Unidentified dengue serotypes in DENV positive samples and detection of other pathogens responsible for an acute febrile illness outbreak 2016 in Cajamarca, Peru

Objective: To describe the prevalence of dengue virus serotypes, as well as other viral and bacterial pathogens that cause acute febrile illness during an outbreak in Cajamarca in 2016. Results: Dengue virus (DENV) was the most frequent etiologic agent detected in 25.8% of samples (32/124), followed by Rickettsia spp. in 8.1% (10/124), Zika virus in 4.8% (6/124), Chikungunya virus 2.4% (3/124) and Bartonella bacilliformis 1.6% (2/124) cases. No positive cases were detected of Oropouche virus and Leptospira spp. DENV serotypes identification was only achieved in 23% of the total positive for DENV, two samples for DENV-2 and four samples for DENV-4. During the 2016 outbreak in Cajamarca-Peru, it was observed that in a large percentage of positive samples for DENV, the infecting serotype could not be determined by conventional detection assays. This represents a problem for the national surveillance system and for public health due to its epidemiological and clinical implications. Other viral and bacterial pathogens responsible for acute febrile syndrome were less frequently identified.Revisión por pare

Clinical characteristics and molecular detection of bordetella pertussis in hospitalized children with a clinical diagnosis of whooping cough in Peru

Background and Objectives: Pertussis is an infectious disease caused by the Gram-negative bacterium Bordetella pertussis. In Peru, actual public health programs indicate that vaccination against B. pertussis must be mandatory and generalized, be-sides all detected cases must be reported. The objective of this study was to determine the prevalence of B. pertussis among children under five years of age with a presumptive diagnosis of whopping cough in Cajamarca, a region located in northern Peru. Materials and Methods: The population of this cross-sectional study were children under 5 years old hospitalized as presumptive cases of pertussis during December 2017 to December 2018. The nasopharyngeal samples were analyzed by real-time PCR for the detection of B. pertussis. Results: B. pertussis was identified as PCR + in 42.3% of our sample (33/78). The clinical presentation that was observed most frequently includes paroxysmal coughing (97%), difficulty breathing (69.7%), cyanosis (72.7%) and post-tussive em-esis (60.6%). Additionally, pneumonia was the most observed complication (33.3%). Four of the patients with PCR+ for B. pertussis presented only lymphocytosis, five only leukocytosis, two patients with decreased leukocytosis and lymphocytes and only one patient with leukopenia and relative lymphocytosis. There was a percentage of 84.8% of unvaccinated children in the PCR+ group. Finally, the mother was the most frequent symptom carrier (18.2%). Conclusion: In conclusion, in the studied population there is a high rate of PCR+ cases for B. pertussis. Laboratory values may show leukopenia or lymphopenia in patients with pertussis. It is necessary to use appropriate laboratory diagnostic tests in all infants with respiratory symptoms for B. pertussis. Since, the clinical diagnosis overestimates the diagnosis of pertussis.Revisión por pare

Bordetella pertussis diagnosis in children under five years of age in the Regional Hospital of Cajamarca, Northern Peru

Introduction: Bordetella pertussis is an important human pathogen that causes whooping cough (pertussis), an endemic illness responsible of significant morbidity and mortality, especially in infants and children. Worldwide, there are an estimated of 16 million cases of pertussis, resulting in about 195,000 child deaths per year. In Peru, pertussis is a major health problem that has been on the increase despite immunization efforts. The objective of this study was to determine the prevalence of B. pertussis among children under five years of age suspected to have whopping cough in Cajamarca, Peru. Methodology: Children diagnosed with whooping cough admitted to the Hospital Regional de Cajamarca from August 2010 to July 2013 were included. Nasopharyngeal samples were obtained for B. pertussis culture and polymerase chain reaction (PCR) detection. Results: In 133 children, the pertussis toxin and IS481 gene were detected in 38.35% (51/133) of the cases by PCR, while only 9.02% (12/133) of the Bordetella cultures were positive. The most frequent symptoms in patients with positive B. pertussis were paroxysm of coughing 68.63% (35/51), cyanosis 56.86% (29/51), respiratory distress 43.14% (22/51), and fever 39.22% (20/51). Pneumonia and acute bronchial obstructive syndrome were present in 17.65% (9/51) and 13.72% (7/51) of the cases, respectively. Conclusions: B. pertussis is responsible for an important proportion of whooping cough in hospitalized children in Cajamarca. Epidemiologic surveillance programs for B. pertussis are essential in Peru, especially in children who could most benefit from the vaccine.This work was partially supported by Sanofi Aventis del Peru. The authors thank Javier Vega for the language editin

