Factores Socioeconómicos Asociados a la Presencia de Malaria por Plasmodium Vivax en la Comunidad de Zungarococha, Iquitos, 2018

A study was conducted to determine the relationship between socioeconomic factors and the presence of malaria in the population of the community of Zungarococha during 2018. The present research was quantitative and the design was: non-experimental, transversal, descriptive and correlational. To obtain the sample, a simple probabilistic sampling was used and the interview technique with the survey was used as an instrument. For the analysis and interpretation of the results, the non-parametric free distribution test of Pearson Chi square categorical variables (X2) was chosen. A significant relationship was found between social factors (sex, age, marital status and degree of education) and economic (type of occupation, type of housing and average monthly income) with Plasmodium vivax malaria, but only male people are predictors, ages ranging from 18 to 24 years old, single, who live in a House made with materials other than noble and rustic materials, and whose monthly income is less than 930 soles.Se realizó un estudio para determinar la relación existente entre los factores socioeconómicos y la presencia de malaria en la población de la comunidad de Zungarococha durante el año 2018. La presente investigación fue de tipo cuantitativa y el diseño fue: no experimental, transversal, descriptivo y correlacional. Para obtener la muestra se utilizó un muestreo probabilístico simple y se utilizó la técnica de entrevista con la encuesta como instrumento. Para el análisis e interpretación de los resultados se eligió la prueba no paramétrica de libre distribución de variables categóricas Chi cuadrado de Pearson (X2). Se encontró relación significativa entre factores sociales (sexo, edad, estado civil y grado de instrucción) y económicos (tipo de ocupación, tipo de vivienda e ingreso promedio mensual) con la malaria por Plasmodium vivax, pero solo son predictores las personas de sexo masculino, cuyas edades oscilan entre 18 a 24 años, solteros, que viven en una Vivienda hecha con materiales distintos al material noble y rústicos, y cuyos ingresos mensuales son menores a 930 soles

"We need people to collaborate together against this disease":A qualitative exploration of perceptions of dengue fever control in caregivers' of children under 5 years, in the Peruvian Amazon

BACKGROUND:Dengue Fever presents a significant and growing burden of disease to endemic countries, where children are at particular risk. Worldwide, no effective anti-viral treatment has been identified, thus vector control is key for disease prevention, particularly in Peru where no vaccine is currently available. This qualitative study aimed to explore the perceptions of dengue control in caregivers' of children under 5 years in Peru, to help direct future mosquito control programmes and strategy. METHODS:Eighteen semi-structured interviews were conducted in one health centre in Iquitos, Peru. Interviews were audio-recorded, transcribed and translated by an independent translator. Data were analysed using an inductive thematic approach. FINDINGS:Three core analytic themes were interpreted: (1) awareness of dengue and its control, (2) perceived susceptibility of children, rural riverside communities and city inhabitants, and (3) perceived responsibility of vector control. Participants were aware of dengue symptoms, transmission and larvae eradication strategies. Misconceptions about the day-time biting behaviour of the Aedes aegypti mosquito and confusion with other mosquito-borne diseases influenced preventative practice. Community-wide lack of cooperation was recognised as a key barrier. This was strengthened by attitudes that the government or health centre were responsible for dengue control and a belief that the disease cannot be prevented through individual actions. Participants felt powerless to prevent dengue due to assumed inevitability of infection and lack of faith in preventative practices. However, children and rural communities were believed to be most vulnerable. CONCLUSIONS:Perceptions of dengue control amongst caregivers to under 5's were important in shaping their likelihood to participate in preventative practices. There is a need to address the perceived lack of community cooperation through strategies creating a sense of ownership of community control and enhancing social responsibility. The belief that dengue cannot be prevented by individual actions in a community also warrants attention. Specific misconceptions about dengue should be addressed through the community health worker system and further research directed to identify the needs of certain vulnerable groups

Participant demographics.

<p>Participant demographics.</p

Schematic representation of core analytic themes and subthemes.

<p>Schematic representation of core analytic themes and subthemes.</p

The other <i>Campylobacters</i>: Not innocent bystanders in endemic diarrhea and dysentery in children in low-income settings

