Strategies to reengage patients lost to follow up in HIV care in high income countries, a scoping review

Background: Despite remarkable achievements in antiretroviral therapy (ART), losses to follow-up (LTFU) might prevent the long-term success of HIV treatment and might delay the achievement of the 90-90-90 objectives. This scoping review is aimed at the description and analysis of the strategies used in high-income countries to reengage LTFU in HIV care, their implementation and impact. Methods: A scoping review was done following Arksey & O'Malley's methodological framework and recommendations from Joanna Briggs Institute. Peer reviewed articles were searched for in Pubmed, Scopus and Web of Science; and grey literature was searched for in Google and other sources of information. Documents were charted according to the information presented on LTFU, the reengagement procedures used in HIV units in high-income countries, published during the last 15 years. In addition, bibliographies of chosen articles were reviewed for additional articles. Results: Twenty-eight documents were finally included, over 80% of them published in the United States later than 2015. Database searches, phone calls and/or mail contacts were the most common strategies used to locate and track LTFU, while motivational interviews and strengths-based techniques were used most often during reengagement visits. Outcomes like tracing activities efficacy, rates of reengagement and viral load reduction were reported as outcome measures. Conclusions: This review shows a recent and growing trend in developing and implementing patient reengagement strategies in HIV care. However, most of these strategies have been implemented in the United States and little information is available for other high-income countries. The procedures used to trace and contact LTFU are similar across reviewed studies, but their impact and sustainability are widely different depending on the country studied

Accumulation of polybrominated diphenyl ethers and microbiome response in the great pond snail Lymnaea stagnalis with exposure to nylon (polyamide) microplastics

Microplastics attract widespread attention, including for their potential to transport toxic chemicals in the form of plasticisers and associated hydrophobic organic chemicals, such as polybrominated diphenyl ethers (PBDEs). The aims of this study were to investigate how nylon (polyamide) microplastics may affect PBDE accumulation in snails, and the acute effects of nylon particles and PBDEs on survival, weight change and inherent microbiome diversity and community composition of the pond snail Lymnaea stagnalis. Snails were exposed for 96 hours to BDEs-47, 99, 100 and 153 in the presence and absence of 1% w/w nylon microplastics in quartz sand sediment. No mortality was observed over the exposure period. Snails not exposed to microplastics lost significantly more weight compared to those exposed to microplastics. Increasing PBDE concentration in the sediment resulted in an increased PBDE body burden in the snails, however microplastics did not significantly influence total PBDE uptake. Based on individual congeners, uptake of BDE 47 by snails was significantly reduced in the presence of microplastics. The diversity and composition of the snail microbiome was not significantly altered by the presence of PBDEs nor by the microplastics, singly or combined. Significant effects on a few individual operational taxonomic units (OTUs) occurred when comparing the highest PBDE concentration with the control treatment, but in the absence of microplastics only. Overall within these acute experiments, only subtle effects on weight loss and slight microbiome alterations occurred. These results therefore highlight that L. stagnalis are resilient to acute exposures to microplastics and PBDEs, and that microplastics are unlikely to influence HOC accumulation or the microbiome of this species over short timescales

Eco-epidemiological study of an endemic Chagas disease region in northern Colombia reveals the importance of Triatoma maculata (Hemiptera: Reduviidae), dogs and Didelphis marsupialis in Trypanosoma cruzi maintenance

Submitted by sandra infurna ([email protected]) on 2016-03-22T10:57:09Z No. of bitstreams: 1 andre_pereira_etal_IOC_2015.pdf: 747571 bytes, checksum: 7ec9c4ed898cc8ecea3d542a8489a04e (MD5)Approved for entry into archive by sandra infurna ([email protected]) on 2016-03-22T11:10:47Z (GMT) No. of bitstreams: 1 andre_pereira_etal_IOC_2015.pdf: 747571 bytes, checksum: 7ec9c4ed898cc8ecea3d542a8489a04e (MD5)Made available in DSpace on 2016-03-22T11:10:48Z (GMT). No. of bitstreams: 1 andre_pereira_etal_IOC_2015.pdf: 747571 bytes, checksum: 7ec9c4ed898cc8ecea3d542a8489a04e (MD5) Previous issue date: 2015Universidad de Antioquia UdeA. Grupo BCEL. Medellin, Colombia.Universidad de Antioquia UdeA. Grupo BCEL. Medellin, Colombia.Universidad de Antioquia UdeA. Grupo BCEL. Medellin, Colombia.Secretaría de Salud del Departamento de Bolívar. Unidad de Entomología Médica. Cartagena, Colombia.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Biologia de Tripanossomatídeos. Rio de Janeiro, RJ, Brasil.Centers for Disease Control and Prevention (CDC). Division of Parasitic Diseases and Malaria. Entomology Branch. Atlanta, GA, USA.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Biologia de Tripanossomatídeos. Rio de Janeiro, RJ, Brasil.Universidad de Antioquia UdeA. Grupo BCEL. Medellin, Colombia.Background: In Colombia, Rhodnius prolixus and Triatoma dimidiata are the main domestic triatomine species known to transmit T. cruzi. However, there are multiple reports of T. cruzi transmission involving secondary vectors. In this work, we carried out an eco-epidemiological study on Margarita Island, located in the Caribbean region of Colombia, where Chagas disease is associated with non-domiciliated vectors. Methods: To understand the transmission dynamics of Trypanosoma cruzi in this area, we designed a comprehensive, multi-faceted study including the following: (i) entomological evaluation through a community-based insect-surveillance campaign, blood meal source determination and T. cruzi infection rate estimation in triatomine insects; (ii) serological determination of T. cruzi prevalence in children under 15 years old, as well as in domestic dogs and synanthropic mammals; (iii) evaluation of T. cruzi transmission capacity in dogs and Didelphis marsupialis, and (iv) genetic characterization of T. cruzi isolates targeting spliced-leader intergene region (SL-IR) genotypes. Results: Out of the 124 triatomines collected, 94 % were Triatoma maculata, and 71.6 % of them were infected with T. cruzi. Blood-meal source analysis showed that T. maculata feeds on multiple hosts, including humans and domestic dogs. Serological analysis indicated 2 of 803 children were infected, representing a prevalence of 0.25 %. The prevalence in domestic dogs was 71.6 % (171/224). Domestic dogs might not be competent reservoir hosts, as inferred from negative T. cruzi xenodiagnosis and haemoculture tests. However, 61.5 % (8/13) of D. marsupialis, the most abundant synanthropic mammal captured, were T. cruzi-positive on xenodiagnosis and haemocultures. Conclusions: This study reveals the role of peridomestic T. maculata and dogs in T. cruzi persistence in this region and presents evidence that D. marsupialis are a reservoir mediating peridomestic-zoonotic cycles. This picture reflects the complexity of the transmission dynamics of T. cruzi in an endemic area with non-domiciliated vectors where active human infection exists. There is an ongoing need to control peridomestic T. maculata populations and to implement continuous reservoir surveillance strategies with community participation

