Diagnóstico de infecção por Trypanosoma cruzi nos Postos de Saúde de Salta, Argentina

La enfermedad de Chagas causada por el hemoflagelado Trypanosoma cruzi, constituye un grave problema de Salud Pública. En Argentina, se controla sistemáticamente la sangre a transfundir, la donación de órganos y se ha disminuido notablemente la transmisión vectorial. El objetivo de este proyecto fue implementar el uso del equipo para recolección de sangre capilar y conservación en glicerina (Serokit) en los servicios de enfermería de los Centros de Atención Primaria de la Salud en la ciudad de Salta a fin de conocer la seroprevalencia de infección por Trypanosoma cruzi en pacientes que concurren a los mismos. Para ello se realizó el par serológico HAI y ELISA en las muestras conservadas en Serokit y luego en muestras de sangre tomadas por punción venosa para confirmación. Durante dos años de trabajo se analizaron 1647 pacientes que concurrieron a 28 Centros de Salud, resultando 1,7% (29/1647) seropositivos. El Valor Predictivo Positivo fue 93,50% y el Valor Predictivo Negativo fue 99,8%. Todos los niños seropositivos fueron tratados con Benznidazol. Se concluye que el uso de SEROKIT para la toma y conservación de muestras para posterior diagnóstico de infección por Trypanosoma cruzi es recomendable en Centros de Atención Primaria de la Salud que no cuentan con laboratorio.     Chagas disease is caused by the hemoflagelate parasite Trypanosoma cruzi, and represents a main concern in public health. In Argentina, blood transfusion and organ donation are systematically controlled for T. cruzi infection, and vectorial transmission has dropped significantly. The aim of this project was to implement the use of the equipment for collecting capillary blood and conservation in glycerine (Serokit) in the nursery service of Primary Health Care Centers (PHCC) in the city of Salta, and to know the seroprevalence of T. cruzi infection in PHCC patients. To that aim, the serological pair HAI and ELISA was carried out in samples preserved in Serokit, followed by analysis of blood samples taken by venous punction to confirm the results. During a two-year period, 1647 patients that were assisted at 28 PCHC were analyzed, resulting in 1.7% (29/1647) seropositive samples. Positive Predictive Value was 93.5% and Negative Predictive Value was 99.8%. Every seropositive child was given Benznidazole treatment. It can be concluded that use of Serokit for taking and preserving samples to diagnose serologically T. cruzi infection is recommended in PHCC that lack their own biochemistry laboratory.A doença de Chagas produzida pelo protozoário flagelado Trypanosoma cruzi constitui um grave problema para a Saúde Pública. Na Argentina, o controle sistemático do sangue para transfusão e o do órgão para transplantar, fez com que diminuísse notavelmente a transmissão vetorial. O objetivo deste projeto foi implementar o uso do equipamento para coleta de sangue capilar e conservação em glicerina (Serokit) nos serviços de enfermagem dos Postos de Atenção Primaria da Saúde da cidade de Salta a fim de conhecer a soroprevalência de infecção com Trypanosoma cruzi em pacientes que são atendidos nos mesmos. Foi realizado o par sorológico HAI e ELISA nas amostras conservadas em Serokit e depois nas amostras de sangue retiradas através de uma punção venosa para a confirmação. Durante dois anos de trabalho, foram analisados 1647 pacientes que foram atendidos nos 28 Postos de Saúde, resultando 1.7% (29/1647) soropositivos. O Valor Preditivo Positivo foi Tripae 93.50% e o Valor Preditivo Negativo foi de 99.8%. Todas as crianças soropositivas foram medicadas com Benznidazol. A conclusão é que o uso de Serokit para a tomada e conservação de amostras para posterior diagnóstico de infecção por Trypanosoma cruzi é recomendável nos Postos de Atenção Primária da Saúde onde não existe a disponibilidade de laboratórios.Fil: Sánchez Negrette, Olga. Provincia de Salta. Ministerio de Salud Pública; ArgentinaFil: Monteros, María Concepción. Provincia de Salta. Ministerio de Salud Pública; ArgentinaFil: Davies, Carolina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Salta. Instituto de Patología Experimental. Universidad Nacional de Salta. Facultad de Ciencias de la Salud. Instituto de Patología Experimental; ArgentinaFil: Zaidenberg, Mario Oscar. Ministerio de Salud de la Nación; Argentin

Surto de leishmaniose cutânea americana na cidade de Tartagal, Província de Salta, Argentina, 1993

