New scenarios of Trypanosoma cruzi transmission in the Orinoco region of Colombia

Rhodnius prolixus, a blood-sucking triatomine with domiciliary anthropophilic habits, is the main vector of Chagas disease. The current paradigm of Trypanosoma cruzi transmission in Columbia includes a sylvatic and domiciliary cycle co-existing with domestic and sylvatic populations of reservoirs. The aim of this study is to evaluate the population densities and relative abundance of triatomines and mammals that may be involved in the sylvatic cycle of Chagas disease to clarify the epidemiological scenario in an endemic area in the province of Casanare. Insect vectors on Attalea butyracea palms were captured using both manual searches and bait traps. The capture of mammals was performed using Sherman and Tomahawk traps. We report an infestation index of 88.5% in 148 palms and an index of T. cruzi natural infection of 60.2% in 269 dissected insects and 11.9% in 160 captured mammals. High population densities of triatomines were observed in the sylvatic environment and there was a high relative abundance of reservoirs in the area, suggesting a stable enzootic cycle. We found no evidence of insect domiciliation. Taken together, these observations suggest that eco-epidemiological factors shape the transmission dynamics of T. cruzi, creating diverse scenarios of disease transmission.

Retrospective distribution of Trypanosoma cruzi I genotypes in Colombia

Trypanosoma cruziis the aetiological agent of Chagas disease, which affects approximately eight million people in the Americas. This parasite exhibits genetic variability, with at least six discrete typing units broadly distributed in the American continent. T. cruziI (TcI) shows remarkable genetic diversity; a genotype linked to human infections and a domestic cycle of transmission have recently been identified, hence, this strain was named TcIDom. The aim of this work was to describe the spatiotemporal distribution of TcI subpopulations across humans, insect vectors and mammalian reservoirs in Colombia by means of molecular typing targeting the spliced leader intergenic region of mini-exon gene. We analysed 101 TcI isolates and observed a distribution of sylvatic TcI in 70% and TcIDom in 30%. In humans, the ratio was sylvatic TcI in 60% and TcIDom in 40%. In mammal reservoirs, the distribution corresponded to sylvatic TcI in 96% and TcIDom in 4%. Among insect vectors, sylvatic TcI was observed in 48% and TcIDom in 52%. In conclusion, the circulation of TcIDom is emerging in Colombia and this genotype is still adapting to the domestic cycle of transmission. The epidemiological and clinical implications of these findings are discussed herein.

The use of rapid dengue diagnostic tests in a routine clinical setting in a dengue-endemic area of Colombia

There is insufficient evidence of the usefulness of dengue diagnostic tests under routine conditions. We sought to analyse how physicians are using dengue diagnostics to inform research and development. Subjects attending 14 health institutions in an endemic area of Colombia with either a clinical diagnosis of dengue or for whom a dengue test was ordered were included in the study. Patterns of test-use are described herein. Factors associated with the ordering of dengue diagnostic tests were identified using contingency tables, nonparametric tests and logistic regression. A total of 778 subjects were diagnosed with dengue by the treating physician, of whom 386 (49.5%) were tested for dengue. Another 491 dengue tests were ordered in subjects whose primary diagnosis was not dengue. Severe dengue classification [odds ratio (OR) 2.2; 95% confidence interval (CI) 1.1-4.5], emergency consultation (OR 1.9; 95% CI 1.4-2.5) and month of the year (OR 3.1; 95% CI 1.7-5.5) were independently associated with ordering of dengue tests. Dengue tests were used both to rule in and rule out diagnosis. The latter use is not justified by the sensitivity of current rapid dengue diagnostic tests. Ordering of dengue tests appear to depend on a combination of factors, including physician and institutional preferences, as well as other patient and epidemiological factors.

Molecular identification of Saint Louis encephalitis virus genotype IV in Colombia

Saint Louis encephalitis virus (SLEV) is a member of the Japanese-encephalitis virus serocomplex of the genus Flavivirus. SLEV is broadly distributed in the Americas and the Caribbean Islands, where it is usually transmitted by mosquitoes of the genus Culex and primarily to birds and mammalian-hosts. Humans are occasionally infected by the virus and are dead-end hosts. SLEV causes encephalitis in temperate regions, while in tropical regions of the Americas, several human cases and a wide biological diversity of SLEV-strains have been reported. The phylogenetic analysis of the envelope (E) protein genes indicated eight-genotypes of SLEV with geographic overlap. The present paper describes the genotyping of two SLEV viruses detected in mosquito-pools collected in northern Colombia (department of Cordoba). We used reverse transcription-polymerase chain reaction to amplify a fragment of theE-gene to confirm the virus identity and completeE-gene sequencing for phylogenetic analysis and genotyping of the two-SLEV viruses found circulating in Córdoba. This is the first report of SLEV genotype IV in Colombia (Córdoba) in mosquitoes from a region of human inhabitation, implicating the risk of human disease due to SLEV infection. Physicians should consider SLEV as a possible aetiology for undiagnosed febrile and neurologic syndromes among their patients who report exposure to mosquito-bites.