Mobile Application Credismart

Para considerar este proyecto se detectó un problema en la recepción de información que obtienen los ciudadanos al momento de realizar indagaciones de créditos. Este sustento se encuentra en un informe del BCRP, “el cual indica que la deuda por habitante se multiplico entre el 2001 y 2017, de este grupo el 12% corresponde a préstamos de consumo que están en morosidad”. Por ello, nace la idea de crear un aplicativo móvil que acompañe y permita a los usuarios realizar consultas y comparaciones sobre préstamos, así mismo, agilizar el trámite de operación de un crédito personal y otras herramientas que mejoren su experiencia. De esta manera, se busca que las personas obtengan un canal de información fiable ayude a tomar una decisión inteligente y encontrar una oportunidad de ahorro. Para el desarrollo del proyecto se realizaron experimentos que permitieron identificar la aceptación para realizar la proyección de venta. Con ello, se consideraron diferentes fuentes de ingreso siendo la principal la comisión por préstamo adquirido, que se realiza a las entidades financieras, además de elaborar la estructura de procesos operativos, marketing, recursos humanos, responsabilidad social y financiero que tengan coherencia con la problemática que se pretende solucionar. Por último, dentro de los análisis cuantitativos para dar inicio al proyecto se necesita una inversión de S./38,593.25 soles para después mostrar una utilidad de S./95, 450.02 durante los cinco primeros años, por lo que se obtiene un valor del proyecto de S./. 101, 625.25In order to consider this project, a problem was detected in the reception of information obtained by citizens when making credit inquiries. This support is found in a report by the BCRP, "which indicates that the debt per inhabitant multiplied between 2001 and 2017, of this group 12% corresponds to consumer loans that are in arrears". Therefore, the idea of creating a mobile application that accompanies and allows users to make queries and comparisons on loans, as well as streamline the process of operating a personal credit and other tools that improve your experience. In this way, the aim is for people to obtain a reliable information channel to help them make an intelligent decision and find a savings opportunity. For the development of the project, experiments were carried out to identify acceptance and to be able to make the sales projection. With this, different sources of income were considered, the main one being the commission for the loan acquired, which is made to the financial entities, in addition to elaborating the structure of operative processes, marketing, human resources, social and financial responsibility that are coherent with the problem to be solved. Finally, within the quantitative analyses projected to start the project, an investment of S./ 38, 593.25 soles are needed to later show a profit of S./95,450. 02 during the first three years, so a project value of S./101, 665.25.Trabajo de investigació

An emerging public health threat: Mayaro virus increases its distribution in Peru

Background: The infection caused by Mayaro virus (MAYV), which presents as an acute febrile illness, is considered a neglected tropical disease. The virus is an endemic and emerging pathogen in South America and the Caribbean, responsible for occasional and poorly characterized outbreaks. Currently there is limited information about its expansion and risk areas. Methods: A cross-sectional study was performed in 10 urban primary care health centers in the Cajamarca region of Peru from January to June 2017. A total of 359 patients with suspected febrile illness were assessed. RNA was extracted from serum samples, following which MAYV real-time reverse transcriptase PCR (RT-PCR) for the detection of the nsP1 gene was performed. Results: MAYV was detected in 11.1% (40/359) of samples after RT-PCR amplification and confirmatory DNA sequencing. Most infections were detected in the adult population aged 18–39 years (40%) and 40–59 years (32.5%). Headache was the most frequent symptom in patients with MAYV infection (77.5%), followed by fever (72.5%), myalgia (55.0%), and arthralgia (50.0%). During the study, most of the MAYV cases were seen in May (47.5%) and April (35.0%), corresponding to the dry season (months without rain). Conclusions: This study is novel in describing the presence of MAYV in Cajamarca, an Andean region of Peru. Symptoms are non-specific and can be confused with those of other arbovirus or bacterial infections. Molecular biology methods such as RT-PCR allow the timely and accurate detection of MAYV and could thus be considered as a tool for surveillance in endemic areas.This research was supported by the Bio & Medical Technology Development Program of the National Research Foundation (NRF) funded by the Korean government (MSIT) (No. 2015M3A9B6073666 ). This study was supported by CONCYTEC Peru , under the contract No 164-2016-FONDECYT, Lima, Peru. Incentive for Research of the Universidad Peruana de Ciencias Aplicadas (No. UPC-C-01-2019), Lima, Peru. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Revisión por pare

Diarrhoea caused by rotavirus in a regional Peruvian hospital: determination of circulating genotypes

Artículo sustentado el 30 de Enero 2014 para la obtención del título profesional Médico Cirujano en la Escuela de Medicina, Facultad de Ciencias de la Salud. Universidad Peruana de Ciencias Aplicadas - UPC.Artículo publicado el 27 de Abril de 2014 en la Revista Transactions of the Royal Society of Tropical Medicine & Hygiene (Oxford University Press).Background: Gastroenteritis by rotavirus is responsible for approximately 810 annual deaths/year in children under 5 years in Peru and emerging rotavirus genotypes have led to concerns regarding cross-protection by the vaccines available. Moreover, there are no reports on the molecular-epidemiology of rotavirus diarrhea in Peru Methodology: A total of 131 stool samples were obtained from children under 5 years old hospitalized from January 2010 to December 2012 in the Hospital Regional de Cajamarca, Peru. ELISA and RT-PCR techniques were performed for rotavirus detection. G and P typing of rotavirus-positive samples were obtained by semi-nested multiplex RT-PCR and sequencing was performed to confirm the PCR results. Results: Of the 117 samples available, 18.80% (22/117) tested positive for rotavirus by ELISA and 35.90% (42/117) by RT-PCR. Among the G-genotype identified, G9 in 35.71% (15/42) and G12 in 33.33% (14/42) were the most prevalent. With the most common combination being G12/P6 in 23.81% (10/42). Conclusions: A high prevalence of the G12/P6 genotype was detected. It is know that this genotype is not covered by the current vaccines available. More in depth studies are needed to know the current rotavirus genotypes presents in Peru.Revisión por pare

