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Multispecies and multiple anthelmintic resistance on cattle nematodes in a farm in Argentina: the beginning of high resistance?

There are very few resistance records on cattle nematodes. South American successive records have been increasing rapidly since the year 2000. In Argentina, increasing dissatisfaction based on the exclusive use of macrocyclic lactones has prompted the use of benzimidazoles in the Pampean region. The studied farm is located in the Argentina humid Pampas and had apparently poor results after anthelmintic treatments. Evaluation of resistance was firstly based on faecal egg reduction after treatment in November 2001 and June 2002 and was complemented with worm counts obtained by necropsy in June 2002. The study reports that the reduction of faecal egg excretion after benzimidazole (reduction 31-79%) or ivermectin treatments (76-97%) in November 2001 was insufficient and these poor results were confirmed in June 2002 (benzimidazoles (65-89%) and ivermectin (47-77%)). Several methods for evaluating faecal egg count reduction were performed and yielded different results. A new method based on the estimated faecal egg counts (corrected from the initial faecal egg counts and animal type using a general linear model) was used and gave higher flexibility in the interpretation of putative resistance to anthelmintics. From necropsy results, it could be concluded that Cooperia oncophora was resistant to avermectins and benzimidazoles and that Cooperia punctata, Ostertagia ostertagi and Haemonchus placei were resistant to benzimidazoles. This case of multispecies and multidrug resistance is probably not unique and could reflect the emergence of resistances in Argentina. This emergence is probably due to the intensive use of anthelmintics, the absence of refugia, and the frequent circulation of infected cattle.

Albendazole↗

Sensitization to soybean hull allergens in subjects exposed to different levels of soybean dust inhalation in Argentina.

BACKGROUND: Soybean hulls (SHs) have been identified as the source of aeroallergens responsible for soybean asthma outbreaks. However, the prevalence of sensitization to SH allergens in subjects from Argentina, a country where soybeans are produced, is unknown. OBJECTIVE: The purpose of this study was to determine the prevalence of sensitization to SH by in vivo and in vitro tests in subjects with asthma or allergic rhinitis and in control subjects from Argentina who have been exposed to different levels of soybean dust inhalation (SDI). METHODS: Exposure to SDI is defined as follows: (1) direct = occupational, (2) indirect = proximity to soybean fields or grain elevators, and (3) urban = urbanized areas without a known source of SDI. Two groups were studied. Group 1 consisted of 365 subjects with asthma or allergic rhinitis and group 2 (control group) of 50 healthy individuals. Subjects from both groups were classified according to their exposure to SDI. All subjects completed standard questionnaires. Prick skin tests (STs) with an SH extract and with common allergens were performed on all subjects. Specific IgE and IgG4 to SH were measured in sera of 51 of 56 subjects from group 1 who had a positive ST to SH and in all sera from group 2. RESULTS: Fifty-six (15.3%) subjects from group 1 and no subjects from group 2 had a positive ST to SH (wheal SH/wheal histamine >/=0.5). In group 1, positive STs to SH were 38.7%, 20.3%, and 8.2% in subjects with direct, indirect, and urban exposures, respectively (P <.001). Monosensitization to SH is absent in all subjects from group 1. The percent of subjects with positive STs to mites, pollen, and molds was highest in those with a positive ST to SH versus those with a negative ST to SH (P <.01). Asthmatic patients with a positive ST to SH, compared with those exclusively sensitized to mites, had a higher frequency of daily or weekly symptoms (59.4% vs 25.7%, respectively, P <.001) and a higher percent of glucocorticoid dependence (52.8% vs 34%, respectively, P <.01). Percent positive IgE in group 1 and group 2 were 39.2% and 10% (P <.001) and percents positive IgG4 are 27.4% and 12%, respectively (not significant). In subjects from group 1 and group 2 with direct exposure percents positive IgE are 58.3% and 13.3% (P < .001) and percents positive IgG4 were 75% and 20%, respectively (P < .02). IgG4 in group 1 was significantly higher in subjects with direct exposure compared with subjects with indirect or urban exposure. CONCLUSION: This study demonstrated that there was (1) a high prevalence of sensitivity to SH in subjects with asthma or allergic rhinitis from Argentina and (2) an association between sensitivity to SH and severity of asthma and level of exposure to SDI.

Administration, Inhalation↗

Nosocomial infections in medical-surgical intensive care units in Argentina: attributable mortality and length of stay.

