14 resultados para RENDICIÓN DE CUENTAS - RAMA EJECUTIVA – COLOMBIA - 2014

em Scielo Saúde Pública - SP


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El cultivo de aguacate en Colombia ha presentado un incremento en el área sembrada durante la última década, especialmente en clima frío moderado, entre 1.800 y 2.500 msnm. La variedad Hass se destaca por tener la mayor área sembrada en este clima, en el departamento de Antioquia-Colombia. Este cultivo presenta grandes retos tecnológicos para su expansión; entre ellos el manejo de enfermedades ocupa un lugar predominante por las implicaciones que tiene en costos, impacto en la salud, ambiente y restricciones para exportaciones. La marchitez, ocasiona la muerte de numerosos árboles en todas las etapas del cultivo y presenta la mayor incidencia y severidad de las enfermedades identificadas para este cultivo. El desconocimiento de los agentes causales de esta enfermedad, ha llevado a realizar prácticas de manejo encaminadas principalmente al control del oomycete Phytophthora cinnamomi Rands, como único agente causal. Esta investigación tuvo como objetivo identificar los distintos agentes causales de la marchitez del aguacate y la relación de su incidencia con las prácticas de manejo en lotes cultivados en el departamento de Antioquia-Colombia. Los resultados encontrados muestran que la marchitez es el principal problema del cultivo de aguacate. Los microorganismos P. cinnamomi, Phytophthora heveae Thompson, Phytophthora citrícola Sawada, Verticillium sp., y Cylindrocarpon destructans (Zinss) Scholten fueron aislados y reprodujeron los síntomas asociados a marchitez. Las condiciones de bajo contenido de oxigeno el suelo también reprodujeron la sintomatología de marchitez, involucrando también un origen abiótico en la etiología.

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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.

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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.

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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.

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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.

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Malaria is still a primary health problem in Colombia. The locality of Tierradentro is situated in the municipality of Montelíbano, Córdoba, in the northwest of Colombia, and has one of the highest annual parasite index of malaria nationwide. However, the vectors involved in malaria transmission in this locality have not yet been identified. In this study, the local anthropophilic Anopheles composition and natural infectivity with Plasmodium were investigated. In August 2009, 927 female Anopheles mosquitoes were collected in eight localities using the human landing catch method and identified based on their morphology. Cryptic species were determined by restriction fragment length polymorphism-internal transcribed spacer (ITS)2 molecular analysis. Eight species [Anopheles nuneztovari s.l. (92.8%), Anopheles darlingi (5.1%), Anopheles triannulatus s.l. (1.8%), Anopheles pseudopunctipennis s.l. (0.2%), Anopheles punctimacula s.l. (0.2%), Anopheles apicimacula (0.1%), Anopheles albimanus (0.1%) and Anopheles rangeli (0.1%)] were identified and species identity was confirmed by ITS2 sequencing. This is the first report of An. albimanus, An. rangeli and An. apicimacula in Tierradentro. Natural infectivity with Plasmodium was determined by ELISA. None of the mosquitoes was infectious for Plasmodium. An. nuneztovari s.l. was the predominant species and is considered the primary malaria vector; An. darlingi and An. triannulatus s.l. could serve as secondary vectors.

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Since 1984, Anopheles (Kerteszia) lepidotus has been considered a mosquito species that is involved in the transmission of malaria in Colombia, after having been incriminated as such with epidemiological evidence from a malaria outbreak in Cunday-Villarrica, Tolima. Subsequent morphological analyses of females captured in the same place and at the time of the outbreak showed that the species responsible for the transmission was not An. lepidotus, but rather Anopheles pholidotus. However, the associated morphological stages and DNA sequences of An. pholidotus from the foci of Cunday-Villarrica had not been analysed. Using samples that were caught recently from the outbreak region, the purpose of this study was to provide updated and additional information by analysing the morphology of female mosquitoes, the genitalia of male mosquitoes and fourth instar larvae of An. pholidotus, which was confirmed with DNA sequences of cytochrome oxidase I and rDNA internal transcribed spacer. A total of 1,596 adult females were collected in addition to 37 larval collections in bromeliads. Furthermore, 141 adult females, which were captured from the same area in the years 1981-1982, were analysed morphologically. Ninety-five DNA sequences were analysed for this study. Morphological and molecular analyses showed that the species present in this region corresponds to An. pholidotus. Given the absence of An. lepidotus, even in recent years, we consider that the species of mosquitoes that was previously incriminated as the malaria vector during the outbreak was indeed An. pholidotus, thus ending the controversy.