Malaria in gold-mining areas in Colombia

Gold-mining may play an important role in the maintenance of malaria worldwide. Gold-mining, mostly illegal, has significantly expanded in Colombia during the last decade in areas with limited health care and disease prevention. We report a descriptive study that was carried out to determine the malaria prevalence in gold-mining areas of Colombia, using data from the public health surveillance system (National Health Institute) during the period 2010-2013. Gold-mining was more prevalent in the departments of Antioquia, Córdoba, Bolívar, Chocó, Nariño, Cauca, and Valle, which contributed 89.3% (270,753 cases) of the national malaria incidence from 2010-2013 and 31.6% of malaria cases were from mining areas. Mining regions, such as El Bagre, Zaragoza, and Segovia, in Antioquia, Puerto Libertador and Montelíbano, in Córdoba, and Buenaventura, in Valle del Cauca, were the most endemic areas. The annual parasite index (API) correlated with gold production (R2 0.82, p < 0.0001); for every 100 kg of gold produced, the API increased by 0.54 cases per 1,000 inhabitants. Lack of malaria control activities, together with high migration and proliferation of mosquito breeding sites, contribute to malaria in gold-mining regions. Specific control activities must be introduced to control this significant source of malaria in Colombia.

Participación social en salud: conceptos de usuarios, líderes comunitarios, gestores y formuladores de políticas en Colombia. Una mirada cualitativa.

BACKGROUND Health sector reforms taking place in Colombia during the Nineties included policies to promote social participation in the health system, which is considered essential to its functioning. The aim of this article is to analyse the meaning and the significance of participation in health for the different social actors involved in implementing policies in Colombia. METHODS A qualitative, descriptive, exploratory study was carried out using focal groups (FG) and semi-structured individual interviews (I) of the different social actors: 210 users (FG), 40 community leaders (FG), 3 policy makers (E) and 36 healthcare professionals (E). A carried out analysis was content up of the contents. The study area corresponded to the municipalities of Tulua and Palmira in Colombia. RESULTS The concept of participation was interpreted differently depending on the actor studied: for users and leaders the concept referred to contributing ideas, presence in social spaces, solidarity and frequently, and use of the health services. Healthcare professionals considered the activities carried out by institutions together with the community as social participation, the use of services and affiliation to the health system. Policy markers considered participation to concern evaluation and control of the health services by the community, to improve its quality. CONCLUSIONS The different concepts of participation reveal dif ferences between the content of the policy and how it is understood and interpreted by the different social actors in their interaction with the health services. These different perspectives must be taken into account to develop a link between society and the health services.

Detection of all four dengue serotypes in Aedes aegypti female mosquitoes collected in a rural area in Colombia

The Aedes aegypti vector for dengue virus (DENV) has been reported in urban and periurban areas. The information about DENV circulation in mosquitoes in Colombian rural areas is limited, so we aimed to evaluate the presence of DENV in Ae. aegypti females caught in rural locations of two Colombian municipalities, Anapoima and La Mesa. Mosquitoes from 497 rural households in 44 different rural settlements were collected. Pools of about 20 Ae. aegypti females were processed for DENV serotype detection. DENV in mosquitoes was detected in 74% of the analysed settlements with a pool positivity rate of 62%. The estimated individual mosquito infection rate was 4.12% and the minimum infection rate was 33.3/1,000 mosquitoes. All four serotypes were detected; the most frequent being DENV-2 (50%) and DENV-1 (35%). Two-three serotypes were detected simultaneously in separate pools. This is the first report on the co-occurrence of natural DENV infection of mosquitoes in Colombian rural areas. The findings are important for understanding dengue transmission and planning control strategies. A potential latent virus reservoir in rural areas could spill over to urban areas during population movements. Detecting DENV in wild-caught adult mosquitoes should be included in the development of dengue epidemic forecasting models.

Social Determinants of Child Health in Colombia: Can Community Education Moderate the Effect of Family Characteristics?