Bordetella pertussis diagnosis in children under five years of age in the Regional Hospital of Cajamarca, Northern Peru

Introduction: Bordetella pertussis is an important human pathogen that causes whooping cough (pertussis), an endemic illness responsible of significant morbidity and mortality, especially in infants and children. Worldwide, there are an estimated of 16 million cases of pertussis, resulting in about 195,000 child deaths per year. In Peru, pertussis is a major health problem that has been on the increase despite immunization efforts. The objective of this study was to determine the prevalence of B. pertussis among children under five years of age suspected to have whopping cough in Cajamarca, Peru. Methodology: Children diagnosed with whooping cough admitted to the Hospital Regional de Cajamarca from August 2010 to July 2013 were included. Nasopharyngeal samples were obtained for B. pertussis culture and polymerase chain reaction (PCR) detection. Results: In 133 children, the pertussis toxin and IS481 gene were detected in 38.35% (51/133) of the cases by PCR, while only 9.02% (12/133) of the Bordetella cultures were positive. The most frequent symptoms in patients with positive B. pertussis were paroxysm of coughing 68.63% (35/51), cyanosis 56.86% (29/51), respiratory distress 43.14% (22/51), and fever 39.22% (20/51). Pneumonia and acute bronchial obstructive syndrome were present in 17.65% (9/51) and 13.72% (7/51) of the cases, respectively. Conclusions: B. pertussis is responsible for an important proportion of whooping cough in hospitalized children in Cajamarca. Epidemiologic surveillance programs for B. pertussis are essential in Peru, especially in children who could most benefit from the vaccine.This work was partially supported by Sanofi Aventis del Peru. The authors thank Javier Vega for the language editin

Bordetella pertussis in children hospitalized with a respiratory infection: clinical characteristics and pathogen detection in household contacts

Abstract Objective Describe the prevalence of Bordetella pertussis via PCR in children under 5 years old hospitalized as probable cases of pertussis and report the most common clinical features among them. Results A positive PCR result for B. pertussis was observed in 20.5% of our samples (18/88), one-third of them were from infants between 2 and 3 months old. The most common symptoms were paroxysms of coughing (88.9%), difficulty breathing (72.2%), cyanosis (77.8%) and fever (50%). The mother was the most common symptomatic carrier (27.8%), followed by uncles/aunts (22.2%) among children with pertussis

Parasitosis by <i>Fasciola hepatica</i> and Variations in Gut Microbiota in School-Aged Children from Peru

(1) Background: Human fascioliasis is considered an endemic and hyper-endemic disease in the Peruvian Andean valleys. Our objective was to determine variations in the composition of the gut microbiota among children with Fasciola hepatica and children who do not have this parasitosis. (2) Method: A secondary analysis was performed using fecal samples stored in our biobank. The samples were collected as part of an epidemiological Fasciola hepatica cross-sectional study in children from 4 through 14 years old from a community in Cajamarca, Peru. (3) Results: In a comparison of the bacterial genera that make up the intestinal microbiota between the F. hepatica positive and negative groups, it was found that there are significant differences in the determination of Lactobacillus (p = 0.010, CI: 8.5–61.4), Bacteroides (p = 0.020, CI: 18.5–61.4), Clostridium (p Bifidobacterium (p = 0.018, CI: 1.1–28.3), with each of these genera being less frequent in children parasitized with F. hepatica. (4) Conclusions: These results show that F. hepatica may be associated with direct or indirect changes in the bacterial population of the intestinal microbiota, particularly affecting three bacterial genera

Diagnosis of Carrion’s Disease by Direct Blood PCR in Thin Blood Smear Negative Samples.

Bartonella bacilliformis is the etiologic agent of Carrion’s disease. This disease has two well established phases, the most relevant being the so called Oroya Fever, in which B. bacilliformis infect the erythrocytes resulting in severe anemia and transient immunosuppression, with a high lethality in the absence of adequate antibiotic treatment. The presence of B. bacilliformis was studied in 113 blood samples suspected of Carrion’s disease based on clinical criteria, despite the absence of a positive thin blood smear, by two different PCR techniques (using Bartonella-specific and universal 16S rRNA gene primers), and by bacterial culture. The specific 16S rRNA gene primers revealed the presence of 21 B. bacilliformis and 1 Bartonella elizabethae, while universal primers showed both the presence of 3 coinfections in which a concomitant pathogen was detected plus Bartonella, in addition to the presence of infections by other microorganisms such as Agrobacterium or Bacillus firmus. These data support the need to implement molecular tools to diagnose Carrion’s disease