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PubMed2004

Incomplete surveillance of a dengue-2 epidemic in Ibagué, Colombia, 1995-1997.

From April 1995 through November 1997 a dengue epidemic occurred in Ibagué (400,000 population), Colombia, where 3,419 cases were reported and DEN 2 virus was isolated from seven patients. A sero-survey conducted in 1996 found evidence of previous dengue infection in 9.6% of the population, indicating that many infections had not been reported. The dengue infections occurred in all age groups, but children under five years of age were most frequently infected. Forty-five percent of this Ibagué population were born after the re-appearance of dengue in Colombia in 1972, but have never been infected with dengue virus. Most of the cases reported as dengue hemorrhagic fever did not fulfill the current case definition. Aedes aegypti larvae were found in 19% of dwellings surveyed, most often in uncovered low tanks used for water storage. Many residents were not acquainted with the domestic nature of the mosquito vector. Health workers attributed the failure of the dengue control programs to lack of leadership and other administrative problems.

Adolescent↗
PubMed2005

[Factor analysis and validation of a Spanish version of the Brief Psychiatric Rating Scale in Colombia].

INTRODUCTION: A validation study was directed toward an evaluation of the Brief Psychiatric Rating Scale (BPRS) in a Spanish-language version in Colombia. The BPRS is important because it is one of the most widely used scales in clinical and research settings in mental health. METHODS: The BPRS was administered to 149 psychiatric impatients and the scores evaluated for factorial structure and internal consistency. Test-retest and inter-rater reliability were assessed in a sub-sample of 30 patients. Concurrent validity was analyzed by comparing scores on BPRS with scores on GAF scale. Sensitivity to change was evaluated by comparing scores in two clinically different settings. RESULTS: Principal component factor analysis indicated a structure with three domains: schizophreniform, bipolarity and depression. The instrument showed good internal consistency (Cronbach's alpha = 0.79). Coefficients corresponding to inter-rater and test-retest reliability were 0.94 and 0.82 respectively. Correlation between BPRS and GAF was 0.7 (Spearman). Within-subjects ANOVA showed the scale to be an instrument good sensitivity for detecting changes in of clinical characteristics. CONCLUSION: We concluded that the Spanish language version evaluated in Colombia to be a valid clinical-report instrument with adequate psychometric properties.

Adult↗
PubMed2005

[Malaria screening in blood donors in Cali, Colombia].

INTRODUCTION: In Colombia, blood units for transfusions are in short supply. In Cali, a city in central western Colombia, the situation is exacerbated by a policy of scrupulous rejection of blood donors who may have been exposed to malaria infection. Cali is free of malaria transmission, but it lies close to the Pacific Coast, a highly endemic region. Currently, malaria screening in potential blood donors is based only on an interview. A more sensitive and objective malaria test will increase the number of acceptable donors and, hence, increase the available blood supply. OBJECTIVE: Three malaria tests were evaluated, thick smear, ELISA-IgG and ELISA-HRPII, using a semi-nested PCR as gold standard. MATERIAL AND METHODS: The study was undertaken in a blood bank of Cali, from February to May 2002, where 286 individuals were examined. Blood thick smear, ELISA-IgG and ELISA-HRPII (Pan Malaria Antibody ELISA and Malaria Ag CELISA) results were compared to semi-nested PCR data. RESULTS: Of the 286 donors tested, 115 were rejected because of a history of traveling or living in a malaria endemic area within the last year. However, none of these applicants were malaria-positive using the three testing methods. CONCLUSION: To improve the screening process, laboratory tests for malaria are recommended for donors who are exposed to a risk of malaria infection. Additional studies are necessary for selection of most sensitive test, however.

Adolescent↗
PubMed2005

[Isolation of Cryptococcus gattii serotype B from detritus of Eucalyptus trees in Colombia].

