Transmisión del virus del dengue y su relación con factores climáticos durante los períodos intra e interepidémicos en Santo Domingo, República Dominicana

Antecedentes: Aedes spp. y la dinámica del virus del dengue está altamente influenciada por factores ambientales. Una relación detallada entre el clima y la enfermedad en los períodos inter e intra-epidémicos podrían beneficiar la vigilancia del dengue para optimizar la preparación y las políticas adecuadas de control de vectores. Métodos: se analizaron los informes de casos de dengue y las variables climáticas en Santo Domingo, República Dominicana, para determinar la correlación del período 2012-2018 y los diferentes tiempos de retraso. Se llevó a cabo un análisis de regresión de dichas variables para comprender mejor las relaciones entre las tasas de incidencia del dengue y los cambios climáticos. Resultados: durante los brotes epidémicos, la temperatura (r = 0.73, p <0.001) y la humedad relativa (r = -0.22, p = 0.009) se correlacionan significativamente con la incidencia del dengue con un retraso de 9 semanas, el análisis de regresión muestra que la temperatura media (b = 62.401, p < 0.001), precipitación (b = 2.810, p <0.001) y humedad relativa (b = -5.462, p = 0.025) fueron predictores significativos. Durante los períodos inter-epidémico, la temperatura (r = 0.23, p <0.001) tuvo una correlación significativa con la incidencia del dengue con un retraso de 7 semanas, la humedad relativa (b = 1.454, p <0.05) y la temperatura media (b = 5.14, p <0.01) son predictores significativos de la cantidad de casos de dengue. La precipitación no se correlacionó significativamente con la incidencia del dengue. Conclusiones: existe una relación no lineal entre los factores climáticos y la incidencia del dengue. La infección por dengue depende del clima, y la temperatura parece jugar un papel importante en los factores climáticos

ARBOVIROSIS TRANSMITIDAS POR MOSQUITOS (DIPTERA: CULICIDAE) EN LA REPÚBLICA DOMINICANA: UNA REVISIÓN

Entre las enfermedades infecciosas emergentes, el grupo de las arbovirosis tiene un notable impacto mundial debido a su potencial epidémico y propagación sin precedentes. Estas enfermedades, de naturaleza principalmente zoonótica, constituyen un serio problema de salud pública en las Américas y especialmente en el Caribe, donde algunas presentan un patrón de transmisión prácticamente ininterrumpido durante todo el año, convirtiéndose además en un obstáculo al desarrollo económico. De hecho, en las últimas décadas se ha observado un aumento significativo de brotes epidémicos causados por arbovirus emergentes y reemergentes en muchos países caribeños, como es el caso de la República Dominicana, donde enfermedades como el dengue, chikungunya y más recientemente los virus Zika y Mayaro están causando gran alarma en el sistema sanitario. Indudablemente, otros factores como la falta de recursos y planes adecuados de acción son motivos, entre otros, que influyen negativamente en el control de estas virosis. El presente trabajo pretende trata la situación de las principales arbovirosis vehiculadas por mosquitos (Diptera: Culicidae) que afectan a las islas del Caribe, en especial a La Española, la segunda en extensión de las Antillas

North–south pathways, emerging variants, and high climate suitability characterize the recent spread of dengue virus serotypes 2 and 3 in the Dominican Republic

Background: Dengue fever remains a significant public health challenge in tropical and subtropical regions, with its transmission dynamics being influenced by both environmental factors and human mobility. The Dominican Republic, a biodiversity hotspot in the Caribbean, has experienced recurrent dengue outbreaks, yet detailed understanding of the virus's transmission pathways and the impact of climatic factors remains limited. This study aims to elucidate the recent transmission dynamics of the dengue virus (DENV) in the Dominican Republic, utilizing a combination of genomic sequencing and epidemiological data analysis, alongside an examination of historical climate patterns. Methods: We conducted a comprehensive study involving the genomic sequencing of DENV samples collected from patients across different regions of the Dominican Republic over a two-year period. Phylogenetic analyses were performed to identify the circulation of DENV lineages and to trace transmission pathways. Epidemiological data were integrated to analyze trends in dengue incidence and distribution. Additionally, we integrated historical climate data spanning several decades to assess trends in temperature and their potential impact on DENV transmission potential. Results: Our results highlight a previously unknown north–south transmission pathway within the country, with the co-circulation of multiple virus lineages. Additionally, we examine the historical climate data, revealing long-term trends towards higher theoretical potential for dengue transmission due to rising temperatures. Conclusion: This multidisciplinary study reveals intricate patterns of dengue virus transmission in the Dominican Republic, characterized by the co-circulation of multiple DENV lineages and a novel transmission pathway. The observed correlation between rising temperatures and increased dengue transmission potential emphasizes the need for integrated climate-informed strategies in dengue control efforts. Our findings offer critical insights for public health authorities in the Dominican Republic and similar settings, guiding resource allocation and the development of preparedness strategies to mitigate the impacts of climate change on dengue transmission.info:eu-repo/semantics/publishedVersio

