Hemoglobinopatías en comunidades de raza negra de los ríos Cayapas y Onzoles, cantón Eloy Alfaro, provincia de Esmeraldas, Ecuador

Blood samples from 1,364 individuals of Black race, inhabitants of the area bordering the Cayapas and Onzoles rivers, located in the northwest corner of the Esmeraldas' province, were analysed for haemoglobinopathies by means of haemoglobin electrophoresis using cellulose acetate and citrate agar plates. Of the studied population, 75.7% (1,032) were found to have normal haemoglobin and 24.3% (332) had some homoglobin variant. The rnost frequent variant was Hb.AS with 84.9% (282), followed by Hb.AF 9.6% (32), Hb.SS 2.7% (9), Hb.FS 2.4% (8) and Hb.FF 0.3% (1). The highest prevalence of haemoglobinopathies (31.8%) was detected in young people, 0-9 years of age, and in those aged 10-1 9 (25.8%). A higher prevalence was found in males than females throughout the two river areas studied. On the Cayapas river, cetiain geographical areas were found to have a high prevalence of haemoglobinopathies such as in Trinidad (45.5%) and Santa María (37.9%), while on the Onzoles river the prevalence was more uniform. These findings are discussed, particularly the prevalence of the genotype Hb .SS (2.7%) and the one case (0.3%) with Hb.FF electrophoretic characteristics which requires more detailed study.Se analizaron muestras de sangre de 1.364 individuos de raza negra pura, habitantes de la ribera de los ríos Cayapas y Onzoles, norte de la provincia de Esmeraldas, para hernoglobinopatías mediante electrofóresis de hemoglobina sobre acetato de celulosa y agar de citrato. El 75,7% (1.032) de la población estudiada presenta hemoglobina normal y 24,3% (332) tienevariantes de hemoglobina. La variante más frecuente fue Hb.AS con 84,9% (282), seguida de Hb.AF 9,6% (32), Hb.SS 2,7% (9), Hb.FS 2,4% (8) y Hb.FF 0,3% (1). La prevalencia más elevada se detectó en los grupos de edad jóvenes, 0-9 años (31,8%) y 10-19 años (25,8%). Los hombres presentaron mayor prevalencia que las mujeres en los dos ríos estudiados y existen áreas geográficas características con alta prevalencia en el río Cayapas, Trinidad (45,5%) y Santa María (37,9%), mientras que en el río Onzoles la prevalencia es más uniforme. Se discuten los hallazgos encontrados, principalmente, la prevalencia del genotipo Hb.SS (2,7%) y de un caso (0,3%) con características de Hb.FF que merecen ser estudiados con más detalle

El pian en la provincia de Esmeraldas, Ecuador

A clinical and serological epidemiological study in a yaws focus in cantón Eloy Alfaro, in the Santiago basin area of the province of Esmeraldas, showed a prevalence of 11.3% for active skin lesions and seropositivity of 94.9%. The Santiago river was found to be hyperendemic for yaws (prevalence 17.9), while the Zapallito river was rnesoendemic and the Cayapas and Onzole rivers were hypoendemic. Active and latent evidence of yaws was found only in the black race. Children, aged 5-12, were found to have the highest incidence (55.8%) of clinical lesions, the majority being found on the legs (64.2%). The most prevalent lesions (55.4%) were papilloma. Mass treatment of all positive communities, using benzathine penicillin G, was carried out according to WHO recommendations.Se realizó un estudio epidemiológico, clínico y serológico del pian en la cuenca del río Santiago, cantón Eloy Alfaro, provincia de Esmeraldas, el cual demostró una prevalencia del 11,3% con lesiones dérmicas activas y una seropositividad del 94,9%. El área del río Santiago era hiperendémica para el pian (prevalencia 17,9%; seropositividad 98,0%), mientras que el río Zapallito era mesoendémico y los ríos Cayapas y Onzole, hipoendémicos. Se encontró evidencia del pian, activa y latente, solamente en la raza negra. La mayor incidencia de las lesiones clínicas (55,8%) se encontró en los niños de 5-12 años de edad, localizándose el porcentaje superior en las piernas (64,2%). Los papilomas fueron las lesiones más frecuentes (55,4%). Se administró tratamiento masivo con penicilina benzatínica, según las normas de OMS, en todas las comunidades positivas para esta enfermedad

El pian en la provincia de Esmeraldas, Ecuador

Se realizó un estudio epidemiológico, clínico y serológico del pian en la cuenca del río Santiago, cantón Eloy Alfaro, provincia de Esmeraldas, el cual demostró una prevalencia del 11,3% con lesiones dérmicas activas y una seropositividad del 94,9%. El área del río Santiago era hiperendémica para el pian (prevalencia 17,9%; seropositividad 98,0%), mientras que el río Zapallito era mesoendémico y los ríos Cayapas y Onzole, hipoendémicos. Se encontró evidencia del pian, activa y latente, solamente en la raza negra. La mayor incidencia de las lesiones clínicas (55,8%) se encontró en los niños de 5-12 años de edad, localizándose el porcentaje superior en las piernas (64,2%). Los papilomas fueron las lesiones más frecuentes (55,4%). Se administró tratamiento masivo con penicilina benzatínica, según las normas de OMS, en todas las comunidades positivas para esta enfermedad