Contextual effects on child health have been investigated extensively in previous research. However, few studies have considered the interplay between community characteristics and individual-level variables. This study examines the influence of community education and family socioeconomic characteristics on child health (as measured by height and weight-for-age Z-scores), as well as their interactions. We adapted the Commission on Social Determinants of Health (CSDH) framework to the context of child health. Using data from the 2010 Colombian Demographic and Health Survey (DHS), weighted multilevel models are fitted since the data are not self-weighting. The results show a positive impact of the level of education of other women in the community on child health, even after controlling for individual and family socioeconomic characteristics. Different pathways through which community education can substitute for the effect of family characteristics on child nutrition are found. The interaction terms highlight the importance of community education as a moderator of the impact of the mother’s own education and autonomy, on child health. In addition, the results reveal differences between height and weight-for-age indicators in their responsiveness to individual and contextual factors. Our findings suggest that community intervention programmes may have differential effects on child health. Therefore, their identification can contribute to a better targeting of child care policies.

El concepto de dios en las sociedades animistas, politeístas y monoteístas

Con el ánimo de llevar a cabo una somera visión comparativa desde una perspectiva antropológica, trataremos de ubicar cada modelo conceptual de dios en un tiempo y en una civilización humana determinada en Occidente. Queremos detenernos a describir con leves pinceladas el concepto religioso que se ha tenido de dios en nuestra historia en tres etapas concretas: Paleolítico, Mundo Antiguo y Edad Media, en las cuales han predominado respectivamente las diferentes concepciones de dios (el animismo, el politeísmo y el monoteísmo).

Historia cultural de los cuidados paliativos en las sociedades primitivas: revisión integrativa

Este estudio tiene el objetivo de describir la evolución de los cuidados paliativos, reflexionando sobre la posibilidad de su origen en las culturas primitivas y su relación con el inicio del culto a los muertos. Se describe el cambio producido en las estructuras, las interacciones simbólicas y sociales implicadas en el desempeño de cuidados paliativos durante la prehistoria: unidad funcional, marco funcional y elemento funcional. El marco teórico se fundamenta en la historia cultural, el modelo estructural dialéctico y el interaccionismo simbólico. Se aplicaron técnicas de categorización y análisis de la historia cultural y el estructuralismo dialéctico. Los cuidados paliativos ya existían en las sociedades primitivas vinculados, en gran medida, a los ritos de transición con un alto contenido simbólico. Las estructuras sociales: unidad funcional, marco funcional y elemento funcional; constituyen los pilares sobre los que se sustentaron los cuidados paliativos en las sociedades prehistóricas.

Health risk behavior pattern among students from Cartagena, Colombia: prevalence and associated variables

The aim of the study was to determine the prevalence and variables associated with the pattern of risky health behavior (PRHB) among adolescent students in Cartagena, Colombia. A cross-sectional study was designed to investigate PRHB in a random cluster sample of students from middle and high schools. The associations were adjusted by logistic regression. A total of 2,625 students participated in this research, with ages from 10 to 20 years, mean=13.8 years (SD=2.0), and 54.3% were women. A total of 332 students reported PRHB (12.7%, 95%CI 11.4–14.0). Age over 15 years (OR=2.19, 95%CI 1.72–2.79), not being heterosexual (OR=1.98, 95%CI 1.36-2.87), poor/mediocre academic performance (OR=1.87, 95%CI 1.47–2.38), family dysfunction (OR=1.78, 95%CI 1.40–2.28) and male gender (OR=1.58, 95%CI 1.24–2.01) were associated with PRHB. One in every eight students presented a PRHB. It is important to pay greater attention to students who are over 15 years of age, male, not heterosexual, with a poor/mediocre academic performance and a dysfunctional family.