Modelo de Cascada de Atención para la co-infección de las hepatitis virales para el cuidado continuo en personas con VIH/Sida

Introduction: Co-infections of viral hepatitis and HIV represent a risk due to their high transmissibility and com-plications. It is vitally important that barriers to access and management of HIV and Hepatitis B and C co-infections can be identified. The purpose of the study is to describe the cascade of attention for the preparation of viral hepatitis in people living with HIV/AIDS. Methods: The management and follow-up indicators of the patients currently monitored in first-level care clinics in Santo Domingo and Santiago were delimited. The data collected was analyzed from the written records of the patients in follow-up to evaluate the epidemiological and serological data that was obtained from the clinical files. Results: It was demonstrated that 100% of the patients were enrolled, 85.7% were considered as retained in care of HIV / HBV coinfection and only 71.4% received ART-based on Tenofovir. The cascade of care for HIV / HCV coinfection shows a linkage to care of 87.5% of patients, 75% were retained and none received treatment. Conclusions: Identifying the risk factors that influence the gaps in the cascade of care is essential to optimize the management and monitoring of coinfected patients, with special interest in those that might receive immediate treat-ment to prevent liver cytopathological sequelae.Introducción: las coinfecciones con hepatitis virales y el VIH representan un riesgo por su alta transmisibilidad y complicaciones. Es de vital importancia que se puedan identificar las barreras de acceso y manejo de las coinfeccio-nes del VIH y la Hepatitis B y C. El propósito del estudio es describir la cascada de atención para la coinfección de las hepatitis virales en personas viviendo con VIH/SIDA. Métodos: se delimitaron los indicadores de manejo y seguimiento de los pacientes monitoreados actualmente en clínicas de primer nivel de atención en Santo Domingo y Santiago. Los datos recopilados fueron analizados a partir de los registros escritos de los pacientes en seguimiento, para evaluar los datos epidemiológicos y serológicos que se obtuvieron de los archivos clínicos. Resultados: se demostró que un 100 % de los pacientes fueron enrolados, 85.7 % se consideraron como retenidos en el manejo de la coinfección VIH/VHB y solamente 71.4 % recibieron TARV basado en Tenofovir. La casca-da de atención para la coinfección VIH/VHC muestra un vínculo de 87.5 % de los pacientes, 75 % fueron retenidos y ninguno recibió tratamiento. Conclusión: la identificación de los factores de riesgo que influyen en las brechas de la cascada es fundamental para optimizar el manejo y monitoreo de los pacientes coinfec-tados, teniendo en cuenta que es preciso poder reconocer aquellos infectados para iniciar tratamiento de inmediato y así prever secuelas citopatológicas hepáticas

Clima e incidencia de la Malaria durante períodos inter e intra-epidémicos en el Gran Santo Domingo, República Dominicana

Climate change has important public health implications, which are increased in malaria. In areas where the different species of Plasmodium had never been identified before, it became a reality. . Consequently, understanding the relationship between this disease and climate has become a global health priority. In this study, we extracted the reported cases of malaria and the climate reports from public information databases between 2012 and 2018. Through regression analysis, we compared weekly malaria cases with climate averages of a week of delay. During the inter-epidemic periods, relative humidity (b = .1101, p <0.001) and mean temperature (b = 0.118, p <0.001) were significant predictors of malaria incidence. However, during intra-epidemic periods, these predictors behave differently: relative humidity (b = -0.265, p <0.05) and mean temperature (b = -1.47, p <0.001). Average temperature and relative humidity drive the incidence of malaria in Santo Domingo. These two variables can serve as predictors for future outbreaks in regions of high population incidence.El cambio climático tiene importantes implicaciones de salud pública, las cuales se incrementan en la malaria. En zonas donde nunca antes se había identificado las diferentes especies de Plasmodium se convirtió en realidad. Por consiguiente, la comprensión de la relación entre esta enfermedad y el clima se ha convertido en una prioridad de salud global. En este estudio extrajimos los casos reportados de malaria y los informes climáticos de bases de datos de información pública entre 2012 y 2018. Mediante análisis de regresión confrontamos los casos de malaria semanales con promedios climáticos de semana de retraso. Durante los períodos inter-epidémicos la humedad relativa (b = .1101, p <0.001) y la temperatura media (b = 0.118, p < 0.001) fueron predictores significativos de incidencia de malaria. Sin embargo, durante los períodos intra-epidémicos, estos predictores se comportan de manera diferente: humedad relativa (b = -0.265, p<0.05) y temperatura media (b = -1.47, p<0.001). La temperatura media y la humedad relativa impulsan la incidencia de malaria en Santo Domingo. Estas dos variables pueden servir de predictores para futuros brotes en regiones de alta incidencia poblacional

Genomic Surveillance of SARS-CoV-2 Variants in the Dominican Republic and Emergence of a Local Lineage