BACKGROUND: Nosocomial infections are an important public health problem in many developing countries, particularly in the intensive care unit (ICU). Limited data exists on the incidence and burden of nosocomial infection in the ICU in Argentina. METHODS: We performed baseline prospective nosocomial infection surveillance of all patients for 6 months in 3 medical-surgical ICUs (MS-ICUs) in Argentina (2 months in each ICU). Nosocomial infections were identified using the Centers for Disease Control and Prevention National Nosocomial Infections Surveillance definitions. Overall and site-specific nosocomial infection rates, attributable mortality, and excess length of hospital stay were calculated. RESULTS: The overall nosocomial infection rate was 27% and 90 per 1000 patient-days. The most common site of infection was catheter-related bloodstream infection (32%), followed by ventilator-associated pneumonia (25%), and catheter-associated urinary tract infection (23%). The rate of central catheter-associated bloodstream infection in the MS-ICU was 44.61 per 1000 device-days, with an attributable mortality of 25%, and 12 attributable extra days of hospital stay. The urinary catheter-associated urinary tract infection rate in the MS-ICU was 22.55 per 1000 urinary catheter-days, with an attributable mortality of 5%, and 5 excess extra days of hospital stay. The ventilator-associated pneumonia rate in the MS-ICU was 50.87 per 1000 ventilator-days with an attributable mortality of 35%, and 10 attributable extra days of hospitalization. CONCLUSION: Our study finds high rates of nosocomial infections in ICUs in Argentina, associated with a considerable attributable mortality and excess length of stay. Ongoing targeted surveillance and implementation of infection control strategies is necessary to control this growing problem.

Argentina↗

Identification of human immunodeficiency virus type 1 subtypes B and F B/F recombinant and dual infection with these subtypes in Argentina.

DNA sequences encoding the third variable region (V3) of human immunodeficiency virus type-1 (HIV-1) envelope glycoprotein gp120 were obtained from 18 infected individuals residing in different regions of Argentina. Proviral DNA representing the env V3 region was obtained by PCR from uncultured peripheral blood mononuclear cells (PBMC) and genetic heterogeneity was examined by phylogenetic analysis. Sequences representing the gag p17 region were also obtained for a subset of these samples. Moreover, 1 sample that it was not possible to classify according to initial phylogenetic analysis was further analysed by molecular cloning of both V3 and p17 regions. Phylogenetic analysis according to different methodologies were performed comparing obtained sequences with a set of reference sequences representing previously characterized HIV-1 subtypes. The recombinant identification program (RIP) was used to study the presence of possible recombinant sequences. Phylogenetic analysis demonstrated that viruses representing both subtypes B and F are circulating among HIV-1 infected individuals in Argentina. In addition, RIP analysis showed that an initially unclassified sequence exhibited similarities to subtypes B and F in different fragments of the V3 region. Separate phylogenetic analysis of each of these fragments revealed divergent clustering, suggesting that this sequence harbours a point of recombination within the V3 loop. Interestingly, we also identified a dually infected individual with viruses belonging to subtypes B and F, as demonstrated by molecular cloning analysis of the env V3 and the gag p17 regions. Taken together, our study shows that both subtypes B and F are circulating in different regions of Argentina. Moreover, the data presented here show that dual infections with subtypes B and F can occur, and consequently B/F recombinant sequences are arising in the region.

Adult↗

Seat belt use in Argentina--a 10-year struggle.

Can a nongovernmental organization influence or determine seat belt use in a nation? The problems that implementing such a simple, yet effective, measure for traffic safety may trigger in a developing country are impossible to imagine. Just having the right laws is not enough: A great effort is necessary to create awareness and inform the population, but the governmental authorities in Argentina are not doing this, nor do they show any interest in it. In most of the developing countries, the situation is similar. Starting from a diagnosis of seat belt use by means of systematic observations, a program of awareness and massive education was developed for national radio and TV about the advantages of seat belt use. The first stage of this program was launched at the end of 1991, and it continues to this day. Articles in newspapers and communications and requests on the same subject sent to public officials also have helped mobilize public opinion on seat belt use. After 10 years of systematic and continued work by a nongovernmental organization, seat belt use is now part of the government's agenda and there is a high rate of "almost voluntary" seat belt use. The voluntary seat belt use in the city of Buenos Aires has reached 26.9%, and in national highways 58.9%. The roads that have been traveled in Argentina (documented with follow-up statistics) may be useful as guidelines for other countries that are starting this process, and may help to shorten times, avoid pitfalls, and save lives since it is estimated that 1,100 more lives could be saved every year in Argentina when seat belts become the norm.

Accidents, Traffic↗

High seroprevalence of bloodborne viruses among street-recruited injection drug users from Buenos Aires, Argentina.

Injection drug use is the main mechanism of human immunodeficiency virus (HIV) transmission in Argentina (40% of reported AIDS cases in Argentina). This study was conducted among street-recruited injection drug users (IDUs) from Buenos Aires, with the aim of estimating seroprevalence and coinfection of HIV, hepatitis B virus (HBV), hepatitis C virus (HCV), and human T-lymphotropic viruses (HTLVs). A total of 174 volunteers participated in this study; 137 were men (78.7% of volunteers). The average age of the participants was 30 years. Only 64 of participants (37%) had no viral infection, whereas 110 (63%) were infected with > or =1 viruses. Seroprevalences were 44.3% for HIV, 54.6% for HCV, 42.5% for HBV, 2.3% for HTLV-I, and 14.5% for HTLV-II. Among the 77 HIV-infected persons, only 6.5% (5 persons) were not coinfected with other viruses; 88.3% (68) were coinfected with HCV and 68.8% (53) were coinfected with HBV. We demonstrated the existence of multiple viral infections with a high rate of prevalence in IDUs in Buenos Aires, Argentina.

