RESUMO
El objetivo del presente estudio es efectuar el análisis del impacto de la vigilancia en sus diferentes modalidades en el control de la infección por T. cruzi y la densidad vectorial (Triatoma infestans). Material y métodos: El trabajo fue desarrollado en el Departamento de Capayán, en la provincia de Catamarca, Argentina. Se seleccionaron aleatoriamente 5 comunidades rurales y 3 comunidades peri-urbanas para desarrollar el estudio. Indicadores utilizados: a) infestación domiciliaria en los meses 24, 48 y 96; y b) Infección por T.cruzi de menores de 14 años. Resultados: Se observa persistencia de triatomineos durante el periodo de seguimiento y cuando se comparan los datos del estudio de base (2007) con los obtenidos en el año 2009 y 2012 existe significancia estadística (p <0.04) entre áreas. Se capturaron 1.89 insectos/intradomicilio en áreas con vigilancia activa versus 5.21 insectos/intradomicilio en áreas donde la misma no existió. Se demuestra la existencia de infecciones recientes en niños menores de 4 años e hijos de mujeres negativas para T. cruzi en áreas sin vigilancia activa (3 niños). Conclusión: En la presente investigación se demuestra el impacto de la vigilancia activa en sus diferentes modalidades por la no existencia de casos nuevos vectoriales en el período de seguimiento. (AU)
The aim of this study is to perform the analysis of the impact of surveillance in its various forms in the control of infection by T. cruzi and vector density (Triatoma infestans). Material and Methods: The work was developed in the Department of Capayán, in the Province of Catamarca, Argentina. Eight rural communities were selected to develop the study. Indicators used: a) house infestation in 24 months, 48 and 96; b) T. cruzi infection in children under 14 years. Results: Persistence of triatomine It is observed during the monitoring period as the baseline study (2007) thus obtained in 2009 compared to 2012 there is statistical significance (p <0.04) between areas. 1.89 insect / intradomicile were captured in areas with active surveillance versus 5.21 insect/intradomicile in areas where it did not exist. The existence of recent infections in children under four years of negative women and children for T. cruzi in areas without active surveillance (3 children) is demonstrated. Conclusion: In this research, the impact of active surveillance in its various forms by Vector exists no new cases in the follow-up period shown. (AU)
Assuntos
Humanos , Criança , Adolescente , Trypanosoma cruzi , Doença de Chagas/epidemiologia , Controle de Vetores de Doenças , Monitoramento Epidemiológico , Argentina , Saneamento de Residências , Programas Nacionais de SaúdeRESUMO
Triatoma infestans is the main vector of Chagas' disease in South America between latitudes 10°S and 46°S. A multilocus microsatellite data set of 836 individuals from 27 populations of T. infestans, from all its range of distribution in Argentina, was analyzed. Our results favor the hypothesis of two independent migration events of colonization in Argentina and secondary contacts. The majority of the populations of the western provinces of Catamarca, La Rioja, San Juan and the west of Cordoba province, had almost no shared ancestry with the rest of the populations analyzed. Probably those populations, belonging to localities close to the Andean region, could have been established by the dispersal line of T. infestans that would have arrived to Argentina through the Andes, whereas most of the rest of the populations analyzed may have derived from the dispersal line of T. infestans in non-Andean lowlands. Among them, those from the provinces of Formosa, Chaco, Santiago del Estero and Santa Fe shared different percentages of ancestry and presented lower degree of genetic differentiation. The migratory movement linked to regional economies and possibly associated with passive dispersal, would allow a higher genetic exchange among these populations of T. infestans. This study, using microsatellite markers, provides a new approach for evaluating the validity of the different hypotheses concerning the evolutionary history of this species. Two major lineages of T. infestans, an Andean and non-Andean, are suggested.
Assuntos
Doença de Chagas/transmissão , Insetos Vetores/genética , Triatoma/genética , Animais , Argentina , Geografia , Controle de Insetos/métodos , Repetições de Microssatélites , Filogenia , Triatoma/patogenicidadeRESUMO
Variation in the mtDNA 16S ribosomal RNA gene in populations of Triatoma infestans (Klug) was surveyed. DNA sequence comparisons yielded 18 haplotypes among 130 individuals from 16 localities that represent a large proportion of the range of T. infestans in Argentina. The most common genotype in all populations was found in 76.9% of individuals and two other haplotypes were shared among different populations. The remaining 15 haplotypes were present exclusively in one of the populations, suggesting currently low levels of genetic exchange. Analysis of mtDNA 16S sequences uncovered substantial genetic variation among T. infestans populations. Haplotype and nucleotide diversities varied among populations, from 0% to 0.84% and 0% to 0.29%, respectively. It appears that this locus has a low mutation rate. Uncorrected pairwise differences of T. infestans haplotypes ranged from 0% to 1.2%. The molecular phylogeny supported the monophyly of T. infestans haplotypes and clustered two different pairs of haplotypes with a moderate degree of bootstrap support (approximately 60%). Mitochondrial DNA phylogeographic differentiation was not evident, suggesting a recent rapid spread of the species. Analysis of molecular variance showed hierarchical structure in the data. Considerably less variation was found among T. infestans populations from the northwest and northeast regions than among those belonging to the central area. Such a lack of variation may be indicative of one or more past population bottlenecks.
