications had lower PC and plateletcrit (PT) and higher PDW values. A higher risk of thrombocytopenia was identified in patients with severe anemia, neurologic complications, pulmonary complications, liver dysfunction, renal impairment and severe hypoglycemia. The presence of thrombocytopenia (<150,000 platelets/µL) was associated with a higher probability of liver dysfunction. Conclusions Young age, longer duration of illness and higher parasitemia are associated with severe thrombocytopenia. Our study showed that thrombocytopenia is related to malaria complications, especially liver dysfunction. High PDW in patients with severe malaria may explain the mechanisms of thrombocytopenia that is common in this group of patients.

Dengue in Brazil and Colombia: a study of knowledge, attitudes, and practices

Introduction This study was conducted in Brazil and Colombia,where dengue is endemic and vector control programs use chemical insecticides. Methods We identified knowledge, attitudes, and practices about dengue and determined the infestation levels of Aedes aegypti in one Brazilian and four Colombian communities. Results The surveys show knowledge of the vector, but little knowledge about diagnosis, prognosis, and treatment. Vector infestation indices show Brazil to have good relative control, while Colombia presents a high transmission risk. Conclusions Given the multidimensionality of dengue control, vertical control strategies are inadequate because they deny contextualized methods, alternative solutions, and local empowerment.

Cryptococcosis in Atlántico, Colombia: an approximation of the prevalence of this mycosis and the distribution of the etiological agent in the environment

ABSTRACTINTRODUCTION:Cryptococcosis is an invasive disease acquired by inhalation of infectious propagules from the environment. Currently, compulsory notification of the spread of this disease is not required in Colombia. However, reporting of human immunodeficiency virus (HIV)/acquired immune deficiency syndrome cases to the National Surveillance System has suggested that there is a growing population at risk of contracting cryptococcosis. Few studies have described the occurrence of cryptococcosis in Colombia. Therefore, in this study, we examined the pathology of this disease in Atlántico, Colombia and determined the distributions of Cryptococcus neoformans and Cryptococcus gattii in the environment.METHODS:Clinical samples/isolates were gathered from cases of cryptococcosis previously diagnosed at health institutions in Atlántico, and surveys were completed by clinicians. The environmental study considered 32 sampling points and three tree species, i.e., Quickstick ( Gliricidia sepium ), Almond ( Terminalia catappa ), and Pink trumpet ( Tabebuia rosea ). Environmental and clinical samples/isolates were analyzed for phenotypic and genotypic confirmation.RESULTS:From 1997-2014, 41 cases of cryptococcosis were reported. The mean patient age was 40.5 years (range: 18-63 years); 76% were men, and 78% were HIV positive. Isolation was possible in 38 cases ( C. neoformans , molecular type VNI in 37 cases and C. gattii , molecular type VGI in one case). In 2012-2014, 2,068 environmental samples were analyzed with a positivity of 0.4% ( C. neoformans , molecular type VNI) in Almond and Pink trumpet trees.CONCLUSIONS:Cryptococcus neoformans , molecular type VNI had a higher prevalence than C. gattii and was associated with human exposure and the pathogenesis of cryptococcosis in this geographical region.