An American cutaneous leishmaniasis outbreak, with cases clustering during 1993 in Tartagal city, Salta, was reported. The outbreak involved 102 individuals, 43.1% of them with multiple ulcers. Age (mean: 33 years old) and sex distribution of cases (74.5% males), as well as working activity (70 forest-related), support the hypothesis of classical forest transmission leishmaniasis, despite the fact that the place of permanent residence was in periurban Tartagal. Moreover, during July, sandflies were only collected from one of the 'deforestation areas'. Lutzomyia intermedia was the single species of the 491 phlebotomines captured, reinforcing the vector incrimination of this species. Most infections must have been acquired during the fall (April to June), a pattern consistent with previous sandfly population dynamics data. Based on the epidemiological and entomological results, it was advised not to do any vector-targeted periurban control measures during July. Further studies should be done to assess if the high rate of multiple lesions was due to parasite factors or to infective vector density factors.Foi registrado um surto de leishmaniose cutânea americana, com casos agrupados na cidade de Tartagal, província de Salta, durante 1993. O surto envolveu 102 indivíduos, 43,1% deles com úlceras múltiplas. A idade (média: 33 anos) e distribuição de sexo nos casos (74,5% homens) como também a ocupação (70% relacionado com a floresta), apóia a hipótese da clássica transmissão de leishmaniose na floresta, apesar do fato de que o lugar de residência permanente estava na área periurbana de Tartagal. Além disso, durante julho, foram colecionados flebótomos só de uma área de desmatamento. Lutzomyia intermedia foi a única espécie dos 491 flebotomíneos capturados e reforça a incriminação de vetor desta espécie. A maioria das infecções deve ter sido adquirida durante o outono (abril para junho), um padrão consistente com dados prévios sob a dinâmica de população de flebótomos. Com base nos resultados, epidemiológicos e entomológicos foi aconselhado não fazer qualquer controle sobre vetores na área periurbana durante julho. Mais adiante deveriam ser feitos estudos para avaliar se a alta taxa de lesões múltiplas foi devido a fatores do parasita ou a fatores de densidade do vetor

Malaria transmission in two localities in north-western Argentina

<p>Abstract</p> <p>Background</p> <p>Malaria is one of the most important tropical diseases that affects people globally. The influence of environmental conditions in the patterns of temporal distribution of malaria vectors and the disease has been studied in different countries. In the present study, ecological aspects of the malaria vector <it>Anopheles </it>(<it>Anopheles</it>) <it>pseudopunctipennis </it>and their relationship with climatic variables, as well as the seasonality of malaria cases, were studied in two localities, El Oculto and Aguas Blancas, in north-western Argentina.</p> <p>Methods</p> <p>The fluctuation of <it>An. pseudopunctipennis </it>and the malaria cases distribution was analysed with Random Effect Poisson Regression. This analysis takes into account the effect of each climatic variable on the abundance of both vector and malaria cases, giving as results predicted values named Incidence Rate Radio.</p> <p>Results</p> <p>The number of specimens collected in El Oculto and Aguas Blancas was 4224 (88.07%) and 572 (11.93%), respectively. In El Oculto no marked seasonality was found, different from Aguas Blancas, where high abundance was detected at the end of spring and the beginning of summer. The maximum mean temperature affected the <it>An. pseudopunctipennis </it>fluctuation in El Oculto and Aguas Blancas. When considering the relationship between the number of malaria cases and the climatic variables in El Oculto, maximum mean temperature and accumulated rainfall were significant, in contrast with Aguas Blancas, where mean temperature and humidity showed a closer relationship to the fluctuation in the disease.</p> <p>Conclusion</p> <p>The temporal distribution patterns of <it>An. pseudopunctipennis </it>vary in both localities, but spring appears as the season with better conditions for mosquito development. Maximum mean temperature was the most important variable in both localities. Malaria cases were influenced by the maximum mean temperature in El Oculto, while the mean temperature and humidity were significant in Aguas Blancas. In Aguas Blancas peaks of mosquito abundance and three months later, peaks of malaria cases were observed. The study reported here will help to increase knowledge about not only vectors and malaria seasonality but also their relationships with the climatic variables that influence their appearances and abundances.</p

