Encuesta seroepidemiológica de pian en la Costa Pacífica colombiana

Yaws has been endemic in the Pacific Coast of Colombia, but the actual prevalence is not known. For this reason we carried out a survey in the communities of this part of the countty where cases had been observed. The active search for cases was based on clinical observations of patients with dermatological disorders, to whom VDRL and FA-ABS tests were administered. The epidemiological survey included 4 intradomiciliary cases for each of the clinical patients detected and also 42 extradomiciliary cases. From a total of 1,830 persons examined, only 6 presented positive results for the VDRL and FTA-ABS tests, which represents a treponema infection prevalence of 0.3%. None of the clinically suspected yaw cases reacted positively to the mentioned tests. These findings permit us to conclude that yaws is not a public health problem in the Pacific Coast of Colombia, and that the sole use of clinical parameters induces to mistaken diagnosis.El pian ha sido endémico en la Costa Pacífica colombiana, pero actualmente su frecuencia real es desconocida, razón por la cual se realizó un estudio en las comunidades de esta zona del país donde se habían conocido casos de pian. Se hizo búsqueda activa de casos clínicos sospechosos a través de examen físico de personas con problemas dermatológicos; a todos ellos se les practicaron exámenes serológicos de VDRL y FTA-ABS. Por cada caso clínico sospechoso de pian, se estudiaron - por clínica y serologia - 4 contactos intradomiciliarios y 42 contactos extradomiciliarios. De las 1.830 personas examinadas, sólo 6 fueron reactivas a las pruebas de VDRL y FTA-ABS, lo cual representa una prevalencia de treponematosis de 0,3%. Ninguna de las pruebas serológicas fue reactiva en los casos clínicos sospechosos de pian. Esto nos lleva a concluir que, en la Costa Pacífica colombiana, el pian no es un problema de salud pública y que se registran como pian otras enfermedades cuando el diagnóstico tiene sólo bases clínicas

Dengue en el embarazo: efectos en el feto y el recién nacido.

The risk of dengue virus infection during pregnancy has increased due to the current rash of frequent and severe dengue epidemics. The effects of dengue virus in the fetus and newborn children have been studied only superficially and with contradictory results. Therefore, a retrospective cohort study was conducted in Medellin, Colombia, to describe the fetal and postnatal effects of dengue virus infection acquired during pregnancy. Twenty-two babies born from mothers who suffered dengue during the epidemics of 1998 were compared with babies from non-infected mothers. In the exposed cohort, three premature births occurred, three children suffered from fetal anomalies and four children were born with low weight. In the non-exposed children, none of these problems were found. Psychomotor development was normal in both groups. Only the low weight subgroup was statistically significant (Fisher test, p = 0.045). These results suggested that the children from women with dengue during pregnancy present low weight, greater frequency of premature birth and increased fetal distress. A larger sample is necessary to confirm these results.El riesgo de infección por el virus del dengue durante el embarazo se está incrementando ante mayores y más severas epidemias, y las consecuencias sobre el feto y el recién nacido han sido poco estudiadas y, en otros casos, los resultados han sido contradictorios. Por esta razón, se realizó en Medellín un estudio de cohorte retrospectiva, cuyo objetivo fue determinar los efectos que produce el dengue durante el embarazo sobre el feto y el recién nacido. En dicho estudio se evaluaron 22 recién nacidos hijos de mujeres que presentaron dengue durante la epidemia de 1998 y se compararon con 24 recién nacidos, hijos de mujeres embarazadas sin dengue. En la cohorte con dengue se encontraron 3 niños prematuros, 3 niños con sufrimiento fetal y 4 niños con bajo peso al nacer. En la cohorte no expuesta no se encontraron niños con estos problemas. El desarrollo psicomotor fue normal en ambos grupos. De las observaciones anteriores, sólo fue estadísticamente significativa la frecuencia de niños con bajo peso al nacer (prueba exacta de Fisher, p=0,045). Estos resultados preliminares muestran que los recién nacidos de madres que sufrieron dengue durante la gestación tuvieron riesgo de bajo peso al nacer y presentaron con mayor frecuencia prematurez y sufrimiento fetal, aunque se requiere aumentar el tamaño de la muestra para confirmar estos resultados. Sin embargo, es necesario estrechar la vigilancia a las madres embarazadas con dengue dados los efectos nocivos sobre la evolución del recién nacido

