Epidemiological studies of tick-borne bacterial pathogens in urban and peri-urban areas of the Metropolitan Area of Buenos Aires

Urbanization has created a new geography, where there are no longer metropolitan areas surrounded by well-defined rural areas. Urban, semi-urban and semi-rural areas create an urban-rural interface, and in turn converge with natural areas (in some cases areas protected) in an urban-wild interface. All these areas are interrelated, allowing a large circulation of people, domestic animals, food products, and traffic of fauna (legal and illegal), providing new opportunities for the dispersal of pathogens and vectors. The increase of human and animal cases of infections caused by tick-borne pathogens in urban and peri-urban areas in recent years, together with the appearance and / or presence of infectious agents originating in natural areas, is closely related with these interfaces. In this sense, most domestic and wild animals (especially synanthropic) present in urban and peri-urban environments can act as hosts for some species of ticks and, in turn, be exposed to a variety of pathogens to which they may be susceptible. To analyze the richness of tick species in the urban-natural interface, in the Autonomous City of Buenos Aires, with emphasis on protected urban areas and neighboring neighborhoods, studies were carried out in the Rodrigo Bueno neighborhood (with high epidemiological risk and in close relationship with the Costanera Sur Ecological Reserve) and in the Ciudad Universitaria - Costanera Norte Ecological Reserve, both in the environment and in companion animals. Studies are currently being carried out on ticks and associated pathogens in areas of urban-rural-natural interfaces in the Exaltación de la Cruz district (Province of Buenos Aires). These studies contribute to the knowledge about the epidemiology of microorganisms transmitted by ticks in urban and peri-urban environments, within the framework of the "One Health" concept.Fil: González, S. Universidad de Buenos Aires. Facultad de Ciencias Veterinarias. Cátedra de Estadística. Buenos Aires, ArgentinaFil: González, S. Universidad de Buenos Aires. Facultad de Ciencias Veterinarias. Centro de Estudios Transdisciplinarios de Epidemiología (CETE). Buenos Aires, ArgentinaFil: Graciano, L. Universidad de Buenos Aires. Facultad de Ciencias Veterinarias. Cátedra de Salud Pública. Buenos Aires, ArgentinaFil: Graciano, L. Universidad de Buenos Aires. Facultad de Ciencias Veterinarias. Centro de Estudios Transdisciplinarios de Epidemiología (CETE). Buenos Aires, ArgentinaFil: Labanchi Alurralde, M. Universidad de Buenos Aires. Facultad de Ciencias Veterinarias. Centro de Estudios Transdisciplinarios de Epidemiología (CETE). Buenos Aires, ArgentinaFil: Cicuttin, G.L. Universidad de Buenos Aires Facultad de Ciencias Veterinarias, Cátedra de Salud Pública. Buenos Aires, ArgentinaFil: Cicuttin, G.L. Universidad de Buenos Aires. Facultad de Ciencias Veterinarias. Centro de Estudios Transdisciplinarios de Epidemiología (CETE). Buenos Aires, ArgentinaFil: Cicuttin, G.L. Gobierno de la Ciudad Autónoma de Buenos Aires. Ministerio de Salud. Instituto de Zoonosis Luis Pasteur. Buenos Aires, ArgentinaFil: Marcos E. Universidad de Buenos Aires. Facultad de Ciencias Veterinarias. Cátedra de Salud Pública. Buenos Aires, ArgentinaFil: Marcos E. Universidad de Buenos Aires. Facultad de Ciencias Veterinarias. Centro de Estudios Transdisciplinarios de Epidemiología (CETE). Buenos Aires, ArgentinaFil: Degregorio, O. Universidad de Buenos Aires. Facultad de Ciencias Veterinarias. Cátedra de Salud Pública. Buenos Aires, ArgentinaFil: Degregorio, O. Universidad de Buenos Aires. Facultad de Ciencias Veterinarias. Centro de Estudios Transdisciplinarios de Epidemiología (CETE). Buenos Aires, ArgentinaLa urbanización ha creado una nueva geografía, donde ya no hay áreas metropolitanas rodeadas de zonas\nrurales bien definidas. Áreas urbanas, semiurbanas y semirurales crean una interfase urbana-rural, y confluyen a su vez con áreas naturales (en algunos casos áreas protegidas) en una interfase urbana-silvestre. Todas estas áreas están relacionadas entre sí, posibilitando una gran circulación de personas, animales domésticos, productos alimenticios, y el tráfico (legal e ilegal) de fauna, proporcionando nuevas oportunidades para la dispersión de patógenos y vectores. El incremento en la ocurrencia de casos, humanos y animales, de infecciones causadas por patógenos transmitidos por garrapatas, en áreas urbanas y periurbanas en los últimos años, junto a la aparición y/o presencia de agentes infecciosos originados en áreas naturales, está íntimamente relacionado con estas interfases. En ese sentido, la mayoría de los animales domésticos y silvestres (especialmente sinantrópicos) presentes en entornos urbanos y periurbanos pueden actuar como hospedadores para algunas especies de garrapatas, y a su vez, exponerse a una variedad de patógenos a los que pueden ser susceptibles. Para analizar la riqueza de especies de garrapatas en la interfase urbana-natural en la Ciudad Autónoma de Buenos Aires, con énfasis en las áreas urbanas protegidas y los barrios aledaños, se realizaron estudios en el Barrio Rodrigo Bueno (de alto riesgo epidemiológico y en estrecha relación con la Reserva Ecológica Costanera Sur) y en la Reserva Ecológica Ciudad Universitaria ? Costanera Norte, tanto en el ambiente como en animales de compañía. Actualmente, se desarrollan estudios sobre garrapatas y patógenos asociados en áreas de interfases urbano-rural natural en el partido de Exaltación de la Cruz (Provincia de Buenos Aires). Estos estudios aportan al conocimiento sobre la epidemiología de los microorganismos transmitidos por garrapatas en ambientes urbanos y periurbanos en el marco del concepto de "Una Salud"