Accumulation of nylon microplastics and polybrominated diphenyl ethers and effects on gut microbial community of Chironomus sancticaroli

Microplastics (MP) are emerging contaminants with the capacity to bind and transport hydrophobic organic compounds of environmental concern, such as polybrominated diphenyl ethers (PBDEs). The aim of this study was to investigate the ingestion of nylon (polyamide) MP alone and when associated with PBDEs and their effects on Chironomus sancticaroli larvae survival and microbiome structure. Survival, PBDE uptake and microbial community composition were measured in fourth instar larvae exposed for 96 h to BDEs- 47, 99, 100 and 153 in the presence and absence of 1% w/w MP in sediment. Microbiome community structures were determined through high throughput sequencing of 16S small subunit ribosomal RNA gene (16S rRNA). Initial experiments showed that larvae ingested MP faster at 0.5% w/w MP, while depuration was more efficient at 1% w/w MP, although retention of MP was seen even after 168 h depuration. No mortality was observed as a result of PBDEs and MP exposure. MP had a negative effect on PBDE concentration within larvae (η2 = 0.94) and a negative effect on sediment concentrations (η2 = 0.48). In all samples, microbial communities were dominated by Alphaproteobacteria, Betaproteobacteria, Actinobacteria and Gammaproteobacteria. Bacterial alpha diversity was not significantly affected by PBDEs or MP exposure. However, the abundance of discrete bacterial taxa was more sensitive to MP (X2 = 45.81, p = 0.02), and PBDE exposure. Our results highlight that C. sancticaroli showed no acute response to MPs and PBDEs, but that MPs influenced bacterial microbiome structure even after only short-term acute exposure

Salud bucal: representaciones sociales en madres gestantes de una población urbana. Medellín, Colombia Oral health: social representations among pregnant mothers. Medellin, Colombia

A partir de la teoría de las representaciones sociales, se realizó una investigación cualitativa con el propósito de comprender las representaciones sociales del proceso salud-enfermedad bucal en madres gestantes de una población urbana. Se entrevistaron 28 mujeres adultas asistentes al programa prenatal en una institución de salud de la ciudad de Medellín. Las entrevistas fueron grabadas y transcritas y se analizaron mediante codificación abierta, axial y selectiva, de acuerdo con la teoría fundada. Los hallazgos revelaron que si bien para las madres gestantes la boca del hijo no ocupa un lugar preponderante al inicio del ciclo vital, gana importancia con el proceso de crecimiento y desarrollo del niño, cuando además de su papel en la masticación y alimentación, adquiere una carga social relevante. El análisis dio cuenta de cómo confluyen en las madres de una población urbana representaciones arraigadas en la tradición, con nuevas visiones en cuya construcción hay elementos de los discursos profesionales y de los medios de comunicación; entre ellas, la estrecha relación salud bucal-dientes, la salud atada a prácticas saludables y a la utilización de servicios de salud y salud bucal como ventaja social, relacionada con la estética.<br>Based on the theory of social representations, a qualitative investigation was conducted in order to assess social representations in oral heath in pregnant mothers living in an urban environment. Twenty-eight pregnant adult women attending a prenatal program at a health institution in the city of Medellín, Colombia, were interviewed. The interviews were recorded and transcribed; analysis was performed through open, axial and selective coding, in line with grounded theory. Findings revealed that although pregnant mothers are not greatly concerned about oral health after birth and in early childhood, it increases in importance during growth and development of the child when, besides chewing and feeding aspects, it acquires a socially important role. Analysis revealed how social representations anchored in tradition, with new elements from health professional discourses as well as mass media influences coexist in mothers in an urban environment. These include the close relationship between oral health and teeth, health linked to healthy practices as well as recourse to health services and oral health as a social advantage, related to esthetic aspects