<div><p>Background</p><p><i>Campylobacter</i> is one of the main causes of gastroenteritis worldwide. Most of the current knowledge about the epidemiology of this food-borne infection concerns two species, <i>C</i>. <i>coli</i> and <i>C</i>. <i>jejuni</i>. Recent studies conducted in developing countries and using novel diagnostic techniques have generated evidence of the increasing burden and importance of other <i>Campylobacter</i> species, i.e. non-<i>C</i>. <i>coli/jejuni</i>. We performed a nested case-control study to compare the prevalence of <i>C</i>. <i>coli/jejuni</i> and other <i>Campylobacter</i> in children with clinical dysentery and severe diarrhea as well as without diarrhea to better understand the clinical importance of infections with <i>Campylobacter</i> species other than <i>C</i>. <i>coli/jejuni</i>.</p><p>Methodology/Principal findings</p><p>Our nested case-control study of 439 stool samples included dysenteric stools, stools collected during severe diarrhea episodes, and asymptomatic stools which were systematically selected to be representative of clinical phenotypes from 9,160 stools collected during a birth cohort study of 201 children followed until two years of age. Other <i>Campylobacter</i> accounted for 76.4% of the 216 <i>Campylobacter</i> detections by qPCR and were more prevalent than <i>C</i>. <i>coli/jejuni</i> across all clinical groups. Other <i>Campylobacter</i> were also more prevalent than <i>C</i>. <i>coli/jejuni</i> across all age groups, with older children bearing a higher burden of other <i>Campylobacter</i>. Biomarkers of intestinal inflammation and injury (methylene blue, fecal occult test, myeloperoxidase or MPO) showed a strong association with dysentery, but mixed results with infection. MPO levels were generally higher among children infected with <i>C</i>. <i>coli/jejuni</i>, but <i>Shigella</i>-infected children suffering from dysentery recorded the highest levels (26,224 ng/mL); the lowest levels (10,625 ng/mL) were among asymptomatic children infected with other <i>Campylobacter</i>. Adjusting for age, sex, and <i>Shigella</i> infection, dysentery was significantly associated with <i>C</i>. <i>coli/jejuni</i> but not with other <i>Campylobacter</i>, whereas severe diarrhea was significantly associated with both <i>C</i>. <i>coli/jejuni</i> and other <i>Campylobacter</i>. Compared to asymptomatic children, children suffering from dysentery had a 14.6 odds of <i>C</i>. <i>coli/jejuni</i> infection (p-value < 0.001, 95% CI 5.5–38.7) but were equally likely to have other <i>Campylobacter</i> infections–odds ratio of 1.3 (0.434, 0.7–2.4). Children suffering from severe diarrhea were more likely than asymptomatic children to test positive for both <i>C</i>. <i>coli/jejuni</i> and other <i>Campylobacter</i>–OR of 2.8 (0.034, 1.1–7.1) and 1.9 (0.018, 1.1–3.1), respectively. Compared to the <i>Campylobacter</i>-free group, the odds of all diarrhea given <i>C</i>. <i>coli/jejuni</i> infection and other <i>Campylobacter</i> infection were 8.8 (<0.001, 3.0–25.7) and 2.4 (0.002, 1.4–4.2), respectively. Eliminating other <i>Campylobacter</i> in this population would eliminate 24.9% of the diarrhea cases, which is almost twice the population attributable fraction of 15.1% due to <i>C</i>. <i>coli/jejuni</i>.</p><p>Conclusions/Significance</p><p>Eighty-seven percent of the dysentery and 59.5% of the severe diarrhea samples were positive for <i>Campylobacter</i>, <i>Shigella</i>, or both, emphasizing the importance of targeting these pathogens to limit the impact of dysentery and severe diarrhea in children. Notably, the higher prevalence of other <i>Campylobacter</i> compared to <i>C</i>. <i>coli/jejuni</i>, their increasing burden during early childhood, and their association with severe diarrhea highlight the importance of these non-<i>C</i>. <i>coli/jejuni Campylobacter</i> species and suggest a need to clarify their importance in the etiology of clinical disease across different epidemiological contexts.</p></div

List of primers and probes used for the detection of <i>Campylobacter</i> (genus specific), <i>Campylobacte</i>r <i>coli/jejuni</i>, and <i>Shigella</i>.

<p>List of primers and probes used for the detection of <i>Campylobacter</i> (genus specific), <i>Campylobacte</i>r <i>coli/jejuni</i>, and <i>Shigella</i>.</p

Prevalence of <i>Campylobacter</i> and <i>Shigella</i> among children suffering from dysentery and severe diarrhea in peri-urban communities in Loreto, Peru.

<p>Prevalence of <i>Campylobacter</i> and <i>Shigella</i> among children suffering from dysentery and severe diarrhea in peri-urban communities in Loreto, Peru.</p

<i>C</i>. <i>coli/jejuni</i>, other <i>Campylobacter</i>, and <i>Shigella</i> prevalence by clinical outcome (asymptomatic infection, dysentery, severe diarrhea) using the qPCR assay.

<p><i>C</i>. <i>coli/jejuni</i>, other <i>Campylobacter</i>, and <i>Shigella</i> prevalence by clinical outcome (asymptomatic infection, dysentery, severe diarrhea) using the qPCR assay.</p

Study population characteristics by clinical outcome (control, dysentery, and severe diarrhea).

<p>Study population characteristics by clinical outcome (control, dysentery, and severe diarrhea).</p

Comparison of <i>C</i>. <i>coli/jejuni</i>, other <i>Campylobacter</i>, and <i>Shigella</i> prevalence by clinical group (control, dysentery, severe diarrhea) using qPCR and culture.

<p>Comparison of <i>C</i>. <i>coli/jejuni</i>, other <i>Campylobacter</i>, and <i>Shigella</i> prevalence by clinical group (control, dysentery, severe diarrhea) using qPCR and culture.</p