Pilot field trial of the EG95 vaccine against ovine cystic echinococcosis in Rio Negro, Argentina: Early impact and preliminary data

The fulltext of this publication will be made publicly available after relevant embargo periods have lapsed and associated copyright clearances obtained.Cystic echinococcosis is endemic in the Rio Negro province of Argentina. After 30 years of control using praziquantel in dogs the transmission rate to humans and sheep has decreased significantly, however transmission persists. The objective of the study is to assess the impact of the inclusion of the EG95 vaccine for sheep in the control programme, including analysis of the vaccine's operative feasibility in field conditions. The vaccine was applied in an area comprising four communities of native people including 79 farms with 3146 lambs and 311 dogs in total. Seventy one farms were designated as control areas where no vaccinations were undertaken while vaccinations of lambs undertaken on 91 farms. Lambs received two vaccinations with the EG95 vaccine followed by a single booster injection when the animals were 1-1.5 years of age. Farm locations were defined using GPS coordinates for the houses. Evidence for Echinococcus granulosus transmission was monitored by coproantigen ELISA on samples of dog faeces, by E. granulosus-specific PCR using soil samples, and anti-E. granulosus antibody assessments in sera from 2 to 4 teeth lambs, purgation of dogs to detect E. granulosus worms and necropsy on adult sheep. Before the vaccine was introduced, 26.2% of sheep with 2-4 teeth were positive using ELISA/WB, the prevalence decreased to 7.8% at the third year following use of the vaccine. Necropsy of animals older than 6 years (not vaccinated) showed that 66.1% of animals were infected with E. granulosus. In dogs, 4% was found positive for E. granulosus using arecoline purgation and 24.7% of the farms were infected using coproELISA/WB. During the first year of vaccination 2721 lambs received the first vaccine dose and 2448 received a booster. In the second year 2138 lambs were initially vaccinated and 1745 received a booster, and 1308 animals received the third dose. During the third year 1110 lambs received the first dose from which 539 received a booster and 723 animals received the third dose. An analysis of advantages and limitations of the diagnostic techniques used and the ability of the geospatial analysis to detect risk area are included. Based in the immunodiagnostic techniques, the EG95 vaccine has been able to prevent the infection in animals up to 3 years old. Also, the difficulties in the field for the correct vaccine administration and the social features and habits that may impact on echinococcosis control are included in the analysis

Early diagnosis, treatment and follow-up of cystic echinococcosis in remote rural areas in Patagonia: impact of ultrasound training of non-specialists.

