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.

Mejoramiento de la eficiencia productiva de caprinos de leche de la zona norte de la provincia de Córdoba por el control de enfermedades infecciosas y parasitarias (Red Pictor)

En el norte de la Provincia de Córdoba, la progresiva intensificación de la producción láctea caprina, debido al fuerte incentivo desde áreas gubernamentales, ha dado como resultado la aparición de algunos problemas sanitarios que generalmente pasan desapercibidos cuando las condiciones productivas se desarrollan en sistemas extensivos y muy rudimentarios. Se comienzan a visualizar problemas sanitarios-productivos inherentes a sistemas de mayor eficiencia y derivados de una mayor carga animal y productividad individual como son las parasitosis por nematodes gastrointestinales y las mastitis. El control químico de ambas afecciones se está llevando a cabo en forma totalmente empírica y con un uso indiscriminado e irracional de antimicrobianos y antiparasitarios, con fracasos terapéuticos, aparición de residuos y sin control de tiempos de retiro. En este contexto, además de las pérdidas productivas, existe un riesgo real de enviar leche al consumo o a la industrialización con concentraciones importantes de antibióticos y/o antiparasitarios. Por todo ello, con este proyecto nos planteamos como objetivos identificar principales especies bacterianas y parasitarias que infectan a nuestros rodeos caprinos; identificar los antimicrobianos y antiparasitarios que se utilizan; realizar los mismos estudios de eficacia, farmacocinética y de resistencia, siendo los beneficiarios directos de estos resultados los productores, el profesional veterinario, los consumidores y la industria láctea.

Compatibilidad jurídica de la celebración de Tratados de Libre Comercio (TLCs) extra bloque por parte de Estados miembros de acuerdos de integración regional latinoamericanos con la normativa regional: Especial referencia al Mercado Común del Sur (MERCOSUR) y a la Comunidad Andina de Naciones (CAN)

El objetivo focal del proyecto consiste en efectuar un estudio sobre la compatibilidad y factibilidad jurídica de la celebración y concreción de Tratados de Libre Comercio (TLCs) por parte de Estados miembros de acuerdos de integración regionales con terceros Estados, sobre la base de lo establecido en la normativa propia de los procesos de integración del Mercado Común del Sur (MERCOSUR) y de la Comunidad Andina de Naciones (CAN); También se examinará la conformidad de lo planteado con lo dispuesto por la normativa de la Organización Mundial del Comercio (OMC), organización multilateral de la cual son miembros los países miembros del MERCOSUR y de la CAN. Dicho estudio se plasmará en una publicación especializada. En el supuesto de determinarse mediante la investigación la compatibilidad y factibilidad jurídica para la celebración y concreción de los tratados descriptos (en uno o en ambos casos), el proyecto prevé precisar los respectivos requisitos pertinentes, tanto en lo vinculado a la normativa regional como en lo relacionado con la normativa de la OMC. La celebración y/o la manifiesta intención de concretar TLCs por parte de algunos Estados miembros del MERCOSUR y de la CAN, así como la enérgica oposición política de otros Estados miembros de dichos procesos de integración regional, hacen que la investigación jurídica además de resultar pertinente por actualidad, derive de indudable necesidad. El proyecto pretende efectuar un riguroso análisis jurídico de la temática, a fin de contribuir de esta forma a intentar resolver, sobre bases sólidas, las actuales discrepancias interestatales en el seno de cada uno de los procesos de integración a los que pertenecen las universidades involucradas en el proyecto de investigación (Universidad Católica de Córdoba -UCC- y Pontificia Universidad Javeriana -PUJ-). Se aspira a que los resultados del proyecto de investigación constituyan una respuesta de calidad de la comunidad universitaria

Control de Mastitis y de residuos de antimicrobianos en leche de cabra

En la provincia de Córdoba hay un fuerte incentivo, desde las áreas gubernamentales como de otras organizaciones, a establecimientos de tambos de cabras y su posterior industrialización, con el fin de desarrollar áreas rurales muy deprimidas. Los productos y subproductos lácteos derivados de estas explotaciones son comercializados para la población con intolerancia a la lactosa bovina, generalmente infantes, y a consumidores de alto poder adquisitivo; en ambos casos la exigencia de la calidad del producto es fundamental. La progresiva intensificación de la producción láctea caprina, debido a los planes gubernamentales, ha dado como resultado una creciente detección de problemas sanitarios en los rodeos, con alta incidencia de mastitis. Esto lleva a un uso indiscriminado e irracional de antimicrobianos, con fracasos terapéuticos, aparición de residuos y sin control de tiempos de retiro, existiendo un riesgo real de enviar leche al consumo o a la industrialización con concentraciones importantes de antibióticos. Por todo ello, con este proyecto nos planteamos como objetivos: identificar las principales especies bacterianas que infectan a nuestros rodeos caprinos; describir los antimicrobianos que se utilizan; realizar un estudio farmacocinético de los mismos, en particular su disposición plasmática y su excreción en leche; determinar su eficacia y posibles cepas resistentes; establecer un tratamiento efectivo y adaptado a las realidades de la producción caprina cordobesa; fijar tiempos de retiro seguros para el consumidor y la industria láctea.