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Malaria in La Guajira, the most northern state of Colombia, shows two different epidemiological patterns. Malaria is endemic in the municipality of Dibulla whereas in Riohacha it is characterised by sporadic outbreaks. This study aimed to establish whether differences in transmission patterns could be attributed to different vector species. The most abundant adult female species were Anopheles aquasalis, exclusive to Riohacha, and Anopheles darlingi, restricted to Dibulla. Anopheles mosquitoes were identified using morphology and the molecular markers internal transcribed spacer 2 and cytochrome c oxidase I. All specimens (n = 1,393) were tested by ELISA to determine natural infection rates with Plasmodium falciparum and Plasmodium vivax. An. darlingi was positive for P. vivax 210, with an infection rate of 0.355% and an entomological inoculation rate of 15.87 infective bites/person/year. Anopheles albimanus larvae were the most common species in Riohacha, found in temporary swamps; in contrast, in Dibulla An. darlingi were detected mainly in permanent streams. Distinctive species composition and larval habitats in each municipality may explain the differences in Plasmodium transmission and suggest different local strategies should be used for vector control.

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Review of Thompsoniella Guimarães with description of a new species from Colombia (Diptera, Calliphoridae, Mesembrinellinae). The Mesembrinellinae (Diptera, Calliphoridae) are exclusively Neotropical with nine genera comprising 36 recognized species, including the genus Thompsoniella Guimarães with a single species, T. anomala Guimarães. We describe a new species, Thompsoniella andina sp. nov., from the Departments of Antioquia and Caldas, Colombia (Cordillera Central of the Andes, between 2600 - 2700 m) and redescribe T. anomala. A key to the nine genera of Mesembrinellinae and a key to the males of the two species of Thompsoniella are provided. Color photographs to illustrate the two species of Thompsoniella and drawings of the male genitalia of both species are also provided. Here we record Thompsoniella for the first time in Colombia.

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Preliminary study of insects associated to indoor body decay in Colombia. This is the first report studying insects associated to indoor body decay process of a white pig (Sus scrofa) (Artiodactyla, Suidae) in a controlled indoor environment in an urban area of Florencia city, Amazonia Piedmont, Colombia. For a period of 54 days, 9,220 individuals (immature and adults), distributed in 3 orders, 5 families, 10 genera, and 10 species were collected using entomological nets and tweezers. Five decaying stages are described (fresh, bloated, active decay, advanced decay and remains). During the fresh stage we recorded Cochliomyia macellaria (Fabricius, 1775), Chrysomya albiceps (Wiedemann, 1819), Ophyra aenescens (Wiedemann, 1830), Oxysarcodexia sp., Lepidodexia sp. and Lasiophanes sp.; during the bloating stage C. macellaria, C. albiceps, Lucilia eximia (Wiedemann, 1819), Hemilucillia semidiaphana (Rondani, 1850), Musca domestica Linnaeus, 1758, O. aenescens, Oxysarcodexia sp., Lepidodexia sp., Dermestes maculatus De Geer, 1774 and Lasiphanes sp.; during the active decay C. macellaria, C. albiceps, L. eximia, M. domestica, O. aenescens, Lepidodexia sp. D. maculatus and Lasiophanes sp.; during the advanced decay C. macellaria, C. albiceps, M. domestica, Lepidodexia sp. and Lasiophanes sp.; and during the remains stage C. albiceps, D. maculatus and Lasiophanes sp. The insects were sorted out in 3 ecological categories; necrophagous, predators and parasites and sarco-saprophagous. According to Chao and Jack estimators, total richness was observed on day 20, with 100% of the expected species.

