RESUMO
Seroepidemiologic studies were conducted to determine the prevalence of Oropouche (ORO) viral antibody, risk factors, and the incidence of infection among residents of the Amazon region of Peru. Blood samples, as well as demographic, cultural, and medical history data, were collected from residents in a sector of the city of Iquitos and in an adjacent rural and three neotropical rain forest communities. Blood specimens were obtained approximately one year later from a cohort of the same study subjects who were negative for ORO antibody on the initial cross-sectional survey. Sera were tested for ORO IgG antibody by an enzyme-linked immunosorbent assay. Antibody prevalences were 35% for residents of the urban population, 24-46% for the forest communities, and 18% for the rural community. Antibody prevalence increased with age, and subjects who were seropositive were significantly (P = 0.001) older (mean = 33 years) than the seronegative subjects (mean = 15 years). Multivariate analysis revealed that only age, urban and forest residence, and occupation as a farmer or housekeeper remained significantly associated with seropositivity. Seroconversion data for the same populations one year later demonstrated evidence of ORO viral infection among 28% of the residents in the rural community and 2% or less in the forest and urban communities. Oropouche virus infection was significantly associated with older age (P = 0.04) in the rural community (P < 0.001). These data support prior evidence of ORO viral infection among residents of Iquitos and surrounding villages and suggest that transmission of this virus occurs continuously in the population of this area of the Amazon basin.
Assuntos
Anticorpos Antivirais/sangue , Infecções por Bunyaviridae/epidemiologia , Vírus Simbu/imunologia , Adolescente , Adulto , Análise de Variância , Infecções por Bunyaviridae/transmissão , Criança , Pré-Escolar , Estudos Transversais , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Incidência , Lactente , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Peru/epidemiologia , Prevalência , Fatores de Risco , População Rural , Estudos Soroepidemiológicos , População UrbanaRESUMO
The first confirmed outbreak of dengue fever in Peru occurred during 1990 in Iquitos, a city of approximately 300,000 residents in the Amazon region. Because of the apparent establishment of endemic transmission of this mosquito-borne viral disease following the outbreak, epidemiologic studies were initiated in 1992. Blood specimens and data on demographic, environmental, and medical history factors were collected from volunteers in an urban sector of Iquitos, in a rural area on the outskirts of Iquitos, and in three nearby jungle communities. A follow-up blood specimen was obtained approximately one year later from a sample of subjects. Sera were tested for dengue IgG antibody by an enzyme-linked immunosorbent assay, and specificity was verified using a plaque-reduction neutralization test. Dengue antibody prevalence was 66% in the urban population, 26% in the rural population, and 32-67% in the three jungle areas. A significant association was found between age and antibody prevalence, with a steady increase in prevalence from 18% among subjects less than five years of age to greater than 90% for subjects more than 50 years old. Increased antibody prevalence also was associated with urban and jungle residence and with a piped source of household drinking water. Seroconversions were documented in four of five surveyed communities. These results indicate that dengue virus transmission continues in and around Iquitos and suggest that transmission also occurred prior to the 1990 epidemic.
Assuntos
Dengue/epidemiologia , Surtos de Doenças , População Rural , População Urbana , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Anticorpos Antivirais/sangue , Criança , Pré-Escolar , Estudos de Coortes , Estudos Transversais , Vírus da Dengue/imunologia , Feminino , Humanos , Incidência , Lactente , Masculino , Pessoa de Meia-Idade , Peru/epidemiologia , Prevalência , Estudos Soroepidemiológicos , Distribuição por SexoRESUMO
OBJECTIVE: To determine the extent of the HIV-1 epidemic in Peru. DESIGN: Part of a national serosurvey in Peru. METHODS: Between January 1986 and December 1990, 140,976 serum samples were tested for HIV-1 antibody. RESULTS: HIV-1 antibody was found in a high percentage of serum samples provided by 4300 homosexual men (26%), 2204 male sexually transmitted disease patients (10%), 145 drug users (13%), 269 hemophiliacs (10%), and 146 unlicensed female prostitutes (10%). In addition, the prevalence of HIV-1 infection increased substantially among these groups between the beginning and end of the survey period. A low but rising prevalence of HIV-1 antibody was found during this period among serum samples provided by 83,526 blood donors and 11,101 military personnel:total period prevalence, 0.25 and 0.32%, respectively. CONCLUSION: These data indicate that HIV-1 infection is epidemic in Peru among groups at high risk of sexually and parenterally transmitted diseases, and that the risk of infection appears to be low but possibly increasing among the general population.
