Distribución espacial de los vectores de las enfermedades re emergentes (chagas, paludismo y dengue) en el estado de Jalisco, México.

El presente trabajo fue financiado por proyecto: “Frecuencia y distribución espacial de enfermedades emergentes y re emergentes en el occidente de México: Chagas, Paludismo, Dengue, Tuberculosis e Influenza” en los estados de Jalisco, Colima y Nayarit. Un estudio transversal analítico multidisciplinario, con muestreo probabilístico estratificado, dividido en dos vertientes: a) Estudio para estimar prevalencia de punto de las enfermedades adelante señaladas en población abierta así como la distribución espacial de los vectores que transmites estas enfermedades y b) Estudio intencionado en pacientes febriles para determinar la frecuencia de dichas enfermedades en su fase activa. La población objeto del estudio son los habitantes de los Estados de Jalisco, Nayarit y Colima. Este trabajo de tesis consistió en estudiar a los vectores de las enfermedades reemergentes Chagas, Dengue y Paludismo en el estado de Jalisco que correspondió a la Universidad de Guadalajara, y se llevó a cabo en dos fases: en la primera, se enfocó a la identificación y distribución espacial de los vectores en 11 localidades con una n=10 por cada una de estas. En cada vivienda se aplicó una encuesta de vectores, Se utilizó un aspirador (backpack aspirator de bioquip) para colecta de mosquitos intradomiciliarios y peridomiciliarios, colecta manual de larvas y búsqueda activa de triatominos (1hr hombre/vivienda), se dejó una ovitrampa tanto en el interior como en el exterior de cada vivienda y se recogieron 10 días posterior al muestreo. En la segunda fase se seleccionaron 3 localidades de acuerdo a los resultados obtenidos y tomando en cuenta altitud, tipo de hábitat, distancia y recursos para su muestreo. Estos “centros centinela” fueron muestreados mensualmente para la búsqueda y captura de vectores. En ambas fases los organismos capturados fueron depositados en recipientes y rotulados con los datos de colecta y trasladados al laboratorio en donde se identificaron los organismos, se contabilizaron y fueron montados para formar parte de referencia de la colección entomológica. Los resultados alimentaron un Sistema de Información Geográfica (SIG). ABSTRACT The present work was financed by the project: "Frequency and spatial distribution of emerging and re emerging diseases in western Mexico: Chagas, Malaria, Dengue, Tuberculosis and Influenza" in the states of Jalisco, Colima and Nayarit. A multidisciplinary analytical cross-sectional study, with stratified probabilistic sampling, divided into two aspects: a) Study to estimate point prevalence of the diseases indicated in the open population as well as the spatial distribution of the vectors that transmit these diseases and b) Intentional study in patients Febrile to determine the frequency of these diseases in their active phase. The population studied is the inhabitants of the States of Jalisco, Nayarit and Colima. This thesis work consisted in studying the vectors of re-emerging diseases Chagas, Dengue and Malaria in the state of Jalisco that corresponded to the University of Guadalajara, and it was carried out in two phases: in the first, it focused on the identification and spatial distribution of the vectors in 11 localities with an n = 10 for each of these. A vector survey was applied in each house. A vacuum (bioquip backpack aspirator) was used to collect intradomiciliary and peridomiciliary mosquitoes, manual collection of larvae and active search for triatomines (1hr man / house), an ovitrap was left in both the inside and outside of each home and were collected 8 to 10 days after sampling. In the second phase, three localities were selected according to the results obtained and taking into account altitude, habitat type, distance and resources for sampling. These "sentinel centers" were sampled monthly for the search and capture of vectors. In both phases, the captured organisms were deposited in containers, labeled with the collection data and transferred to the laboratory where the organisms were identified, counted and assembled to form a reference part of the entomological collection. The results fed a Geographic Information System (GIS)

El trasplante cardiaco por enfermedad de Chagas en México

The aim of this report is to present the clinical, surgical, paraclinical, therapeutical and epidemiological data supporting the first heart transplant case related to Chagas disease in Mexico. The subject, a 35 year old male, was diagnosed with a dilated cardiomyopathy unable to support life. Serological testing was completed, and T. cruzi isolated after a surgical intervention due to post operatory complications to the transplant. Nine years after transplantation, the patient was considered cured and re-entered the labor force. Patients clinically diagnosed with dilated cardiomyopathy and positive serology for T. cruzi, are frequent, representing 15% in the country. The presence of this case and its diagnostic circumstances indicates the existence of a greater number of already transplanted undiagnosed cases in the country. Therefore it is necessary to recognize the role of Chagas disease in heart transplantation candidates due to dilated cardiomyopathy.El objetivo de este escrito, es presentar los datos clínicos, quirúrgicos, paraclínicos, terapeúticos, y epidemiológicos que sustentan la existencia del primer caso de trasplante cardíaco por cardiopatía chagásica en México. Se trata de un paciente masculino de 35 años de edad, al que se realizó trasplante cardiaco por cardiomiopatia dilatada no compatible con la vida; comprobado por serología y aislamiento del T. cruzi posterior a la intervención quirúrgica realizada al presentar complicaciones posteriores al trasplante. A 9 años del trasplante, el paciente se considera curado y reintegrado al trabajo. Los pacientes diagnosticados clínicamente con miocardiopatía dilatada y serología positiva a T cruzi, son frecuentes, en el orden de 15% en el país. La presencia del presente caso y la circunstancia en que se diagnosticó, orienta la existencia de un mayor número de casos ya trasplantados y no diagnosticados en el país. Por lo tanto, es necesario reconocer en pacientes candidatos a trasplante cardiaco por miocardiopatía dilatada, la enfermedad de Chagas

Predominance of Trypanosoma cruzi Lineage I in Mexico

Randomly amplified polymorphic DNA (RAPD) has emerged as an effective genetic marker for analysis of Trypanosoma cruzi population variability. This method has been used to study the genetic variability of Mexican T. cruzi stocks and to relate these results to previous classifications. High clonal diversity was observed among the Mexican populations: 24 RAPD types were scored among 56 stocks analyzed. Only two stocks (3.6%) belonged to the T. cruzi II lineage, while all others belonged to T. cruzi I. The robustness of these clusters was statistically highly significant. Mexican T. cruzi I stocks formed a homogeneous group with reduced genetic distances among its members. Parasites from this group were isolated from both domestic and sylvatic cycles over a broad geographic area in Mexico. The two Mexican stocks classified as T. cruzi II (isolated from sylvatic cycles) were of the same RAPD type, although they were not closely related to the three reference T. cruzi II stocks circulating in domestic cycles in Argentina, Brazil, Bolivia, and Chile. These stocks were also unrelated to the formerly named Zymodeme III