Plasmodium vivax and Mansonella ozzardi co-infection in North-Western Argentina

A case of co-infection with Plasmodium vivax and Mansonella ozzardi was detected in a blood sample from a person who had shown symptoms of malaria and lived in a city that was close to the Argentina/Bolivia border. The case was detected during a random revision of thick and thin smears from patients diagnosed with malaria from various towns and cities located in north-western Argentina between 1983 and 2001. Trophozoites of P. vivax were observed in the thin blood smear along with M. ozzardi microfilaria (larval form), which presented a long, slender, pointed anucleate tail and the absence of the sheath. This last characteristic is shared with Mansonella perstans, Mansonella streptocerca and Onchocerca volvulus. More rigorously controlled studies to detect other co-infection cases in the area as well as the possibility of importation from Bolivia into Argentina are currently ongoing. The relationship between the malaria parasite and microfilaria, the potential effect of malaria treatment on the development of M. ozzardi, and the possible impact of this microfilaria on the immunity of a person against P. vivax are all still unknown. This contribution constitutes a point of focus for future studies involving the interaction between the parasites and the potential risk that humans are exposed to.Fil: Dantur Juri, Maria Julia. Universidad Nacional de Tucumán. Facultad de Ciencias Naturales e Instituto Miguel Lillo. Instituto Superior de Entomología; Argentina. Universidad Nacional de Chilecito. Instituto de Ambientes de Montaña y Regiones Aridas; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Veggiani Aybar, Cecilia Adriana. Universidad Nacional de Tucumán. Facultad de Ciencias Naturales e Instituto Miguel Lillo. Instituto Superior de Entomología; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Ortega, Eugenia Silvana. Universidad Nacional de Tucumán. Facultad de Ciencias Naturales e Instituto Miguel Lillo. Instituto Superior de Entomología; ArgentinaFil: Galante, Guillermina Begoña. Universidad Nacional de Tucumán. Facultad de Ciencias Naturales e Instituto Miguel Lillo. Instituto Superior de Entomología; ArgentinaFil: Zaidenberg, Mario. Ministerio de Salud de la Nación; Argentin

Spatial patterns of high Aedes Aegypti oviposition activity in northwestern Argentina

Background: In Argentina, dengue has affected mainly the Northern provinces, including Salta. The objective of this study was to analyze the spatial patterns of high Aedes aegypti oviposition activity in San Ramo´n de la Nueva Ora´n, northwestern Argentina. The location of clusters as hot spot areas should help control programs to identify priority areas and allocate their resources more effectively. Methodology: Oviposition activity was detected in Ora´n City (Salta province) using ovitraps, weekly replaced (October 2005–2007). Spatial autocorrelation was measured with Moran’s Index and depicted through cluster maps to identify hot spots. Total egg numbers were spatially interpolated and a classified map with Ae. aegypti high oviposition activity areas was performed. Potential breeding and resting (PBR) sites were geo-referenced. A logistic regression analysis of interpolated egg numbers and PBR location was performed to generate a predictive mapping of mosquito oviposition activity. Principal Findings: Both cluster maps and predictive map were consistent, identifying in central and southern areas of the city high Ae. aegypti oviposition activity. A logistic regression model was successfully developed to predict Ae. aegypti oviposition activity based on distance to PBR sites, with tire dumps having the strongest association with mosquito oviposition activity. A predictive map reflecting probability of oviposition activity was produced. The predictive map delimitated an area of maximum probability of Ae. aegypti oviposition activity in the south of Ora´n city where tire dumps predominate. The overall fit of the model was acceptable (ROC = 0.77), obtaining 99% of sensitivity and 75.29% of specificity. Conclusions: Distance to tire dumps is inversely associated with high mosquito activity, allowing us to identify hot spots. These methodologies are useful for prevention, surveillance, and control of tropical vector borne diseases and might assist National Health Ministry to focus resources more effectively.Fil: Estallo, Elizabet Lilia. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas, Físicas y Naturales. Centro de Investigaciones Entomológicas de Córdoba; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Córdoba. Instituto de Investigaciones Biológicas y Tecnológicas; ArgentinaFil: Más, Guillermo. Instituto Nacional de Tecnología Agropecuaria; ArgentinaFil: Vergara Cid, Carolina. Universidad Nacional de Cordoba. Facultad de Medicina. Instituto de Virologia "Dr. J.M. Vanella". Laboratorio de Arbovirus; ArgentinaFil: Lanfri, Mario Alberto. Comision Nacional de Actividades Espaciales. Instituto de Altos Estudios Espaciales "Mario Gulich"; ArgentinaFil: Ludueña Almeida, Francisco. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas, Físicas y Naturales. Centro de Investigaciones Entomológicas de Córdoba; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Córdoba. Instituto de Investigaciones Biológicas y Tecnológicas; ArgentinaFil: Scavuzzo, Carlos Marcelo. Comision Nacional de Actividades Espaciales. Instituto de Altos Estudios Espaciales "Mario Gulich"; ArgentinaFil: Introini, María Virginia. Ministerio de Salud de la Nación; ArgentinaFil: Zaidenberg, Mario. Ministerio de Salud de la Nación; ArgentinaFil: Almiron, Walter Ricardo. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas, Físicas y Naturales. Centro de Investigaciones Entomológicas de Córdoba; Argentin