INTRODUCTION: Cryptococcus gattii serotype B has been associated with several species of trees in tropical and subtropical regions. Serotype B has been found to be the second most frequently isolated from patients in Colombia, but it has not been isolated from the environment. Therefore, a study was designed to sample plant material from a forest in the province of Cundinamarca, with the aim of establishing the presence and distribution of the C. neoformans complex, specially serotype B. In addition, isolates were evaluated for several phenotypic characteristics associated with virulence. METHODOLOGY: During February and March, 2003, 4 separate sample collections were made. One hundred sixty-seven samples were collected from detritus of eucalyptus and 28 samples from other species of trees. All were processed using the conventional procedure and plated on selective media. The following parameters were measured: cellular and capsular sizes in the filtrates, growth at 37 degrees C, virulence in a mouse animal model system, and mating type as detected by PCR. RESULTS: Cryptococcus gattii serotype B was isolated from 46 eucalyptus samples (27.5%). The cellular size in the filtrates ranged from 3.10 to 4.15 microm and the capsular size from 0.30 and 0.46 microm. The 46 isolates grew at 37 degrees C, but none of them caused the death in the animals during 70-day observation period. All isolates were of mating type a. CONCLUSIONS: This constitutes the first report of the isolation of serotype B, mating type a, from eucalyptus detritus in Colombia.

Animals↗
PubMed2005

[First report of Triatoma nigromaculata (Stål, 1859) (Hemiptera, Reduviidae, Triatominae) for Colombia].

The presence of Triatoma nigromaculata was recorded for the first time in Colombia in the rural village La Playa in the province of Cauca. A single female was captured from an outdoor area near a household. The presence of Trypanosoma parasites in the specimen was not established due to the poor condition of the specimen. The epidemiological importance of this finding is discussed with respect to the potential for transmission of Chagas disease in the province of Cauca and, more broadly, in Colombia.

Animals↗
PubMed2005

[Control of Trypanosoma cruzi infection in blood donors in Colombia, 2003].

INTRODUCTION: Chagas disease is a public health problem in Latin America. Whereas the primary source of transmission is the insect vector, the second is by blood transfusion. Consequently, in Colombia, screening for trypanosomiasis has been obligatory for blood donors since 1995. OBJECTIVE: The effectiveness ot current strategies for infection control in donors was evaluated in order to estimate the risk of blood stock contamination with Chagas disease. The screening data came from the blood banks in the Program of External Evaluation in the Performance of Serology and the reports of the Laboratories of Public Health on confirming donor serology tests. RESULTS: In 2003, 482,371 units of blood were collected in all of Colombia. Of these, 99.9% were analyzed for anti-T. cruzi reactivity, with a positives of 0.42% detected. The Casanare Province presented the biggest number of reactive donors 107/1487 (7.2%), with 75 confirmed positive. In the Program of External Evaluation in the Performance of Serology, 45.5% of all banks participated-all used ELISA for screening of anti-T. cruzi. 1.1% false positives and nofalse negatives were indicated in 12 provinces, where 338,563 units were analyzed for anti- T.cruzi, 1298 units were reactive and 1108 (85.4%) were confirmed by the IFI test. This indicated a rate of Chagas positives of 0.33%. CONCLUSIONS: Although the analysis covered arrived at 99.9% of the blood units, a small degree of infection risk for T. cruzi still remains. The cases of T. cruzi in donors oscillate between 0 and 50 per thousand. This rate is highest in Casanare with a concomitantly high risk for acquisition of transfusional Chagas. ot show negative false results.

Animals↗
PubMed2006

Molecular epidemiology of human immunodeficiency virus-infected individuals in Medellin, Colombia.

To study the molecular epidemiology of human immunodeficiency virus type 1 (HIV-1) strains in Medellín, Colombia, 115 HIV-1-positive individuals who were recruited from an HIV outpatient hospital (Universitario San Vicente de Paul) during the period from July 2001 to January 2002 were genotyped. All samples were analyzed by envelope heteroduplex mobility assay and found to be subtype B. Twenty-four samples were randomly selected for sequencing of the protease and the reverse transcriptase regions; all isolates were found to be subtype B. Phylogenetic analysis of seven nearly full-length genomes showed that all samples were subtype B. This study shows that the HIV epidemic in Colombia continues to be dominated by the subtype B virus. The predominance of subtype B genotypes of HIV-1 strains in Medellín resembles what is seen in the nearby countries of Peru, Ecuador, and Venezuela.

Adolescent↗
PubMed2006

[Seroprevalence of Leptospira infection in habitants of peripheral neighborhoods in Cali, Colombia].

INTRODUCTION: Leptospirosis is a zoonotic disease with varying modes of transmission and clinical expression that affects humans inhabiting urban and rural areas worldwide. In Colombia, little is known regarding leptospirosis in urban settings. OBJECTIVES: To establish the seroprevalence of leptospiral infection in humans, to assess the serological reactivity and to identify factors associated with seropositivity. MATERIALS AND METHODS: We conducted an infection prevalence study in 259 inhabitants of peripheral neighborhoods in the city of Cali, Colombia, stratified by sex and age. Sociodemographic information, time residing in the same neighborhood, occupation, exposure to potentially infectious sources like water or animals, and serum used in a Microagglutination test against 19 Leptospira serovars were obtained. RESULTS: The population was composed mainly of students (37.1%), housewives (32%) and workers in non-formal activities (24.6%). The prevalence of anti-Leptospira antibodies was 23.3% (C195% 18.3-28.3), with high frequency in people older than 57 years of age and significantly higher in men than women (p=0.045). There was an association between the presence of antibodies and contact with animals (p=0.038). Reactivity was observed against 16 of the 19 serovars evaluated, but the antibody titers were low. CONCLUSIONS: The high infection seroprevalence found in this study suggests frequent contact with Leptospira in putatively high risk neighborhoods of Cali. Contact with animals was the most significant factor associated with the presence of anti-Leptospira antibodies.

Adolescent↗
PubMed2006

[Correlation and concordance of three HIV viral load techniques available in Colombia].

OBJECTIVE: To compare the performance of three available technologies for Human Immunodeficiency Virus quantitation in Colombia. METHODS: Samples from different areas of the Country were selected by convenience and underwent Human Immunodeficiency Virus quantitation using three methods: Versant bDNA 3.0 (Bayer), LCx HIV (Abbott) and Amplicor Monitor v1.5 (Roche). All samples were processed at the Centro de Análisis Molecular in Bogotá, Colombia. Results obtained with the three techniques were compared using linear regression. Additionally, the concordance between techniques was assessed calculating the unweighted kappa, the frequency of discordance according to cut-off points of clinical importance, and the frequency of differences exceeding 0.5 logs. RESULTS: The correlation between techniques was highly significant, with an R2 higher than 0.97. The concordance was substantial, with unweighted kappas above 0.7. Nevertheless, the frequency of discordance for cut-off points of clinical importance and the frequency of differences exceeding 0.5 logs were considerable (8.8%-15.6% and 19.6%-36.3% respectively). CONCLUSION: The three technologies for quantitation of viral load are adequate with high levels of correlation and concordance. However, because of the observed variability we recommend comparing a reading from one technique with another reading from the same technique when incorporating the results into clinical decision making.

Colombia↗
PubMed2006

Efficacy of three chloroquine-primaquine regimens for treatment of Plasmodium vivax malaria in Colombia.

Plasmodium vivax malaria is an important cause of morbidity in Central and South America. In Colombia, this is the most prevalent malaria infection, representing 75% of the reported cases. To define the efficacy of the chloroquine and primaquine regimen to eliminate hypnozoites and prevent relapses, we conducted a random controlled clinical trial of three primaquine regimens in an open-label study. We evaluated the anti-relapse efficacy of total primaquine doses of 45, 105, and 210 mg administered at a dosage of 15 mg/day in 210 adults with P. vivax infection from the northwestern region of Colombia. Cure rates for blood-stage P. vivax malaria by day 28 of follow-up were 100% in all groups. Post-treatment reappearance of parasitemia during the six months of follow-up was 45%, 36.6% and 17.6%, respectively, for each group. When compared with other groups, administration of 210 mg was a significant protection factor for reappearance of parasitemia in a malaria-endemic area.

Adult↗
PubMed2006

Tuberculosis control in Bolivia, Chile, Colombia and Peru: why does incidence vary so much between neighbors?

SETTING: In 2003, Peru and Bolivia reported the highest annual tuberculosis (TB) incidence rates in the Americas. Neighboring Colombia and Chile had lower annual incidence rates despite their proximity. OBJECTIVE: To determine what factors contribute to differences in TB incidence rates among Chile, Colombia, Bolivia and Peru. DESIGN: Multiple sources of literature dating between 1990 and 2005 were used and World Health Organization TB control guidelines were consulted for policy level comparisons. RESULTS: Comprehensive implementation of the DOTS strategy is the main factor explaining the differences in TB incidence rates, even after considering socio-economic factors. CONCLUSION: Cross-national comparisons suggest ways to improve regional DOTS implementation.

Bolivia↗
PubMedDate not supplied

[Neuroepidemiology profile of the central zone of the department of Caldas (Colombia), years 2004-2005].

INTRODUCTION: The neurological disease (ND) is a challenge for the medical community, cause of a high degree of morbility, mortality, deterioration in the quality of life of the patient and its family. AIM. To determine the prevalence of ND in the population of the department of Caldas (Colombia): migraine, movement disorders, cerebrovascular diseases, peripheral neuropathy, epilepsy, dementia and insomnia. This last one is innovating aspect in the published Colombian studies has not considered and therefore its prevalence with World Health Organization (WHO) methodology is not known. PATIENTS AND METHODS: This is a population, descriptive study, of cross section. The neuroepidemiological protocol developed by the WHO, modified for Colombia was used. The suspicious cases to suffer ND were evaluated by the neurologist. The information was processed in the statistical package Epi Info 6.04d. RESULTS: Of 787 interviews, 360 were suspicious of ND; additionally 20 non suspicious subjects were evaluated like controls. The global prevalence of ND, excluding insomnia was 13.4%, while including insomnia was 60.4%. The prevalence diseases in sequence (by 1,000 inhabitants) were: insomnia 468 (CI 95%: 433.4-504.4), migraine 278 (CI 95%: 246.3-310.2), dementia (in older 50 years) 51 (CI 95%: 15.8-87), peripheral neuropathy 48 (CI 95%: 32.7-63.4), movement disorders 25 (CI 95%: 13.8-37.0), epilepsy 24 (CI 95%: 12.8-35.5) and cerebrovascular disease 10 (CI 95%: 2.5-17.8). CONCLUSIONS: These results show high prevalence of migraine in our community. Also, the peripheral neuropathy, movement disorders and epilepsy were more frequent than in previous investigations. Dementia and stroke presented prevalence similar to the reported one. The insomnia showed very high prevalence, but by the non possibility of comparison with other local studies, it is need conduced others studies to confirm these findings.

Adolescent↗
PubMed2006

[First case report of Mammomonogamus (Syngamus) laryngeus human infection in Colombia].

First case report of Mammomonogamus (Syngamus) laryngeus human infection in Colombia Parasitic nematodes of the genus Mammomonogamus affect the respiratory tract of domestic mammals. The male and female of M. laryngeus remain in permanent copula so that the pair appears as a "Y'. To date, a few more than 100 cases of human infections by this parasite have been reported in the biomedical literature. This report describes the first infected patient in Colombia. He had a persistent and productive cough and after an episode of coughing a pair of worms were expelled in sputum with total clinical recovery. Since there is scant clinical information about this parasite, this report includes a description of the adult worms, a summary of the epidemiology and the clinical manifestations in humans. Photographs are presented to facilitate future identification by morphological characteristics.

Adolescent↗
PubMed2006

[Outbreaks of human rabies transmitted by vampire bats in Alto Baudó and Bajo Baudó municipalities, department of chocó, Colombia, 2004-2005].

INTRODUCTION: During months May to July 2004, a rabies outbreak in the Embera community of Birrinchao, in the Purricha river basin department of Choc6 was reported with 14 human deaths. Another rabies outbreak was reported in January 2005 in the black communities of Pató and Nauca in the neighboring municipality of Alto Baudó with 3 human deaths. OBJECTIVES: To describe the largest outbreaks of human rabies transmitted by vampire bats reported in Colombia to date. To describe the diagnostic laboratory techniques used, and the activities undertaken for the control of rabies in the area. To discuss the epidemiologic significance and public health implications of these rabies outbreaks. MATERIALS AND METHODS: Rabies diagnosis was achieved by direct immunofluorescence, inoculation of mice and immunohistochemistry. Typing of the virus was achieved by indirect immunofluorescence using monoclonal antibodies. Rabies control activities were undertaken in Bajo Baudó consisting in a population census, human vaccination and application of antirabies sera, vaccination of dogs and cats, and application of anticoagulant to bats. RESULTS: Four human cases were confirmed as positive for rabies in both rabies outbreaks. Another 13 rabies cases in humans were inferred by strong epidemiological links. Rabies antigenic variant 3 was identified in the samples studied. Rabies control activities were conducted for a human rabies outbreak caused by vampire bats. CONCLUSIONS: The human rabies outbreak in Bajo Baudó has been the largest reported in Colombia. It was caused by vampire bats, showing that these animals are a threat for human health. The implementation of control strategies for this kind of epizootic outbreaks is needed in South America. It remains unknown whether there is a link between this outbreak and one reported 6 months later in the neighboring municipality of Alto Baudó.

Adolescent↗
PubMed1991

[Pre-project evaluation of a government based international family planning co-operative project--from a survey at project site in Colombia].

A government based international co-operative project for family planning was formulated between Japan and Colombia. A baseline survey was carried out at the project site in northern Colombia as a pre-project evaluation. A total of 330 households were sampled and the housewives were interviewed concerning family planning. Births averted by the existing government program were estimated employing Bongaarts prevalence model. In addition, background and conditions leading to inability to receive family planning services were analyzed. The results showed that of total births averted, government programs contributed around 50% reflecting the apparent insufficiency of the services in reaching women in their forties and teens. Educational attainment and place of birth on the part of the woman, household income, discussion of number of children desired between husband and wife were among the most important factors for women wishing contraception practice but not being able to receive family planning services. Based on this analysis, a service program was mapped out to meet the need of residents of the project site.

Adolescent↗
PubMedDate not supplied

The impact of national policies on the acceptance of sterilization in Colombia and Costa Rica.

Using data that cover the period 1978 to 1986, this article assesses the effect of policies concerning the provision of female sterilization during the early 1980s. The annual rate of sterilization among ever-married women aged 20-39 in Costa Rica was approximately one-fifth lower in 1985 than in 1982, when sterilization became illegal. Medical committees continued to review each case individually, and sterilizations were still available, especially to less educated women, among whom prevalence increased slightly between 1981 and 1986. However, sterilization prevalence decreased modestly among women aged 35-39 and among the better educated. As of 1986, 16.7 percent of all women who were currently in union relied on sterilization, compared with 17.3 percent in 1981. In Colombia, annual rates of sterilization rose by less than 4 percent from 16.9 in 1977 to 17.5 in 1979, and prevalence increased among women at all educational levels, in rural and urban areas, and especially among women aged 30-44. As a result of the adoption of flexible eligibility criteria, minimal cost, and accessibility in both rural and urban areas in Colombia since 1984, sterilization is now the most preferred contraceptive method there, used by approximately 18.3 percent of all women currently in union as of 1986.

Adult↗
PubMed1989

AIDS in Colombia.

Between January 1984 and December 1987 a total of 178 AIDS cases were reported to the Colombian Ministry of Health. The location of these cases suggests that the human immunodeficiency virus (HIV) is widely distributed in Colombia. Most of those afflicted (97%) have been adult males. HIV seroprevalence studies of selected population groups revealed the highest antibody prevalence (5.65% in females, 22.5% in males) among individuals involved in high-risk behaviors who participated in a free AIDS testing program. High prevalences (from 0.6% to 3.9% in females, and 14.6% to 15.9% in males) were also found in patients (primarily female prostitutes and male homosexuals) attending clinics for sexually transmitted diseases in several urban areas. The number of AIDS cases in Colombia has doubled or tripled annually since reporting began in 1984, a pattern similar to that observed worldwide.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Contraceptive social marketing and community-based distribution systems in Colombia.

Three operations research experiments were carried out in three provinces of Colombia to improve the cost-effectiveness of Profamilia's nonclinic-based programs. The experiments tested: (a) whether a contraceptive social marketing (CSM) strategy can replace a community-based distribution (CBD) program in a high contraceptive use area; (b) if wage incentives for salaried CBD instructors will increase contraceptive sales; and (c) whether a specially equipped information, education, and communication (IEC) team can replace a cadre of rural promoters to expand family planning coverage. All three strategies proved to be effective, but only the CSM system yielded a profit. Despite this, Profamilia discontinued its CSM program soon after the experiment was completed. Unexpected government controls regulating the price and sale of contraceptives in Colombia made the program unprofitable. As a result, family planning agencies are cautioned against replacing CBD programs with CSM. Instead, CBD programs might adopt a more commercial approach to become more efficient.

Colombia↗