PIP: The findings of a national seroprevalence survey conducted in Peru during 1986-90 indicate accelerating rates of human immunodeficiency virus (HIV) among population groups at high risk of sexually transmitted diseases. Two databases were maintained: 1) January 1986-December 1988 and 2) January 1989-December 1990. Of the 140,976 survey participants, 3345 (2.4%) were HIV-positive by Western blot. 2591 participants were selected because of clinical signs suggestive of acquired immunodeficiency syndrome (AIDS); 46.7% were HIV-positive, but the prevalence increased from 19% in the 1986-88 period to 60% during 1989-90. Among the 4300 men who identified themselves as homosexual or bisexual, 26% were seropositive (8% during 1986-88 and 41% during 1989-90). HIV prevalence among 2204 men attending a sexually transmitted diseases clinic was 10.3%, with an increase from 2.0% in the first period to 19.0% in the later period. 10.4% of the 269 hemophiliacs were HIV-infected, with an increase from 8% to 36%. Among the 145 intravenous drug users, the prevalence rose from 1% during 1986-88 to 27% during 1989-90. Among 5827 registered female prostitutes, the prevalence rose from 0.3% to 0.7%; however, a 1990 analysis of 146 unregistered prostitutes revealed a rate of 9.6%. The HIV rates among 285 female and 105 male heterosexual partners of known HIV-positive persons were 50.2% and 40.0%, respectively. HIV prevalence increased from 0.8% during 1986-88 to 8.0% during 1989-90 among 1532 men and 1247 women who requested anonymous HIV testing. The prevalence among 542 male and 615 female medical personnel was 2.3%. Among 78,793 volunteer and 4733 paid blood donors, HIV prevalence was 0.2% (0.3% among paid donors). The period prevalence among 11,101 male military recruits and active duty members increased from 0.009% to 0.5%. Finally, only 0.3% of 21,595 applicants for immigration visas were HIV-positive, and there were no HIV cases among 1234 pregnant women attending antenatal clinics. Although the very low HIV prevalence among military personnel and pregnant women suggests that the virus is not yet widely disseminated within the general population, the finding that 28% of HIV-positive men were married and engaged in bisexual behavior suggests potential for heterosexual transmission in the years ahead.
Assuntos
Surtos de Doenças , Infecções por HIV/epidemiologia , HIV-1 , Feminino , Infecções por HIV/sangue , Soroprevalência de HIV , Humanos , Masculino , Peru/epidemiologia , População , Vigilância da População , Fatores de Risco , Comportamento SexualRESUMO
OBJECTIVES: This study examined the prevalences of antibodies to Treponema pallidum, Chlamydia trachomatis, and herpes simplex virus type 2 in a sample of Peruvian adults. METHODS: Among adults seeking health certification in Lima, Peru, 600 were randomly selected to undergo interviews and serologic testing. RESULTS: Men's reported mean lifetime number of partners (10.6) far exceeded women's (1.1), yet antibody to sexually transmitted infection pathogens among sexually experienced participants was 2.8 times more prevalent among women than among men. Among men, female sex workers accounted for 37% of recent partners, and only sex with female sex workers while using condoms less than half of the time was independently associated with antibody (odds ratio = 3.6, 95% confidence interval = 1.5, 8.8). among women, number of partners was associated with any sexually transmitted infection antibody, while intercourse before 18 years of age was associated with C trachomatis antibody. At every level of perceived risk, sexually transmitted infection antibody was more frequent among women. CONCLUSIONS: Men having unprotected sex with female sex workers had the greatest risk of acquiring infections and (by inference) of transmitting them to women.