Chagas Disease in Ecuador: Evidence for Disease Transmission in an Indigenous Population in the Amazon Region

Two well-defined synthetic peptides TcD and PEP2 were used in a sero-epidemiological study for the detection of Trypanosoma cruzi infections in an indigenous group in the Amazon region of Ecuador. Of the 18 communities studied along the Río Napo, province of Napo, 15 (83.3%) were found to be positive for T. cruzi infection. Of the 1,011 individuals examined 61 (6.03%) resulted positive. A prevalence of infection of 4.8% was found in children aged 1-5 years. The prevalence of infection increased with age, with adults 50 years or older showing a maximum prevalence of 18.8%. Autochthonous transmission of T. cruzi is present among this isolated indigenous populatio

Worldwide Prevalence of <i>mcr</i>-mediated Colistin-Resistance <i>Escherichia coli</i> in Isolates of Clinical Samples, Healthy Humans, and Livestock—A Systematic Review and Meta-Analysis

Background: Antimicrobial resistance is a serious public-health problem throughout the world. Escherichia coli, the most common Gram-negative microorganism, has developed different resistance mechanisms, making treating infections difficult. Colistin is considered a last-resort drug in the treatment of infections caused by E. coli. Plasmid-mediated mobile-colistin-resistant (mcr) genes in E. coli, now disseminated globally, are considered a major public-health threat. Humans, chickens, and pigs are the main reservoirs for E. coli and the sources of antibiotic resistance. Hence, an up-to-date and precise estimate of the global prevalence of mcr resistance genes in these reservoirs is necessary to understand more precisely the worldwide spread and to more effectively implement control and prevention strategies. Methodology: Publications were identified in the PubMed database on the basis of the PRISMA guidelines. English full-text articles were selected from December 2014 to March 2021. Descriptive statistics and a meta-analysis were performed in Excel and R software, respectively. Colistin resistance was defined as the molecular-genetic detection of the mcr genes. The crude and estimated prevalence were calculated for each host and continent. The studies were divided into two groups; community-based when they involved isolates from healthy humans, chickens, or pigs, and clinical studies when they involved only hospital, outpatient, or laboratory isolates. Results: A total of 1278 studies were identified and 218 were included in this systematic review and meta-analysis, divided into community studies (159 studies) and clinical studies (59 studies). The general prevalence of mcr-mediated colistin-resistant E. coli (mcrMCRE) was 6.51% (n = 11,583/177,720), reported in 54 countries and on five continents; Asia with 119 studies followed by Europe with 61 studies registered the most articles. Asia reported the major diversity of mcr-variants (eight of nine, except mcr-2). Worldwide, chickens and pigs proved to be the principal reservoir of mcr with an estimated prevalence of 15.8% and 14.9%, respectively. Healthy humans and clinical isolates showed a lower prevalence with 7.4% and 4.2% respectively. Conclusions: In this systematic review and meta-analysis, the worldwide prevalence of mcr in E. coli isolated from healthy humans, chickens, and pigs was investigated. A wide prevalence and distribution of mcr genes was demonstrated on all continents in E. coli isolates from the selected reservoirs. Understanding the epidemiology and occurrence in the reservoirs of mcr in E. coli on different continents of the world facilitates tracing how mcr genes are transmitted and determining the infection risks for humans. This knowledge can be used to reduce the incidence of zoonotic transmission by implementing the appropriate control programs

Clinical criteria for Mucosal Leishmaniasis diagnosis in rural South America: A systematic literature review

BACKGROUND: Mucosal Leishmaniasis (ML), a neglected tropical disease caused by Leishmania parasites, impairs the quality of life of under-resourced populations in South America. If not treated promptly, this disease progresses to facial deformities and death. The low sensitivity of microscopy results and the unavailability of other accurate tests hamper the diagnosis. As clinical criteria are readily available in any setting, these may be combined in a syndromic algorithm, which in turn can be used as a diagnostic tool. We explore potential clinical criteria for a syndromic diagnostic algorithm for ML in rural healthcare settings in South America. METHODOLOGY/PRINCIPAL FINDINGS: The protocol for this systematic review was pre-registered in PROSPERO with the number: CRD42017074148. In patients with ML, described in case series identified through a systematic retrieval process, we explored the cumulative ML detection rates of clinical criteria. Participants: all patients with active mucosal disease from an endemic area in South America. Any original, non-treatment study was eligible, and case reports were excluded. PUBMED, EMBASE, Web of Science, SCIELO, and LILACS databases were searched without restrictions. The risk of bias was assessed with the JBI checklist for case series. We included 10 full texts describing 192 ML patients. Male gender had the highest detection rate (88%), followed by ulcer of the nasal mucosa (77%), age >15 (69%), and symptom duration >4 months (63%). SIGNIFICANCE: Within this selection of patients, we found that the male gender, ulcer of the nasal mucosa, age >15, and symptom duration >4 months lead to the highest detection rates. However, higher detection comes -naturally- with a higher rate of false positives as well. As we only included ML patients, this could not be verified. Therefore, the criteria that we found to be most promising should be validated in a well-designed prospective study