O Governo das Sociedades Anónimas em Cabo Verde

Um dos grandes desafios que as organizações enfrentam actualmente é o da definição e aplicação de práticas de governabilidade empresarial que permitam atingir uma boa reputação e um crescimento sustentável e onde as expectativas dos diversos stakeholders possam ser harmonizadas. Cabo Verde é uma pequena economia aberta que foi recentemente considerado como país de rendimento médio. A sua adesão à Organização Mundial do Comércio, o estabelecimento da parceria especial com a União Europeia, o processo de privatização das empresas estatais e o interesse que tem despertado a investidores externos, justificam a implementação de padrões de governabilidade empresariais internacionais, ainda que adequados às características do país. Esta dissertação tem como objectivo caracterizar o governo das sociedades anónimas em Cabo Verde, contribuir para a compreensão e conhecimento do tema e servir de orientação para a melhoria do desempenho das empresas. Para o efeito colocámo-nos a seguinte questão: quais são as práticas de governo das sociedades anónimas em Cabo Verde? Para responder à nossa questão aplicámos um questionário a 77 empresas, o qual foi respondido por 35. As respostas obtidas permitem identificar as práticas de governo das sociedades anónimas em Cabo Verde durante o ano de 2008 e compará-las com as práticas europeias com base no relatório da Heidrick & Struggles (2007). Os resultados alcançados validam a nossa hipótese de partida de que sociedades anónimas em Cabo Verde ainda não utilizam as práticas normalmente aceites como Best Practices do Governo das Sociedades. Apesar de haver um Código das Sociedades Comerciais que procura modernizar e adequar a gestão das empresas aos desafios da globalização, a estrutura empresarial existente, constituída na sua grande maioria por pequenas e médias empresas familiares, a pequena percentagem de sociedades anónimas, o facto de não haver uma entidade com a responsabilidade de avaliar a gestão das empresas e, consequentemente, não existirem incentivos que promovam a adopção de boas práticas de „Corporate Governance podem justificar estes resultados.

Prática do Governo das Sociedades em Cabo Verde

O presente relatório de estágio realizado na Bolsa de Valores de Cabo Verde (BVCV) visa analisar as práticas de governo das sociedades em Cabo Verde. Esta análise envolveu uma amostra de 2 empresas cotadas na (BVCV) e 2 empresas consideradas de grande dimensão não cotadas na BVCV. Neste contexto, tentamos analisar dentro dos principais sistemas do governo de sociedades qual o sistema de governo das sociedades usado em Cabo Verde. Para além disso foi feita uma avaliação sobre a percepção dos agentes económicos sobre o governo das sociedades. Com base nos resultados obtidos surgiram a necessidade de propor algumas recomendações sobre as boas práticas do governo das sociedades na legislação de mercado de capitais em Cabo Verde, pois, admitimos que estas poderão ser importantes para a modernização do sistema financeiro cabo-verdiano, reforçando a protecção dos investidores.

O Governo das sociedades Anónimas em Cabo Verde

Um dos grandes desafios que as organizações enfrentam actualmente é o da definição e aplicação de práticas de governabilidade empresarial que permitam atingir uma boa reputação e um crescimento sustentável e onde as expectativas dos diversos stakeholders possam ser harmonizadas. Cabo Verde é uma pequena economia aberta que foi recentemente considerado como país de rendimento médio. A sua adesão à Organização Mundial do Comércio, o estabelecimento da parceria especial com a União Europeia, o processo de privatização das empresas estatais e o interesse que tem despertado a investidores externos, justificam a implementação de padrões de governabilidade empresariais internacionais, ainda que adequados às características do país. Esta dissertação tem como objectivo caracterizar o governo das sociedades anónimas em Cabo Verde, contribuir para a compreensão e conhecimento do tema e servir de orientação para a melhoria do desempenho das empresas. Para o efeito colocámo-nos a seguinte questão: quais são as práticas de governo das sociedades anónimas em Cabo Verde? Para responder à nossa questão aplicámos um questionário a 77 empresas, o qual foi respondido por 35. As respostas obtidas permitem identificar as práticas de governo das sociedades anónimas em Cabo Verde durante o ano de 2008 e compará-las com as práticas europeias com base no relatório da Heidrick & Struggles (2007). Os resultados alcançados validam a nossa hipótese de partida de que sociedades anónimas em Cabo Verde ainda não utilizam as práticas normalmente aceites como Best Practices do Governo das Sociedades. Apesar de haver um Código das Sociedades Comerciais que procura modernizar e adequar a gestão das empresas aos desafios da globalização, a estrutura empresarial existente, constituída na sua grande maioria por pequenas e médias empresas familiares, a pequena percentagem de sociedades anónimas, o facto de não haver uma entidade com a responsabilidade de avaliar a gestão das empresas e, consequentemente, não existirem incentivos que promovam a adopção de boas práticas de „Corporate Governance podem justificar estes resultados.

Impactos da ocupação colonial nas sociedades rurais do sul de Angola

O presente trabalho propõe-se dar um contributo ao estudo das transformações ocorridas nas sociedades rurais do Sul de Angola, em função da ocupação colonial, a partir dos anos 20 e até ao momento da descolonização. Esta realidade foi na altura o objecto de poucos trabalhos de índole científica, e desde a independência registam-se até à data apenas contribuições pontuais.i