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an RNA virus that evolves over time, leading to new variants. In the current study, we assessed the genomic epidemiology of SARS-CoV-2 in the Dominican Republic. A total of 1149 SARS-CoV-2 complete genome nucleotide sequences from samples collected between March 2020 and mid-February 2022 in the Dominican Republic were obtained from the Global Initiative on Sharing All Influenza Data (GISAID) database. Phylogenetic relationships and evolution rates were analyzed using the maximum likelihood method and the Bayesian Markov chain Monte Carlo (MCMC) approach. The genotyping details (lineages) were obtained using the Pangolin web application. In addition, the web tools Coronapp, and Genome Detective Viral Tools, among others, were used to monitor epidemiological characteristics. Our results show that the most frequent non-synonymous mutation over the study period was D614G. Of the 1149 samples, 870 (75.74%) were classified into 8 relevant variants according to Pangolin/Scorpio. The first Variants Being Monitored (VBM) were detected in December 2020. Meanwhile, in 2021, the variants of concern Delta and Omicron were identified. The mean mutation rate was estimated to be 1.5523 × 10−3 (95% HPD: 1.2358 × 10−3, 1.8635 × 10−3) nucleotide substitutions per site. We also report the emergence of an autochthonous SARS-CoV-2 lineage, B.1.575.2, that circulated from October 2021 to January 2022, in co-circulation with the variants of concern Delta and Omicron. The impact of B.1.575.2 in the Dominican Republic was minimal, but it then expanded rapidly in Spain. A better understanding of viral evolution and genomic surveillance data will help to inform strategies to mitigate the impact on public health

Global health reciprocal innovation to address mental health and well-being: strategies used and lessons learnt

Over the past two decades there have been major advances in the development of interventions promoting mental health and well-being in low- and middle-income countries (LMIC), including delivery of care by non-specialist providers, incorporation of mobile technologies and development of multilevel community-based interventions. Growing inequities in mental health have led to calls to adopt similar strategies in high-income countries (HIC), learning from LMIC. To overcome shared challenges, it is crucial for projects implementing these strategies in different global settings to learn from one another. Our objective was to examine cases in which mental health and well-being interventions originating in or conceived for LMIC were implemented in the USA. The cases included delivery of psychological interventions by non-specialists, HIV-related stigma reduction programmes, substance use mitigation strategies and interventions to promote parenting skills and family functioning. We summarise commonly used strategies, barriers, benefits and lessons learnt for the transfer of these innovative practices among LMIC and HIC. Common strategies included intervention delivery by non-specialists and use of digital modalities to facilitate training and increase reach. Common barriers included lack of reimbursement mechanisms for care delivered by non-specialists and resistance from professional societies. Despite US investigators\u27 involvement in most of the original research in LMIC, only a few cases directly involved LMIC researchers in US implementation. In order to achieve greater equity in global mental health and well-being, more efforts and targeted funding are needed to develop best practices for global health reciprocal innovation and iterative learning in HIC and LMIC

Travel surveillance uncovers dengue virus dynamics and introductions in the Caribbean

Abstract Dengue is the most prevalent mosquito-borne viral disease in humans, and cases are continuing to rise globally. In particular, islands in the Caribbean have experienced more frequent outbreaks, and all four dengue virus (DENV) serotypes have been reported in the region, leading to hyperendemicity and increased rates of severe disease. However, there is significant variability regarding virus surveillance and reporting between islands, making it difficult to obtain an accurate understanding of the epidemiological patterns in the Caribbean. To investigate this, we used travel surveillance and genomic epidemiology to reconstruct outbreak dynamics, DENV serotype turnover, and patterns of spread within the region from 2009-2022. We uncovered two recent DENV-3 introductions from Asia, one of which resulted in a large outbreak in Cuba, which was previously under-reported. We also show that while outbreaks can be synchronized between islands, they are often caused by different serotypes. Our study highlights the importance of surveillance of infected travelers to provide a snapshot of local introductions and transmission in areas with limited local surveillance and suggests that the recent DENV-3 introductions may pose a major public health threat in the region

Measurement of the impact-parameter dependent azimuthal anisotropy in coherent ρ0 photoproduction in Pb–Pb collisions at √sNN = 5.02 TeV

The first measurement of the impact-parameter dependent angular anisotropy in the decay of coherently photoproduced ρ0 mesons is presented. The ρ0 mesons are reconstructed through their decay into a pion pair. The measured anisotropy corresponds to the amplitude of the cos(2ϕ) modulation, where ϕ is the angle between the two vectors formed by the sum and the difference of the transverse momenta of the pions, respectively. The measurement was performed by the ALICE Collaboration at the LHC using data from ultraperipheral Pb−Pb collisions at a center-of-mass energy of sNN−−−√ = 5.02 TeV per nucleon pair. Different impact-parameter regions are selected by classifying the events in nuclear-breakup classes. The amplitude of the cos(2ϕ) modulation is found to increase by about one order of magnitude from large to small impact parameters. Theoretical calculations, which describe the measurement, explain the cos(2ϕ) anisotropy as the result of a quantum interference effect at the femtometer scale that arises from the ambiguity as to which of the nuclei is the source of the photon in the interaction