Seminario sobre investigación en tuberculosis en Paraguay : Resumen del evento

Cada año cerca de 3000 casos de Tuberculosis son registrados en el Paraguay. Esta enfermedad es siempre un tema vigente en congresos nacionales e internacionales de infectología o neumología que se realizan el país, pero nunca fue enfocado como tema central de debate, investigación de vanguardia o innovación. Hay registros de varios eventos en donde la tuberculosis es uno, entre varios temas abordados, pero pocas veces fue profundo el nivel de análisis y hasta la fecha nunca estuvieron juntos en nuestro país varios expertos de nivel global sobre el tema, discutiendo los nuevos aspectos de la investigación, las nuevas líneas globales de innovación en el diagnóstico, el tratamiento y el control de la enfermedad.CONACYT – Consejo Nacional de Ciencia y TecnologíaPROCIENCI

Mortality and risk of tuberculosis among people living with HIV in whom TB was initially ruled out

Tuberculosis (TB) misdiagnosis remains a public health concern, especially among people living with HIV (PLHIV), given the high mortality associated with missed TB diagnoses. The main objective of this study was to describe the\xC2\xA0all-cause mortality, TB incidence rates and their\xC2\xA0associated risk factors in a cohort of PLHIV with presumptive TB in whom TB was initially ruled out. We retrospectively followed a cohort of PLHIV with presumptive TB over a 2\xC2\xA0year-period in a rural district in Southern Mozambique. During the study period 382 PLHIV were followed-up. Mortality rate was 6.8/100 person-years (PYs) (95% CI 5.2-9.2) and TB incidence rate was 5.4/100 PYs (95% CI 3.9-7.5). Thirty-six percent of deaths and 43% of TB incident cases occurred in the first 12\xC2\xA0months of the follow up. Mortality and TB incidence rates in the 2-year period after TB was initially ruled out was very high. The\xC2\xA0TB diagnostic work-up and linkage to HIV\xC2\xA0care should be strengthened to decrease TB burden and all-cause mortality among PLHIV with presumptive TB

Infección por COVID 19: estudio seroepidemiológico de cohorte de base poblacional estratificado por edad en Asunción y Central

La pandemia COVID-19, causada por SARS-CoV-2, se originó en Wuhan, China, en diciembre de 2019, y se extendió rápidamente a nivel mundial. En Paraguay, El primer caso confirmado en Paraguay se dio a conocer el 7 de marzo de 2020 en Asunción y para ell 28 de marzo se tiene registro de 206.597 casos confirmados y 4003 muertes. Sin lugar a dudas el número de infecciones por SARS-CoV-2 es mucho mayor que los casos notificados por las infecciones asintomáticas, los casos leves que no buscan asistencia médica, estrategias de testeo, pruebas virológicas que dan falsos negativos y las sub notificaciones. Los estudios serológicos son útiles para estimar la proporción de la población previamente infectada, cuantificar la magnitud de la transmisión, estimar la tasa de letalidad por infección, evaluar el efecto de intervenciones, y estimar el grado de inmunidad de la población. La vigilancia serológica es valiosa para los responsables de la formulación de políticas de salud.CONACYT - Consejo Nacional de Ciencias y TecnologíaPROCIENCI

Rising rural body-mass index is the main driver of the global obesity epidemic in adults

Body-mass index (BMI) has increased steadily in most countries in parallel with a rise in the proportion of the population who live in cities(.)(1,2) This has led to a widely reported view that urbanization is one of the most important drivers of the global rise in obesity(3-6). Here we use 2,009 population-based studies, with measurements of height and weight in more than 112 million adults, to report national, regional and global trends in mean BMI segregated by place of residence (a rural or urban area) from 1985 to 2017. We show that, contrary to the dominant paradigm, more than 55% of the global rise in mean BMI from 1985 to 2017-and more than 80% in some low- and middle-income regions-was due to increases in BMI in rural areas. This large contribution stems from the fact that, with the exception of women in sub-Saharan Africa, BMI is increasing at the same rate or faster in rural areas than in cities in low- and middle-income regions. These trends have in turn resulted in a closing-and in some countries reversal-of the gap in BMI between urban and rural areas in low- and middle-income countries, especially for women. In high-income and industrialized countries, we noted a persistently higher rural BMI, especially for women. There is an urgent need for an integrated approach to rural nutrition that enhances financial and physical access to healthy foods, to avoid replacing the rural undernutrition disadvantage in poor countries with a more general malnutrition disadvantage that entails excessive consumption of low-quality calories.Peer reviewe

Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight NCD Risk Factor Collaboration (NCD-RisC)

From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions