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PubMed1990

Distribution and etiology of leishmaniasis in Colombia.

A total of 340 Leishmania strains, isolated from humans, animals, and sand flies from various regions of Colombia, were examined by isozyme electrophoresis. Seven different Leishmania species were identified. Leishmania panamensis and L. braziliensis were the most common, representing 53.8% and 30.3% of the total, respectively. Isolation rates of the other species were as follows: L. chagasi, 9.4%; L. guyanensis, 2.6%; L. amazonensis, 1.8%; L. mexicana, 0.8%; and a new species requiring additional study, 1.2%. Statistical analyses of representative L. panamensis and L. braziliensis isolates indicated that the populations of these 2 species are genetically very similar. L. panamensis may have a continuous distribution in Colombia west of the eastern Andes Mountains and L. braziliensis may have a continuous distribution east of the western Andes Mountains. Information is given on disease manifestations of the parasites in human hosts and on isolation records from sand flies and animals.

Animals↗
PubMed1993

Human retroviruses in Amerindians of Colombia: high prevalence of human T cell lymphotropic virus type II infection among the Tunebo Indians.

The coexistence of infection with human T lymphotropic virus types I and II (HTLV-I and HTLV-II) has been demonstrated recently among the Wayuu Indians from the Guajira region of Colombia. To ascertain if other Indian groups in Colombia are similarly infected, we tested 1,250 sera, collected between 1990 and 1992 from 18 culturally distinct Amerindian tribes living in widely separated regions, for IgG antibodies against HTLV-I/II using enzyme-linked immunosorbent assay (ELISA) and Western blot. Sera were also tested for antibodies against human immunodeficiency virus types 1 and 2 (HIV-1 and HIV-2) to investigate the overall burden of retrovirus infection in these semi-isolated indigenous groups. A total of 33 of the 1,250 samples were repeatedly reactive to HTLV-I/II antigens by ELISA, and of these, three sera from Waunana/Noanama Indians from the Choco area and two sera from Tunebo Indians from the Santander region were found to be infected with HTLV-I and HTLV-II, respectively, as verified by Western blot and differential ELISA. Thus, despite the small sample size, the overall seroprevalences for HTLV-I and HTLV-II infection among the Waunana/Noanama and Tunebo Indians were 2.1% and 5.0%, respectively. In contrast, none of the 29 Indians who exhibited reactivity to HIV-1/2 by ELISA were seropositive by Western blot. This study adds the Tunebo to the expanding list of Amerindian groups with high prevalences of HTLV-II infection. Further intensive investigations of such indigenous populations will clarify the natural history and disease potential of HTLV-II infection.

Adolescent↗
PubMed2001

Genetic diversity and relationships among Venezuelan equine encephalitis virus field isolates from Colombia and Venezuela.

During field studies of enzootic Venezuelan equine encephalitis (VEE) viruses associated with epizootic emergence, a large number of virus isolates were made in sylvatic foci of Venezuela and Colombia. To rapidly characterize these isolates, antigenic subtypes were determined by means of immunofluorescence and by single-strand conformational polymorphism (SSCP) analysis by use of an 856-bp fragment from the P62 gene, which we used to distinguish genetic variants. Representative isolates were sequenced to assess the sensitivity of SSCP to detect genetic differences. The SSCP analysis distinguished isolates differing by as little as 1 nucleotide; overall, differences of > or = 1 nucleotide were recognized 89% of the time, and the sensitivity to distinguish strains that differed by only 1 or 4 nucleotides was 17 and 57%, respectively. Phylogenetic analyses of representative sequences showed that all recent isolates from the Catatumbo region of western Venezuela and the middle Magdalena Valley of Colombia were closely related to epizootic subtype IAB and IC strains; strains from Yaracuy and Miranda States were more distantly related. Cocirculation of the same virus genotype in both Colombian and Venezuelan foci indicated that these viruses are readily transported between enzootic regions separated by > 300 km. The SSCP analysis appears to be a simple, fast, and relatively efficient method of screening VEE virus isolates to identify meaningful genetic variants.

Aedes↗
PubMed2001

Plasmodium vivax clinically resistant to chloroquine in Colombia.

Chloroquine-resistant Plasmodium vivax has been the subject of numerous case reports and prospective studies from Oceania and Asia. In contrast, only case reports exist from the Americas. We performed a prospective study with 28-day follow-up of clinical responses to chloroquine in 2 P. vivax-endemic regions of Colombia. Three (11%) of 27 patients failed to respond to treatment with the standard regimen of chloroquine (1,500 mg of base over 3 days). One patient demonstrated RI resistance on Day 26; one patient demonstrated RI resistance due to recrudescence of blood stages on Day 11; and one patient demonstrated RII resistance of blood stages by never displaying clearing of peripheral parasitemia. All patients were successfully treated with primaquine, which has some blood stage efficacy against P. vivax, combined with a second course of chloroquine. Clinical resistance of P. vivax to chloroquine is present in Colombia and should be monitored in the Americas.

Animals↗
PubMedDate not supplied

HLA-B27 subtypes in patients with ankylosing spondylitis (As) in Colombia.

OBJECTIVE: We investigated the distribution of HLA-B27 subtypes in patients with ankylosing spondylitis (AS) belonging to two ethnic groups of Colombia. MATERIAL AND METHODS: PCR-SSOs was used to detect the polymorphism in exons 2 and 3 of HLA-B27 in two groups of patients: 39 Mulattos and 20 Mestizos. Fifty-nine of them suffered of ankylosing spondylitis (AS), including two patients with ankylosing spondylitis plus anterior uveitis (AU). Only two out of eight HLA-B27 subtypes studied (B*2701-B*2708) were found. RESULTS: The distribution of these alleles in the whole population was: B*2705: 87.1% and B*2702: 12.8% in the Mulattos group; 80% were B*2705 and 20% B*2702 in Mestizos group. The distribution of HLA-B27 subtypes was: 84.74% of patients with AS were B*2705 and 15.26% B*2702. CONCLUSIONS: There was no significant difference in the distribution of HLA-B27 subtypes among the patients ethnic groups studied. Other authors have shown that B*2705, B*2702 and B*2704, the more frequent subtypes, are equally associated to the disease. Although population studies need to be done to analyze the distribution of subtypes between patients and controls, the low frequency of HLA-B27 within the normal population does not permit to do a representative number of controls; our results suggest that HLA-B*2705 and HLA-B*2702 are the subtypes more frequently associated with AS in patients from the two more prevalent patients ethnic groups in Colombia.

Alleles↗
PubMedDate not supplied

[Neuroepidemiology in the eastern region of Colombia].

OBJECTIVE: To determine the presence of eight neurological disorders (migraine, cerebrovascular disease, disorders of movement, peripheral neuropathy, mental retardation, epilepsy, dementia and the sequelas of head injuries) in the eastern region of Colombia. PATIENTS AND METHODS: Using the neuro epidemiological protocol of the World Health Organization (WHO), modified by our group, together with a questionnaire to determine the sequelas of head injuries and the abbreviated mental test (Mini mental), we interviewed people in the municipalities of Bucaramanga, Piedecuesta and Aratoca. The persons suspected of having neurological disorders, who were over 12 years old, were evaluated by neurologists and those under 12 years old by a neuropaediatrician. RESULTS: In the eastern region, 1,454 persons altogether were interviewed. Neurological conditions were suspected in 454 of these (31.2%), and confirmed in 437 (30.1%). The specific results for these neurological disorders and their respective confidence intervals (in brackets) were: migraine 198.8 (178.7 220.4); peripheral neuropathy: 26.8 (19.4 36.9); epilepsy: 22.7 (15.9 32.1); dementia: 17.9 (11.9 26.5); cerebrovascular disease: 17.2 (11.4 25.7); mental retardation and delayed nervous system development: 15.1 (9.7 23.2); extrapyramidal disorders: 8.3 (4.5 14.8); sequelas of head injuries: 6.9 (3.5 13.1). RESULTS: These results, obtained using a modified version of a WHO protocol, together with dementia and the sequelas of head injuries, will permit the development of health policies and programmes for the control and treatment of neurological disorders prevalent in this region of Colombia

Adult↗
PubMed2002

Outbreak of measles--Venezuela and Colombia, 2001-2002.

Substantial progress has been made toward interrupting indigenous measles transmission in the Region of the Americas. In 2001, the number of confirmed measles cases in the region reached a record low of 537 cases, a 99% decrease since 1990. During 2001, the Dominican Republic and Haiti interrupted indigenous measles transmission successfully, ending known indigenous transmission of the D6 measles virus genotype. This genotype, which had circulated widely in the Region of the Americas since 1995, caused nationwide outbreaks in Argentina, Bolivia, Brazil, the Dominican Republic, and Haiti during 1997-2001. In August 2001, a measles outbreak introduced by a traveler returning from Europe occurred in Venezuela and was exported to Colombia in 2002. This report describes the epidemiology of the outbreaks and control measures implemented by the ministries of health of Venezuela and Colombia.

Adolescent↗
PubMed1993

[Main migration trends and economic internationalization in Colombia].

The author examines migration flows to and from Colombia and notes that "Colombia has been experiencing in the last decades different kinds of spatial mobility, towards the United States, Europe, Venezuela and other countries in Latin America. Since the 80s return flows have become important." The impacts on migration of improved education and women's status, and the lack of legal employment opportunities are examined. (SUMMARY IN ENG)

Americas↗
PubMed2003

[Efficacy of amodiaquine and sulfadoxine/pyrimethamine in the treatment of malaria not complicated by Plasmodium falciparum in Nariño, Colombia, 1999-2002].

The resurgence and spread of antimalarial drug resistance is one of the causes of the worldwide increase of malaria. In Colombia, uncomplicated Plasmodium falciparum malaria has been treated with a combination of amodiaquine (AQ) and sulfadoxine/pyrimethamine (SP) since 2000. The efficacy of these two antimalarials was evaluated after the implementation of the new malaria treatment scheme. In the municipalities of El Charco and Tumaco (Nariño) on the Pacific Coast region, the standard PAHO protocol was used to evaluate antimalarial efficacy in areas of low to moderate malaria transmission. Patients were randomly allocated to treatment regime in two cities of Nariño, El Charco (n = 48) and Tumaco (n = 50). After 14 days none of El Charco patients presented therapeutic failure to either antimalarial. However, in Tumaco after 28 days, 12 of 24 (95% CI: 30.6-69.4) patients presented AQ treatment failure while 4 of 26 (95% CI: 5.1-33.1) patients had SP treatment failure. The high level of AQ treatment failure in Tumaco was unexpected because it had been introduced only recently as an antimalarial treatment in Colombia. The results suggest that the use of the current dose of AQ in combination with SP will be therapeutically useful for less time than expected. Use of combined therapies is a key strategy to delay antimalarial resistance. Unfortunately, its success depends on the efficacy of antimalarial drugs individually.

Adolescent↗
PubMedDate not supplied

[Prevalence of Taenia solium antibodies in humans and in pigs in an endemic area of Colombia].

INTRODUCTION: Cysticercosis (CC) caused by Taenia solium in humans and in pigs is endemic in many rural communities in developing countries. The use of Western blot assays (WB) to determine T. solium antibodies has become the best serological tool available to date for identifying positive individuals in field conditions. AIMS: The aim of this study was to determine the prevalence of T. solium antibodies in humans and in pigs in two rural communities in Antioquia, Colombia. PATIENTS, MATERIALS AND METHODS: Serological identification of humans and pigs with T. solium antibodies was performed using WB assays in two communities in Ituango, Antioquia. During the study, demographic variables, housing and health conditions were taken into account. Contingency tables were drawn up using c2 to compare the proportion of seronegative individuals and seropositive individuals with headache, fainting or convulsions. RESULTS: The prevalence of human and porcine CC obtained was 2.23 and 6.82% in Pascuita and 1.17 and 2.33% in Guacharaquero, both respectively. Of the 11 WB positive patients evaluated by imaging techniques, two individuals were found to have single calcifications in the TAC scan and RMI showed another to have an unspecified lesion. The prevalence of infection in humans and in pigs in two rural communities in the north of the district of Antioquia, Colombia, shows that CC is endemic and that steps must be taken to control it.

Animals↗
PubMedDate not supplied

Epstein-Barr virus-associated gastric carcinoma in Cali, Colombia.

To estimate the incidence of Epstein-Barr virus-associated gastric carcinoma (EBV-GC) in Colombia and to clarify its clinicopathological features, we examined 178 consecutive gastric carcinoma cases, diagnosed during the period from 1996 to 1998, at Hospital Universitario del Valle in Cali, Colombia. The mean age of the cases was 60 years in males and 58 years in females. Using in situ hybridization assay of EBV-encoded small RNA-1 in paraffin-embedded tissue samples, we identified 23 cases of EBV-GC (13%). After excluding remnant carcinoma, which was found to be EBV-negative in this series, there were 19 (18%) male and 4 (6%) female EBV-GC cases, and the male predominance was statistically significant (P=0.004). The proportion of EBV-GCs decreased with age (P for trend = 0.022). Using sex- and age-specific proportions of EBV-GCs estimated by logistic models and gastric cancer incidence in Cali, which was obtained from tumor registry during the period 1987-1991, we estimated sex- and age-specific incidence of EBV-GCs. The incidence of EBV-GCs (per 100,000 person-years) was 4.1 and 1.4 among men and women, respectively, after age adjustment using the standard world population. Pathological features of EBV-GCs were also examined. EBV-GCs accounted for 33% (8/24) of carcinomas located in the stomach cardia, 14% (6/43) of carcinomas in the middle-part of the stomach, and 7% (6/81) of carcinomas in the antrum. The difference by tumor location was statistically significant (P=0.009). Histology-specific analysis using Lauren classification revealed that the proportion of EBV-GCs was not different in intestinal- and diffuse-type carcinomas (13% in both types). When the classification scheme of the Japanese Research Society for Gastric Cancer was used, EBV-GCs were identified more frequently in moderately differentiated tubular adenocarcinoma, and solid poorly differentiated adenocarcinoma when compared to other histological types. No lymphoepitelioma-like histology was found in the present series. The frequency of EBV-GC was slightly higher in advanced tumors, which involved serosa. Further analysis of clinico-pathological features of EBV-GC using a larger number of cases would give invaluable insights into its etiology.

Adenocarcinoma↗
PubMed2003

[Surveillance of Haemophilus influenzae serotypes and antimicrobial resistance in Colombia, 1994-2002].

Invasive disease caused by Haemophilus influenzae serotype b results in high rates of morbidity and mortality among children. In 1994, the Microbiology Group at the Instituto Nacional de Salud (Colombia) initiated a program to detect antimicrobial resistance in H. influenzae. Invasive isolates were collected by hospitals and public health laboratories as part of surveillance programs for acute respiratory infections and acute bacterial meningitis. To determine the evolution of serotypes and antimicrobial resistance patterns, invasive H. influenzae isolates collected from 1994 to 2002 were compared, and the impact of Hib conjugated vaccine in Colombia was reassessed. The analysis included 683 isolates, 379 (55.5%) were recovered from male patients, 370 (54.2%) from children under one year, 227 (33.2%) from children aged 1 to 5, 19 (2.8%) from children aged 6 to 14, and 38 (5.6%) from children over 14 years; 29 (4.2%) with no age data. Clinical classification recorded 493 (72.2%) of the samples were from patients with meningitis, 181 (26.5%) with pneumonia, and 9 (0.9%) with other diseases. Eighty five percent of isolates corresponded to H. influenzae serotype b, 12.9% were non capsular, and 2.0% corresponded to other serotypes (10 a, 1 d, 1 e and 2 f). Of the total number of isolates, 12.0% produced beta lactamase, 13.9% were resistant to ampicillin, 12.7% to trimethoprim sulfamethoxazole (SXT), 5.4% to chloramphenicol, 1% to cefuroxime. All isolates were susceptible to ceftriaxone. During the 10-year period, resistance to SXT increased from 5% to 13%. A significant decrease in meningitis cases was detected among children under one-year old and in the 1 to 5 age group. Before introducing the vaccine, an annual average of 43 and 23 isolates for each of these groups were received. During 2002, 10 and 6 isolates, respectively, were received for each group. Surveillance of invasive H. influenzae isolates has allowed the evaluation of Hib vaccine impact, as well as the detection of an increase of non-capsular isolates, and changes in resistance patterns.

Adolescent↗
PubMed1954

Water-supply systems for rural areas and small communities in Colombia.

As part of a rural-sanitation campaign in Colombia, the National Federation of Coffee Growers of Colombia (NFCG) in 1942 initiated a scheme for ensuring an adequate provision of water to coffee-growers in rural, mountainous areas, both for domestic use and for coffee-processing. Where farms are reasonably closely grouped collective water-supply systems are used, but it is also frequently necessary to construct individual systems. In either case, the cost of installation is shared by the NFCG and those who directly benefit. The average cost of the collective system has been Colombian pesos 12,000 per system, while the cost of individual installations has varied between Colombian pesos 650 and 935. Each collective system is administered and operated by a rural water board composed of local farmers, while technical problems are referred to the engineering staff of the NFCG.In general, the cheaper gravity system is preferred, but in individual installations it has often proved necessary to provide hand pumps or hydraulic rams.Through improvement in the water supply, the prevalence of water-borne diseases has considerably decreased, while the rate of coffee-production has increased.

Agriculture↗
PubMed2003

[Therapeutic efficacy of 3 treatment protocols for non-complicated Plasmodium falciparum malaria, Antioquia, Colombia, 2002].