Demographic history and population structure of Anopheles pseudopunctipennis in Argentina based on the mitochondrial COI gene

Background: Anopheles pseudopunctipennis is an important malaria vector in the Neotropical region and the only species involved in Plasmodium transmission in the Andean foothills. Its wide geographical distribution in America, high preference for biting humans and capacity to rest inside dwellings after feeding, are attributes contributing to its vector status. Previous reports have tried to elucidate its taxonomic status, distinguishing populations from North, Central and South America. In the present study we used a mitochondrial marker to examine the demographic history of An. pseudopunctipennis in northwestern Argentina. Methods: Twelve localities were selected across 550 km of the distribution of this species in Argentina, including two near the Bolivian border and several in South Tucumán, for sampling. A fragment of the cytochrome oxidase I (COI) gene was sequenced and haplotype relationships were analyzed by a statistical parsimony network and a Neighbor-Joining (NJ) tree. Genetic differentiation was estimated with FS T. Historical demographic processes were evaluated using diversity measures, neutrality tests and mismatch distribution. Results: Forty-one haplotypes were identified, of which haplotype A was the most common and widely distributed. Neither the network nor the NJ tree showed any geographic differentiation between northern and southern populations. Haplotype diversities, Tajima’s D T and Fu & Li’s F and D neutrality tests and mismatch distribution supported a scenario of Holocene demographic expansion. Conclusion: The demographic pattern suggests that An. pseudopunctipennis has undergone a single colonization process, and the ancestral haplotype is shared by specimens from all localities, indicating mitochondrial gene flow. Genetic differentiation was minimal, observed only between one northern and one southern locality. The estimated time of the population expansion of this species was during the Holocene. These data suggest that regional vector control measures would be equally effective in both northern and southern localities sampled, but also that insecticide resistant genes may spread rapidly within this region.Fil: Dantur Juri, Maria Julia. Universidad Nacional de Tucumán. Facultad de Ciencias Naturales e Instituto Miguel Lillo. Instituto Superior de Entomología; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Moreno, Marta. New York State Department of Health; Estados Unidos. State University Of New York; Estados Unidos. University Of California At San Diego; Estados UnidosFil: Prado Izaguirre, Mónica J.. Universidad Central de Venezuela; VenezuelaFil: Navarro, Juan C.. Universidad Central de Venezuela; VenezuelaFil: Zaidenberg, Mario O.. Ministerio de Salud de la Nación. Coordinación Nacional de Control de Vectores; ArgentinaFil: Almiron, Walter Ricardo. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas, Físicas y Naturales; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Claps, Guillermo Luis. Universidad Nacional de Tucumán. Facultad de Ciencias Naturales e Instituto Miguel Lillo. Instituto Superior de Entomología; ArgentinaFil: Conn, Jan E.. New York State Department of Health; Estados Unidos. State University Of New York; Estados Unido

Oviposição diária de Aedes aegypti em Orán, Salta (Argentina)

El objetivo del estudio fue determinar los horarios de máxima actividad de oviposición de Aedes aegypti en la ciudad de Orán (noroeste argentino). Se realizaron muestreos quincenales entre noviembre de 2006 y febrero de 2007 (primavera-verano). La ciudad fue dividida en tres zonas (norte, centro, sur), donde fueron seleccionadas al azar las viviendas para colocar dos ovitrampas en el exterior de las mismas. Las ovitrampas fueron reemplazadas cada cuatro horas, desde la mañana (8h) hasta el atardecer (20h). Se registró la mayor cantidad de huevos entre las 16 y 20 h (81%). Estos datos aportan al conocimiento del vector y, por lo tanto, de la posibilidad de control, pudiendo realizarse las fumigaciones en la franja horaria con mayor actividad de oviposición.The study aimed to determinate the maximum daily peak of Aedes aegypti oviposition in the city of Oran, northwestern Argentina. Biweekly samplings were taken between November 2006 and February 2007 (spring-summer). The city was divided into three areas (north, center, and south) and households were randomly selected. Two ovitraps were placed outdoors in the selected houses. Ovitraps were replaced every four hours, from morning (8 a.m.) to late afternoon (8 p.m.). The largest number of eggs was recorded between 4 p.m. and 8 p.m. (81%). These findings enhance our understanding of the vector and thus its control such as spraying during the hours of peak oviposition activity.O objetivo do estudo foi determinar os horários de máxima atividade de oviposição de Aedes aegypti na cidade de Orán (noroeste argentino). Foram realizadas coletas quinzenais, entre novembro de 2006 e fevereiro de 2007 (primavera-verão). A cidade foi dividida em três zonas (norte, centro, sul); foram escolhidos aleatoriamente dez domicílios em cada zona e duas ovitrampas foram instaladas no exterior de cada domicílio. As ovitrampas eram trocadas a cada quatro horas, cobrindo desde a manhã (8h) até a noite (20h). A maior quantidade de ovos (81%) foi registrada entre as 16h e 20h. Esses dados aportam conhecimento do vetor e, portanto, a seu controle, como, por exemplo, realizar a fumegação na faixa horária de maior atividade de oviposição