Encuesta seroepidemiológica de pian en la Costa Pacífica colombiana

El pian ha sido endémico en la Costa Pacífica colombiana, pero actualmente su frecuencia real es desconocida, razón por la cual se realizó un estudio en las comunidades de esta zona del país donde se habían conocido casos de pian. Se hizo búsqueda activa de casos clínicos sospechosos a través de examen físico de personas con problemas dermatológicos; a todos ellos se les practicaron exámenes serológicos de VDRL y FTA-ABS. Por cada caso clínico sospechoso de pian, se estudiaron - por clínica y serologia - 4 contactos intradomiciliarios y 42 contactos extradomiciliarios. De las 1.830 personas examinadas, sólo 6 fueron reactivas a las pruebas de VDRL y FTA-ABS, lo cual representa una prevalencia de treponematosis de 0,3%. Ninguna de las pruebas serológicas fue reactiva en los casos clínicos sospechosos de pian. Esto nos lleva a concluir que, en la Costa Pacífica colombiana, el pian no es un problema de salud pública y que se registran como pian otras enfermedades cuando el diagnóstico tiene sólo bases clínicas

Women's reluctance for pregnancy : Experiences and perceptions of Zika virus in Medellin, Colombia

Objective: To explore how being infected with the Zika virus during pregnancy was experienced by affected women, and how it influenced their family relationships and future family planning. Methods: We conducted a qualitative study, including 19 semistructured interviews with women of reproductive age and confirmed Zika infection during 2015-2018 in Medellin, Colombia. Purposeful sampling was applied, and participants were identified through National Public Health Surveillance System records. Interviews were recorded, transcribed verbatim, and analyzed using content analysis with inductive and deductive approaches. Results: Of 19 women interviewed, eight women identified the pregnancy as unexpected and two women had undergone permanent sterilization. Women had mixed views about decision-making related to family planning, and not having an abortion in a future pregnancy was influenced by religious beliefs. Women knew about vector-borne transmission but were not well informed about sexual transmission of the virus. Women desired better support and guidance to ease concerns about Zika virus. Conclusion: All interviewed women expressed a need for more information about Zika virus and continuous support, specifically after delivery, from healthcare professionals. Communication strategies to enhance culturally sensitive messages and for accurate perception of information are recommended during Zika outbreaks.Supplement: 2. Special Issue: SI</p

Association of IL4R-rs1805016 and IL6R-rs8192284 polymorphisms with clinical dengue in children from Colombian populations

Background: Etiologic studies provide evidence that IL-4R and IL-6R receptors may play important roles in the regulatory mechanisms of the development of clinical dengue, especially in children which is a segment of the population with high severe dengue risk. Moreover, the allele frequencies and genetic associations may be influenced by the populational genetic background. Therefore, we performed a case-control study to evaluate possible associations between SNPs in IL4R and IL6R genes and clinical dengue in children from two Colombian populations. Methods: We genotyped the rs1805016 (IL4R) and rs8192284 (IL6R) by PCR-RFLP method, in 298 symptomatic children and 648 asymptomatic controls. Three individual genetic ancestral proportions (APs) (European, Amerindian, African) were inferred by genotyping 29 AIMs (Ancestry informative markers). The variables gender, APs, and the population of origin were used like confusion variables. Results: We found IL4R-rs1805016 GG genotype and G-allele carriers and IL6R-rs8192284 AA genotype associated with clinical dengue in the pooled and Huila samples. Nevertheless, we found no association of these polymorphisms in the sample of Antioquia. Conclusions: For the first time, we report SNPs in IL4R and IL6R genes associated with clinical dengue, which contributes to understanding the genetic susceptibility to dengue disease. Moreover, these results may be influenced by genetic background and must be evaluated through functional analysis. Keywords: SNPs, Dengue, IL4R, IL6R, Th2 respons

Assessing the reporting of Dengue, Chikungunya and Zika to the National Surveillance System in Colombia from 2014-2017: A Capture-recapture analysis accounting for misclassification of arboviral diagnostics.