High resistance of Plasmodium falciparum malaria to chloroquine poses malaria as a major public health problem in Colombia. In this context, the therapeutic response of uncomplicated P. falciparum malaria patients to chloroquine (CQ), sulfadoxine/pirymethamine (SDXP) and combined therapy (SDXP/CQ) was evaluated according to the WHO/PAHO protocols of 1998. The comparisons were based on a sample of 160 patients with uncomplicated P. falciparum malaria in Turbo and Zaragoza (Antioquia, Colombia). Patients were randomly assigned each of the treatment categories. The results were statistically similar in each municipality. In Turbo percentage of treatment failure was 87.5%, 22.2% and 22.6% for CQ, SDXP and SDXP/CQ, respectively, whereas in Zaragoza, the corresponding treatment failure was 77.7%, 26.5% and 12.1%. During follow up, 50% of subjects with late treatment failure were asymptomatic in Turbo, while 33.3% were asymptomatic in Zaragoza. A high level of treatment failure occurred with CQ monotherapy, while SDXP and SDXP/CQ had acceptable levels of failure, i.e., below 25%. The high percentage of late treatment failure in asymptomatic patients may contribute to increased risk of persistent transmission.

Adult↗
PubMedDate not supplied

[Evaluation indicators of the Healthy Municipalities for Peace strategy in Colombia].

OBJECTIVES: The work that is presented is the first phase of a scale development study. The objectives are: selecting, developing and evaluating indicators for the evaluation of the healthy cities project in Colombia, in order to offer the bases for the construction of a measurement scale. METHODS: The project was executed from January 2001 to August 2002. A validation by construct and an assessment of indicators, according to their importance, data availability and formulation were carried out. A theoretical heuristic model for evaluating the Colombian Healthy Cities Project was developed; based on these model 128 indicators were defined. A preliminary instrument was then made and evaluated by experts in the strategy. A test was carried out in five cities in order to test data availability and formulation. RESULTS: The final results are a heuristic model for the evaluation of the project and an evaluation of each indicator. CONCLUSIONS: The final results are not finished. A greater effort is needed for developing good heuristic models and for building instruments for assessing the healthy cities project in Colombia.

Colombia↗
PubMedDate not supplied

[Focusing on the subsidized health regime in Colombia].

Based on the results of the project "Evaluation of the Processes of the Subsidized health regime" in Colombia, a reflection is presented about the beneficiary selection system--Sisben as a tool to affiliate people to the subsidized health regime. The multiple interpretations which have been given to the Sisben as an instrument to focalize the health services in the poorest populations, are documented and analyzed. This has been interpreted, amongst others, as a measure of the magnitude of poverty, as an approximate indicator of resources or income, or as an evaluation of fulfillment of needs. It was found that amongst the 19 million of poor people living in Colombia in 1997, less than half of them, 8.9 million, have been included in levels 1 and 2 of Sisben, which represents an exclusion error of 53.1%. Of the 10.6 million persons classified in these levels, 1.6% are not poor, giving an inclusion error of 14.9%. The exclusion errors are much more serious than the inclusion ones, because they mean a denial of equal rights and services for all those who are in similar conditions, according to the criteria for assignation of subsidies.

Colombia↗
PubMedDate not supplied

[Estimate of the incidence of occupational diseases in Colombia, 1985-2000].

OBJECTIVES: The occurrence of labor related diseases in Colombia is unknown. The objective of this study was to estimate the incidence of occupational disease in Colombia in the period 1985-2000. METHODS: The annual incidence was estimated with the methodology recommended by Leigh et al. based upon the population estimates of the National Administrative Statistics Department (DANE). RESULTS: The results showed an increase in the incidence of occupational diseases from 68,063 cases in 1985 to 101,645 in 2000. DISCUSSION: The economic losses caused to the social security health system by underreporting of occupational diseases are estimated.

Adolescent↗
PubMed2003

Feeding success of Lutzomyia evansi (Diptera: Psychodidae) experimentally exposed to small mammal hosts in an endemic focus of Leishmania chagasi in northern Colombia.

Lutzomyia evansi is the vector of Leishmania chagasi in northern Colombia. Differences in feeding success were revealed, when this phlebotomine sand fly was fed on five species of small mammal hosts from an endemic focus of visceral leishmaniasis. In each trial, 50 female sand flies were provided access to similar-sized depilated areas of the hind foot of each of 44 individual mammals and allowed to feed for 30 minutes. The number of engorged sand flies was counted at the end of each trial and compared among host species by analysis of variance and Tukey's multiple comparisons test. Sand flies fed least successfully on Sciurus granatensis, a common squirrel in the endemic area. It has not been found infected with L. chagasi. Intermediate numbers of sand flies engorged on Heteromys anomalus and Zygodontomys brevicauda, but these two mammals have not been found infected with L. chagasi and are not expected to be important in transmission. Sand flies fed most successfully on Didelphis marsupialis and Proechimys canicollis. These are the two most abundant mammals in the endemic area and frequently are infected. Results provided further evidence that these two species are the wild mammals with the greatest impact on transmission of L. chagasi in northern Colombia.

Animals↗