Assuntos
DNA Mitocondrial/genética , Variação Genética , RNA Ribossômico 16S/genética , Triatoma/genética , AnimaisRESUMO
The humoral immune response to epitopes expressed on cruzipain was evaluated in 31 Chagas disease patients (CDP) with different degrees of cardiac dysfunction. We took advantage of the availability of anti-Trypanosoma cruzi microsomal fraction monoclonal antibodies (MoAbs) reactive with epitopes that are recognized (5A9B11) or not recognized (1A10C11) by CDP sera. The 5A9B11- and 1A10C11-like epitopes are expressed on cruzipain. The reactivity of 5A9B11 against cruzipain was completely inhibited by sera of severe cardiopathy patients while a partial inhibition was found with sera from chagasic patients with mild disease. CDP sera did not block cruzipain recognition by 1A10C11. The antigenic determinants recognized by CDP sera appeared to be linear and carbohydrate free. When the overall anti-cruzipain immune response was evaluated, 70% of CDP with severe disease showed cruzipain titers higher than 1/800 while none of them displayed titers lower that 1/400. This report shows for the first time that the humoral immune response against epitopes expressed on cruzipain appeared to be related with the severity of chronic Chagas disease.
Assuntos
Anticorpos Antiprotozoários/biossíntese , Cardiomiopatia Chagásica/imunologia , Cardiomiopatia Chagásica/fisiopatologia , Cisteína Endopeptidases/imunologia , Adulto , Idoso , Anticorpos Bloqueadores/sangue , Anticorpos Antiprotozoários/sangue , Anticorpos Antiprotozoários/metabolismo , Especificidade de Anticorpos/imunologia , Antígenos de Protozoários/química , Antígenos de Protozoários/imunologia , Sítios de Ligação de Anticorpos , Ligação Competitiva/imunologia , Carboidratos/sangue , Carboidratos/imunologia , Cardiomiopatia Chagásica/sangue , Doença Crônica , Ensaio de Imunoadsorção Enzimática , Epitopos/sangue , Epitopos/química , Epitopos/imunologia , Humanos , Pessoa de Meia-Idade , Proteínas de ProtozoáriosRESUMO
Using a capture-recapture method, this study evaluates the completeness of the cutaneous leishmaniasis (CL) surveillance system in four districts of Santiago del Estero province, Argentina, for the period 1990-1993. Four reporting sources were evaluated: medical records kept by health facilities, interviews conducted during a case-control study, and the national and provincial levels of the leishmaniasis surveillance system (LSS). Using the capture-recapture method it was estimated that 210 cases (95% confidence interval [CI]: 202-218) of CL occurred in the four districts during the study period. Completeness of reporting to the leishmaniasis surveillance system at the national level was estimated to be 44.8% (95% CI: 43.2-46.4). The study results indicate that there is substantial underreporting within the LSS, although it did show the appropriate secular trends. The reasons for under-reporting and methods for addressing this problem are discussed.
Assuntos
Notificação de Doenças/normas , Leishmania/crescimento & desenvolvimento , Leishmaniose Cutânea/epidemiologia , Animais , Argentina/epidemiologia , Estudos de Casos e Controles , Intervalos de Confiança , Notificação de Doenças/métodos , HumanosRESUMO
Factors related to the characteristics of Hantavirus pulmonary syndrome in Argentina are described. Factors from different scientific fields converge to form the syndrome's analytical framework. Some of these factors are the history of spatial occupation, work and production structures, human migration patterns, ethnic composition, reservoir dynamics and its relationship to the different circulating viruses, and human behavior. Furthermore, the multiple factors are expressed in three ecological frameworks, associated with three different geographical regions of Argentina: 1) Northwest; 2) Central ("wet Pampa"); and 3) South Andean. In order to understand the actual causality of health or disease as an interaction of many factors, research on the primary biological, social, and environmental determinants of diseases should attend to the complexity of variable relationships in each region. The multiple-factor convergence approach allows for the design of appropriate strategies to improve the population's health status. Therefore, strategies should be developed and transferred by multidisciplinary teams, while their sustainability should be assured by community participation beginning with the earliest steps of research onward.