Assuntos
Infecções por Chlamydia/epidemiologia , Chlamydia trachomatis , Herpes Genital/epidemiologia , Comportamento Sexual , Sífilis/epidemiologia , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Peru/epidemiologia , Prevalência , Estudos Soroepidemiológicos , Distribuição por Sexo , Fatores Sexuais , Inquéritos e Questionários , Saúde da População UrbanaRESUMO
UNLABELLED: Huanta is an Andean valley of Peru, located at 2400 meters above sea level with a population of 45,000 inhabitants. Viral hepatitis is widely known in the area due to its severe clinical symptoms and high morbidity and mortality. METHODS: A study on the prevalence of hepatitis A, B and D markers among 143 clinically healthy school students was carried out. The students were selected randomly from 4 schools in the city. The subjects provided epidemiological data regarding viral hepatitis and a venous blood sample to determine HBsAg, anti HBc antibody, anti-HBc IgM, anti HAV and anti HDV by the ELISA technique (Abbott Lab.). RESULTS: A total of 93 males and 50 females participated in the study. The mean age was 13.2 years (7-20 y.). Anti HAV was detected in 140 of them (98%). Prior infection by HBV was detected in 117 (82%) and an active infection in 4 of them (2.7%). The rate of HBsAg carriers was 16.0% (23). HDV infection was found in 21 of 117 (17.9%) individuals infected by the HBV. HBV infection and the previous use of injections represented a significant association (OR:3.7 IC 1.3-11, p < 0.012). No differences in sex were noted. CONCLUSION: A high prevalence of HAV, HBV, and HDV was found among school students in Huanta and this was the first report of hepatitis delta in the area. The association of HBV infection and the use of injections was meaningful. The high prevalence of HBV and HDV suggests the existence of a relationship to the morbidity and mortality by hepatitis in Huanta, thus the need for control programs by means of immunization against HBV.
Assuntos
Hepatite A/epidemiologia , Hepatite B/epidemiologia , Hepatite D/epidemiologia , Adolescente , Adulto , Criança , Estudos Transversais , Feminino , Hepatite A/imunologia , Anticorpos Anti-Hepatite A , Anticorpos Anti-Hepatite/análise , Hepatite B/imunologia , Anticorpos Anti-Hepatite B/análise , Antígenos de Superfície da Hepatite B/análise , Hepatite D/imunologia , Vírus Delta da Hepatite/imunologia , Humanos , Masculino , Peru/epidemiologiaRESUMO
Four hundred female sex workers attending a sexually transmitted disease clinic in Lima, Peru, were interviewed for demographic information and medical, contraceptive, and sexual practice histories. Cervical cultures were done for Neisseria gonorrhoeae and Chlamydia trachomatis, and serum was tested for antibodies to human immunodeficiency virus, human T cell lymphotropic virus type I (HTLV-I), Treponema pallidum, C. trachomatis, herpes simplex virus type 2 (HSV-2), and Haemophilus ducreyi. The prevalence of HTLV-I increased with duration of prostitution from 3.6% (< 3 years) to 9.3% (3-6 years) to 15.9% (> 6 years; P < .01). After adjustment for duration of prostitution, reduced risk of HTLV-I was significantly correlated with condom use for more than half of all sexual exposures for > 3 years (odds ratio [OR], 0.34; 95% confidence interval [CI], 0.13-0.89). Further adjusting for condom use, HTLV-I seropositivity was associated with C. trachomatis (OR, 3.7; 95% CI, 1.4-13.2) and with antibody to HSV-2 (OR, 3.7; 95% CI, 0.5-29.6). Thus, duration of prostitution, lack of consistent condom use, and past infection with C. trachomatis were significantly associated with HTLV-I seropositivity.
Assuntos
Infecções por HTLV-I/epidemiologia , Trabalho Sexual , Adulto , Fatores Etários , Análise de Variância , Preservativos/estatística & dados numéricos , Estudos Transversais , Escolaridade , Feminino , Anticorpos Anti-HTLV-I/sangue , Infecções por HTLV-I/complicações , Humanos , Pessoa de Meia-Idade , Peru/epidemiologia , Prevalência , Análise de Regressão , Fatores de Risco , Comportamento Sexual , Infecções Sexualmente Transmissíveis/complicações , Infecções Sexualmente Transmissíveis/epidemiologiaRESUMO
The prevalence of antibodies to hepatitis C virus (anti-HCV) was determined in 105 patients with biopsy-proven chronic liver disease and 128 comparison patients without any evidence of liver pathology living in Lima, Peru. Using a second-generation EIA screening and supplemental immunoblot assay, anti-HCV was detected in four of 13 patients with chronic hepatitis, in 11% of 85 patients with cirrhosis, and in none of seven patients with hepatocellular carcinoma. Only two (1.6%) comparison patients without liver disease had anti-HCV. Hepatitis B surface antigen (HBsAg) was found in 23% of patients with chronic hepatitis, 12% of patients with cirrhosis, and three of seven patients with hepatocellular carcinoma. There was no evidence of chronic viral hepatitis or alcohol abuse (reported by one-third of subjects) in 48% of chronic liver disease patients. These preliminary data suggest that among this South American population neither hepatitis B nor hepatitis C infection is the predominate cause of chronic liver disease and that other infectious or environmental factors may be important.