BackgroundChikungunya, dengue, and Zika are three different arboviruses which have similar symptoms and are a major public health issue in Colombia. Despite the mandatory reporting of these arboviruses to the National Surveillance System in Colombia (SIVIGILA), it has been reported that the system captures less than 10% of diagnosed cases in some cities.Methodology/principal findingsTo assess the scope and degree of arboviruses reporting in Colombia between 2014-2017, we conducted an observational study of surveillance data using the capture-recapture approach in three Colombian cities. Using healthcare facility registries (capture data) and surveillance-notified cases (recapture data), we estimated the degree of reporting by clinical diagnosis. We fit robust Poisson regressions to identify predictors of reporting and estimated the predicted probability of reporting by disease and year. To account for the potential misclassification of the clinical diagnosis, we used the simulation extrapolation for misclassification (MC-SIMEX) method. A total of 266,549 registries were examined. Overall arboviruses' reporting ranged from 5.3% to 14.7% and varied in magnitude according to age and year of diagnosis. Dengue was the most notified disease (21-70%) followed by Zika (6-45%). The highest reporting rate was seen in 2016, an epidemic year. The MC-SIMEX corrected rates indicated underestimation of the reporting due to the potential misclassification bias.ConclusionsThese findings reflect challenges on arboviruses' reporting, and therefore, potential challenges on the estimation of arboviral burden in Colombia and other endemic settings with similar surveillance systems

Statistical properties of the surface velocity field in the northern Gulf of Mexico sampled by GLAD drifters

The Grand LAgrangian Deployment (GLAD) used multiscale sampling and GPS technology to observe time series of drifter positions with initial drifter separation of O(100 m) to O(10 km), and nominal 5 min sampling, during the summer and fall of 2012 in the northern Gulf of Mexico. Histograms of the velocity field and its statistical parameters are non-Gaussian; most are multimodal. The dominant periods for the surface velocity field are 1–2 days due to inertial oscillations, tides, and the sea breeze; 5–6 days due to wind forcing and submesoscale eddies; 9–10 days and two weeks or longer periods due to wind forcing and mesoscale variability, including the period of eddy rotation. The temporal e-folding scales of a fitted drifter velocity autocorrelation function are bimodal with time scales, 0.25–0.50 days and 0.9–1.4 days, and are the same order as the temporal e-folding scales of observed winds from nearby moored National Data Buoy Center stations. The Lagrangian integral time scales increase from coastal values of 8 h to offshore values of approximately 2 days with peak values of 3–4 days. The velocity variance is large, O(1)m2/s2, the surface velocity statistics are more anisotropic, and increased dispersion is observed at flow bifurcations. Horizontal diffusivity estimates are O(103)m2/s in coastal regions with weaker flow to O(105)m2/s in flow bifurcations, a strong jet, and during the passage of Hurricane Isaac. The Gulf of Mexico surface velocity statistics sampled by the GLAD drifters are a strong function of the feature sampled, topography, and wind forcingEnvironmental Fluid Mechanic

Active galactic nuclei: what’s in a name?

Active Galactic Nuclei (AGN) are energetic astrophysical sources powered by accretion onto supermassive black holes in galaxies, and present unique observational signatures that cover the full electromagnetic spectrum over more than twenty orders of magnitude in frequency. The rich phenomenology of AGN has resulted in a large number of different "flavours" in the literature that now comprise a complex and confusing AGN "zoo". It is increasingly clear that these classifications are only partially related to intrinsic differences between AGN, and primarily reflect variations in a relatively small number of astrophysical parameters as well the method by which each class of AGN is selected. Taken together, observations in different electromagnetic bands as well as variations over time provide complementary windows on the physics of different sub-structures in the AGN. In this review, we present an overview of AGN multi-wavelength properties with the aim of painting their "big picture" through observations in each electromagnetic band from radio to gamma-rays as well as AGN variability. We address what we can learn from each observational method, the impact of selection effects, the physics behind the emission at each wavelength, and the potential for future studies. To conclude we use these observations to piece together the basic architecture of AGN, discuss our current understanding of unification models, and highlight some open questions that present opportunities for future observational and theoretical progress.Comment: Accepted for publication in Astronomy & Astrophysics Review, 56 pages, 25 figure