Cystic echinococcosis (CE) is a chronic, complex and neglected disease caused by the larval stage of Echinococcus granulosus. The effects of this neglect have a stronger impact in remote rural areas whose inhabitants have no chances of being diagnosed and treated properly without leaving their jobs and travelling long distances, sometimes taking days to reach the closest referral center. BACKGROUND: In 1980 our group set up a control program in endemic regions with CE in rural sections of Rio Negro, Argentina. Since 1997, we have used abdominopelvic ultrasound (US) as a screening method of CE in school children and determined an algorithm of treatment. OBJECTIVES: To describe the training system of general practitioners in early diagnosis and treatment of CE and to evaluate the impact of the implementation of the field program. MATERIALS AND METHODS: In 2000, to overcome the shortage of radiologists in the area, we set up a short training course on Focused Assessment with Sonography for Echinococcosis (FASE) for general practitioners with no previous experience with US. After the course, the trainees were able to carry out autonomous ultrasound surveys under the supervision of the course faculty. From 2000 to 2008, trainees carried out 22,793 ultrasound scans in children from 6 to 14 years of age, and diagnosed 87 (0.4%) new cases of CE. Forty-nine (56.4%) were treated with albendazole, 29 (33.3%) were monitored expectantly and 9 (10.3%) were treated with surgery. DISCUSSION: The introduction of a FASE course for general practitioners allowed for the screening of CE in a large population of individuals in remote endemic areas with persistent levels of transmission, thus overcoming the barrier of the great distance from tertiary care facilities. The ability of local practitioners to screen for CE using US saved the local residents costly travel time and missed work and proved to be an efficacious and least expensive intervention tool for both the community and health care system

Female sexuality and vaginal health across the menopausal age

Objective:The primary aim was to evaluate changes in female sexuality across the menopausal period, and the secondary objective was to test the associations of female sexuality domains with vaginal atrophy and its symptoms.Methods:A cross-sectional multicenter study was performed involving 518 women, 40 to 55 years of age, consulting outpatient gynecological services at 30 centers across Italy. Vaginal atrophy was identified by the contemporaneous presence of a pH >5, subjective vaginal dryness, and an objective sign. The relationships between vaginal atrophy and its main symptoms (vaginal dryness and dyspareunia), and Female Sexual Function Index (FSFI) score and its domains (desire, arousal, orgasm, dyspareunia, lubrication, and sexual satisfaction) were analyzed.Results:The prevalence of sexual dysfunction, as defined by a FSFI score <26.55, was 70.6%, increasing from 55% in the years 40 to 45, to 82.8% (P<0.01) in the years 52 to 55 of age. Mean FSFI score decreased from 40 to 45, to 46 to 48 years of age (23.13±9.76 vs 19.49±9.88; P<0.05), and from 48 to 51, to 52 to 55 years of age (21.3±8.06 to 17.59±9.11; P<0.01). Independent determinants of FSFI were age, vaginal atrophy, and the presence of vaginal dryness and dyspareunia (R2 0.208; P=0.011). FSFI score was independently correlated (R2 0.116) with weight (CR -0.067; 95% confidence interval [CI] -0.126, -0.006; P<0.032), menopausal status (CR -2.406; 95% CI -4.180, -0.63; P<0.008), and vaginal dryness (CR -5.647; 95% CI -7.677, -3.618; P<0.0001). Vaginal dryness was the only variable correlated independently with each FSFI domain, including desire (also correlated with menopausal status), arousal (with age and menopausal status), lubrication (with age), orgasm (with age), satisfaction (with vaginal atrophy and being an ex-smoker), and dyspareunia (with age and spontaneously referred dyspareunia).Conclusions:In the perimenopausal years, FSFI score decreases and sexual dysfunction increases by about 30%. Vaginal dryness is the symptom of vaginal atrophy most closely related to all domains of female sexuality