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La granadilla es la segunda especie en importancia económica del género Passiflora y Colombia es el principal productor del mundo con 53.000 t/año. Son pocos los estudios sobre la diversidad intraespecifica en la especie que permitan establecer las relaciones genéticas entre individuos. El objetivo de esta investigación fue explorar la variabilidad genética de la granadilla cultivada en Colombia por medio de marcadores microsatélites. Diez marcadores microsatélites fueron evaluados en 41 accesiones (82 individuos) provenientes de los principales departamentos productores. Un total de cinco microsatélites fueron amplificados con 66 alelos identificados y un promedio de 12,2, entre ellos 7 únicos y 13 raros. Los índices de diversidad mostraron un contenido de información polimórfica de 0,74 (PIC), y una heterocigocidad promedio observada (Ho) y esperada (He) de 0,98 y 0,96 bajo condiciones de equilibrio de Hardy-Weinberg. La distancia genética promedio dentro y entre poblaciones fue de 0,65 y 0,80, siendo Boyacá, Valle del Cauca y Putumayo los más distantes (>0,87). Los análisis de clasificación arbórea (nj) y factorial de correspondencia múltiple (AFCM) revelaron poca estructuración geográfica de las accesiones y dispersión de los individuos de un mismo origen. La carencia de estructuración y la alta variabilidad intraespecífica podría explicarse por el fenómeno de alogamia presente en la especie y el intercambio de semillas entre productores. En conclusión, estos resultados sugieren una evaluación agromorfológica complementaria que permita establecer la variabilidad genética total e implementar un programa de mejoramiento genético por medio de la selección asistida de genotipos superiores en búsqueda de cultivares más productivos y resistentes a problemas fitosanitarios que afectan los cultivos.

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Babesia sp. is a protozoan hemoparasite that affects livestock worldwide. The Colombian Middle Magdalena is an enzootic region for babesiosis, but there is no previous research providing detail on its transmission cycle. This study aims to assess some Babesia sp. infection indicators in cattle and ticks from the area, by using direct microscopic and molecular techniques to detect the infection. In the cattle, 59.9% and 3.4 % positivity values for B. bigemina and mixed infection (B. bovis + B. bigemina) were found respectively. In ticks, the positivity of B. bigemina reached 79.2% and 9.4% for the mixed infection. The degree of infestation in the region was 3.2 ticks per bovine. There was positive correlation between tick control acaricide frequencies and infestation in bovines. This leads us to infer that control periodicity greater than 90 days, in stable zones, is an abiotic factor that benefits the acquisition of protective immunity in calves, the natural control of the infection and eventual disease absence. It is necessary to monitor the disease by applying new entomological and parasitological indicators showing the complexity of this phenomenon.

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The objectives of this research were to evaluate (1) weed species presented in rice fields in relation to the geographical zone and crop rotation and (2) the resistance level of Ischaemum rugosum to the herbicide bispyribac-sodium. For the first objective, were sampled 79 commercial fields of rice to establish weed density, coverage, and rotation system in the evaluated fields with record of bispyribac-sodium application of at least five years. To reach the second objective, the seeds were collected from plants in commercial fields with different control levels of bispyribac-sodium herbicide. Seeds were germinated in trays under controlled conditions. When plants presented three leaves these were treated with bispyribac-sodium at different doses. Percentages of control and dry weight of plants were evaluated 12 days after treatments (dat). Dominant species in evaluated fields was I. rugosum, with a frequency of 100%, presenting escapes to different chemical commercial treatments. No significant differences were recorded between rotation systems, nevertheless, the most of I. rugosum population was found in the system rice-fallow-rice. The response of applications at different concentrations allows concluding that 65% of samples had resistance at different degrees reported as indexes from 2 to 42 which are related to rotation systems.

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Introduction: Tuberculosis is a common opportunistic infection in renal transplant patients. Objective: To obtain a clinical and laboratory description of transplant patients diagnosed with tuberculosis and their response to treatment during a period ranging from 2005 to 2013 at the Pablo Tobón Uribe Hospital. Methods: Retrospective and descriptive study. Results: In 641 renal transplants, tuberculosis was confirmed in 12 cases. Of these, 25% had a history of acute rejection, and 50% had creatinine levels greater than 1.5 mg/dl prior to infection. The disease typically presented as pulmonary (50%) and disseminated (33.3%). The first phase of treatment consisted of 3 months of HZRE (isoniazid, pyrazinamide, rifampicin and ethambutol) in 75% of the cases and HZME (isoniazid, pyrazinamide, moxifloxacin and ethambutol) in 25% of the cases. During the second phase of the treatment, 75% of the cases received isoniazid and rifampicin, and 25% of the cases received isoniazid and ethambutol. The length of treatment varied between 6 and 18 months. In 41.7% of patients, hepatotoxicity was associated with the beginning of anti-tuberculosis therapy. During a year-long follow-up, renal function remained stable, and the mortality rate was 16.7%. Conclusion: Tuberculosis in the renal transplant population studied caused diverse nonspecific symptoms. Pulmonary and disseminated tuberculosis were the most frequent forms and required prolonged treatment. Antituberculosis medications had a high toxicity and mortality. This infection must be considered when patients present with a febrile syndrome of unknown origin, especially during the first year after renal transplant.