Assuntos
Meio Ambiente , Síndrome Pulmonar por Hantavirus/epidemiologia , Orthohantavírus , Animais , Argentina/epidemiologia , Demografia , Surtos de Doenças , Reservatórios de Doenças , Orthohantavírus/classificação , Síndrome Pulmonar por Hantavirus/transmissão , Síndrome Pulmonar por Hantavirus/virologia , Promoção da Saúde , Humanos , Fatores de Risco , Roedores/classificaçãoRESUMO
We have previously shown that titers of soluble platelet selectin (s-P-selectin) and soluble vascular cell adhesion molecule-1 (s-VCAM-1) were increased in sera of patients with chronic Trypanosoma cruzi infection. In this study, we analyzed the expression of CD49d-integrins, that bind to VCAM-1, and sialyl Lewis x (SLe(x)), which binds selectins, in peripheral blood lymphocytes of 27 patients with Chagas' disease at different levels of disease severity. Patients with a mild form of Chagas' disease showed a lower number of CD49d(+) cells, in comparison with those with severe chronic cardiopathy. Decreased levels of CD49d(+) cells were detected in CD3(-) cell populations. Conversely, SLe(x) expression was found to be decreased in patients with severe Chagas' disease. Levels of soluble platelet endothelial cell adhesion molecule-1 (s-PECAM-1) were significantly increased in the plasma of patients with severe Chagas' disease while unaltered levels of MCP-1 were recorded. These data show that VCAM-1 and P-Selectin ligands are differentially expressed during the chronic phase of the Trypanosoma cruzi infection. These findings also reinforce a role of the P-selectin/SLe(x) adhesion pathway rather than very late antigen-4 (VLA-4)/VCAM-1, in the pathogenesis of Chagas' disease.
Assuntos
Antígenos CD/biossíntese , Cardiomiopatia Chagásica/imunologia , Ativação Linfocitária , Oligossacarídeos/biossíntese , Adulto , Idoso , Cardiomiopatia Chagásica/sangue , Cardiomiopatia Chagásica/diagnóstico , Quimiocina CCL2/sangue , Doença Crônica , Humanos , Integrina alfa4 , Integrinas/biossíntese , Pessoa de Meia-Idade , Molécula-1 de Adesão Celular Endotelial a Plaquetas/sangue , Antígeno Sialil Lewis X , Linfócitos T/imunologiaRESUMO
The objective of this work was evaluate risk factors for acquiring cutaneous leishmaniasis in Salta, the region with the greatest indices of transmission in Argentina. A Case-cohort study was realized from June 1989 to December 1992. The procedures performed on cases and controls included: a) socio-demographic questionnaire; b) domestic and peridomestic environment description; c) physical exam of skin and nasal and oral mucosal; d) Montenegro Skin Test. Multivariate analysis showed a significant risk for factors outside the home (cattle management, hunting, sleeping at the work place) and while at home (sleeping outside of the bedroom, presence of three or more pigs in the yard and windows that cannot be locked in the closed position). This association allowed the identification of risk factors linked to the transmission of leishmaniasis in the home for the first time in Salta (Argentina).
Assuntos
Leishmaniose Cutânea/epidemiologia , Adolescente , Adulto , Argentina/epidemiologia , Criança , Pré-Escolar , Estudos de Coortes , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Fatores de RiscoRESUMO
Unselected nationwide cohorts of Argentine men 18 years of age summoned for military service were tested for antibodies to Trypanosoma cruzi each year from 1981 to 1993. After an initial screening using indirect hemagglutination test, the positive sera were retested by titrated indirect hemagglutination and immunofluorescence antibody tests at 39 laboratories or at the national reference center in Buenos Aires. Nearly 1.8 million men were examined for T. cruzi antibodies using the same standardized procedures under a quality assurance program. The prevalence of seropositivity for T. cruzi decreased significantly from 5.8% in 1981 to 1.9% in 1993, but the decrease was not homogeneous among provinces within each region or constant over time. Prior to the nationwide control campaign initiated in 1961-1962, 15 provinces had high (> 20%) percentages of houses with domiciliary infestation by Triatoma infestans bugs, which decreased to nine provinces in 1982, and four provinces in 1992. The observed decrease in the prevalence of seropositivity for T. cruzi may be mostly attributed to the spraying with insecticides to eliminate the domiciliary populations of Triatoma infestans. The lack of a sustainable triatomine surveillance program set a limit to the decrease of seropositivity rates and prompted a revised strategy based on community participation.