Assuntos
Hepatite Viral Humana/epidemiologia , Hepatopatias/etiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma Hepatocelular/complicações , Carcinoma Hepatocelular/etiologia , Doença Crônica , Feminino , Hepatite/complicações , Hepatite/etiologia , Anticorpos Anti-Hepatite/sangue , Antígenos de Superfície da Hepatite B/imunologia , Hepatite C/sangue , Hepatite C/complicações , Hepatite C/epidemiologia , Hepatite Viral Humana/complicações , Hepatite Viral Humana/imunologia , Humanos , Cirrose Hepática/complicações , Cirrose Hepática/etiologia , Hepatopatias/complicações , Neoplasias Hepáticas/complicações , Neoplasias Hepáticas/etiologia , Masculino , Pessoa de Meia-Idade , Peru/epidemiologiaRESUMO
A Peruvian female prostitute population was evaluated over a 3-year period to determine the incidence and risk factors of retroviral and viral hepatitis transmission. At three survey periods, a questionnaire was administered and serum samples were obtained. A total of 966 subjects were studied, with 34% followed for 38 months, 22% followed for 18 months, and 44% evaluated just once. On initial evaluation, 3 (0.3%) had HIV-1 antibody, 170 (17.6%) had HTLV-I antibody, 578 (59.8%) had anti-HBc, and 7 (0.7%) had antibody to hepatitis C virus. The mean annual incidence of HTLV-I and hepatitis B infection was 1.6% and 4.7%, respectively. Univariate and logistic regression analysis of prevalence data indicated an association between sexual activity and HTLV-I and hepatitis B infection, but no independent risk factors were identified in cohort analysis. Parenteral risk factors were not associated with transmission, except for a small percentage of subjects who may have acquired hepatitis B infection from blood transfusions. These findings suggest that there is a high incidence of HTLV-I and hepatitis B infection from heterosexual contact in this female prostitute population.
Assuntos
Infecções por HTLV-I/epidemiologia , Hepatite B/epidemiologia , Hepatite C/epidemiologia , Hepatite Viral Humana/epidemiologia , Trabalho Sexual , Adulto , Feminino , Anticorpos Anti-HIV/sangue , HIV-1/imunologia , Anticorpos Anti-HTLV-I/sangue , Infecções por HTLV-I/transmissão , Hepacivirus/imunologia , Anticorpos Anti-Hepatite/sangue , Hepatite B/transmissão , Anticorpos Anti-Hepatite B/sangue , Hepatite C/transmissão , Anticorpos Anti-Hepatite C , Hepatite Viral Humana/transmissão , Humanos , Incidência , Pessoa de Meia-Idade , Peru/epidemiologia , Prevalência , Modelos de Riscos Proporcionais , Análise de Regressão , Fatores de Risco , Comportamento Sexual , Parceiros Sexuais , Reação TransfusionalRESUMO
A mosquito capture program was initiated to study mosquito species and their potential for arboviral transmission in the Peruvian Amazon. More than 35,000 mosquitoes of 13 different genera and at least 25 species were captured in urban and sylvan sites in the Iquitos area. These findings represent the first published list of Peruvian mosquitoes since 1971 and the first such list from the Peruvian Amazon.
Assuntos
Culicidae/classificação , Insetos Vetores/classificação , Animais , Infecções por Arbovirus/transmissão , PeruRESUMO
The epidemiology of HTLV-I infection in female prostitutes was studied in a survey of 395 prostitutes from Callao, Peru (the port city of Lima), 72 prostitutes from Iquitos, Peru (another port city on the Amazon River), and 510 prenatal clinic patients from Lima. Prostitutes reported a mean of 8.8 years (range, 1-39 years) of active prostitution and a mean of 205 sexual contacts during the month prior to the study. The percentage of prostitutes with HTLV-I antibody (21.8%) was significantly higher than patients attending a prenatal clinic (3.1%; P less than .0001). The prevalence of HTLV-I antibody increased steadily with age in prostitutes, but no age trend was noted in prenatal patients. By multiple logistic regression analysis, an independent association was found between HTLV-I seropositivity and a history of prostitution in Callao, age, and positive syphilis serology when all 977 study subjects were evaluated. When prostitutes alone were analyzed, the number of years of exposure as a practicing prostitute was associated with HTLV-I seropositivity after controlling for age. These data indicate a greatly increased risk of HTLV-I infection in prostitutes in Callao, Peru, and suggest an association between sexual activity and HTLV-I transmission.