Patrones de abundancia de especies de Anopheles en tres ambientes del noroeste de Argentina

Las modificaciones antropogénicas en relación a los cam-bios en el medio ambiente, pueden afectar la distribución y abundancia de las especies de anofelinos. Los cambios en el uso pueden contribuir a la emergencia de los hábitats de inmaduros, y consecuentemente la de mosquitos adul-tos. El objetivo de este estudio fue conocer la abundancia de las especies de anofelinos en cada ambiente, caracteri-zado por diferentes grados de disturbios producidos por el hombre, y las potenciales implicancias para la transmisión de malaria. Los mosquitos adultos fueron capturados entre 2001-2005 en seis localidades ubicados en diferentes lati-tudes del noroeste de Argentina: Aguas Blancas, El Oculto, San Ramón de la Nueva Orán (provincia de Salta), y Capitán Cáceres, La Florida y Sargento Moya (provincia de Tucumán). Las muestras fueron colectadas en tres ambientes: natural, borde y peri-urbano. Se utilizó un modelo mixto linear ge-neralizado con efecto aleatorio, tomando en cuenta el mo-delo zero-inflation y el uso de dos modelos de distribución binomiales negativos. Un total de 12.878 hembras pertene-cientes a An. pseudopunctipennis , An. argyritarsis, An. strodei y An. triannulatus fueron capturados entre otras especies. Anopheles pseudopunctipennis fue igualmente abundante en los tres ambientes. La abundancia de esta especie fue mayor en El Oculto que en Aguas Blancas, y decreció en Capitán Cáceres, seguido por La Florida y Sargento Moya. Anopheles argyritarsis fue principalmente abundante en el ambiente natural, seguido por el ambiente borde. Mientras que la abundancia en el ambiente peri-urbano disminuyó 69 % comparado con el borde. Hubo una significativa reducción en abundancia desde Aguas Blancas seguido por El Ocul-to y La Florida. La abundancia de An. strodei fue significa-tivamente menor en el ambiente periurbano en relación al ambiente borde. Tomando en cuenta los sitios del presente estudio, se observó que en El Oculto la abundancia de esta especie fue mucho mayor que Aguas Blancas y La Florida. El hecho de que An. pseudopunctipennis fue igualmente abundante en los tres ambientes, y que An. argyritarsis fue más abundante en el ambiente natural seguido del borde, debería ser considerado de importancia epidemiológica, siendo que esta área representa un área de potencial riesgo de transmisión de malaria.Fil: Dantur Juri, Maria Julia. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico - Tucumán. Unidad Ejecutora Lillo; Argentina. Universidad Nacional de Chilecito; ArgentinaFil: Flores, Gabriela Cecilia. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico - Tucumán. Unidad Ejecutora Lillo; ArgentinaFil: Santana, Mirta Sara. Catedra de Microbiologia ; Departamento de Clinica Medica ; Facultad de Medicina ; Universidad Nacional de Tucuman;Fil: Galindo, Liliana María. Catedra de Microbiologia ; Departamento de Clinica Medica ; Facultad de Medicina ; Universidad Nacional de Tucuman;Fil: Villarroel Martínez, Edecio Ismael. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico - Tucumán. Unidad Ejecutora Lillo; ArgentinaFil: Zaidenberg, Mario. Ministerio de Salud. Dirección de Enfermedades Transmisibles por Vectores; ArgentinaXIX Simposio Internacional sobre Enfermedades DesatendidasCiudad Autónoma de Buenos AriesArgentinaFundación Mundo San