Adolescent↗

Molecular subtyping of Salmonella enterica serovar Typhi isolates from Colombia and Argentina.

Salmonella Typhi is the etiological agent of typhoid fever with 16 million annual cases estimated worldwide. In Colombia and Argentina it is a notifiable disease but many cases have only a clinical diagnosis. Molecular subtyping of S. Typhi is necessary to complement epidemiologic analysis of typhoid fever. The aims of this study were to determine the genetic relationships between the strains circulating in both countries and to evaluate possible variations in the distribution of 12 virulence genes. A total of 136 isolates were analyzed by pulsed-field gel electrophoresis (PFGE) with XbaI following PulseNet protocols and analysis guidelines. Eighty-three different PFGE patterns were identified, showing high diversity among the strains from both countries. Three outbreaks, two in Colombia and one in Argentina, were caused by strains of different PFGE types. In Colombia, two PFGE patterns were found predominantly, which included 36.6% of the isolates from that country. No association was found between the PFGE patterns and the year or place of isolation of the strains, the age of the patients or type of sample. However, several clusters were detected, which included isolates recovered predominantly either from Colombia or Argentina. Most of the strains (97%) exhibited a single virulence profile, suggesting that the pathogenicity markers analyzed are of limited value for strain discrimination and do not correlate with the origin of the isolates (intestinal vs. extra-intestinal). Since the creation of PulseNet Latin America, this was the first international study conducted in South America. The PFGE types identified were incorporated into the Regional S. Typhi PulseNet Database and are now available for comparison with those of strains isolated in other regions. This information will be used for active surveillance, future studies, and outbreak investigations.

Argentina↗

Health conditions in Argentina: facing the twenty-first century.

This paper describes the state of health in Argentina. As in other countries in the Latin American region, the public sector and the role of the state in Argentina are in the midst of structural transformation. Public policy has been formulated with the aim of improving economic efficiency in the long term, often at the cost of basic services, such as health, education and safety. Provision of health care services to a population characterized by high levels of poverty and unemployment, which is also rapidly growing and ageing, needs to be addressed when major policies are decided. Otherwise, a large group of inhabitants in Argentina will not be able to reach the universally proposed minimum levels of health by the year 2000.

Adolescent↗

Prevalence of Helicobacter pylori infection in Argentina: results of a nationwide epidemiologic study. Argentinean Hp Epidemiologic Study Group.

Our aim was to assess the prevalence of Helicobacter pylori (Hp) infection in Argentina, in the general population and by age groups, and to determine the value of various epidemiologic variables as predictors of Hp infection. The study comprised 754 subjects (443 women 158.7%], 311 men [41.3%]) from both genders, consecutively recruited from health centers where patients were undergoing routine medical analyses. Average age was 32 +/- 22 years. The pediatric group included subjects < or =18 years of age (n = 261). Stratification was based primarily on climatic factors and secondarily on sanitary and demographic considerations. Hp infection status was assessed through a quick serologic test. The overall Hp infection prevalence in Argentina was 35.7 +/- 3.8%. The age was statistically significant using a multiple regression test (p < 0.01). Furthermore, the socioeconomic (p < 0.05) and educational level (0 < 0.01) in the adults and the water sources (p < 0.01) in the pediatric group were all statistically significant according the multiple regression test. The overall Hp infection prevalence in Argentina was 35.7 +/- 3.8%. Age was a predictor of Hp infection status. There is evidence of low infection prevalence in children. a higher prevalence in adolescents, and a more noticeable increase at 40 years of age. Furthermore, the socioeconomic and educational level in adults and the water sources in the pediatric group explained, in part, the occurrence of Hp infection.

Adolescent↗

Seroepidemiology of HTLV-I/II in Argentina: an overview.

In this report, the results of seroepidemiologic studies of human T-lymphotropic virus type I (HTLV-I) and type II (HTLV-II) infections in different population groups in Argentina have been compiled. The studies have shown a high prevalence of HTLV-I/II infection in blood donors in the provinces in the north of Argentina (1.0% in Jujuy, 0.7% in Salta, and 0.6% in Formosa) and a low prevalence in the provinces in the central region of the country (<or=0.1%). High rates of HTLV-I (0.45%-2.78%) and HTLV-II (2.78%-21.9%) infections have been documented in Native Indian groups and have highlighted the importance of sexual and mother-to-child transmission of the viruses. The presence of HTLV-I/II antibodies in HIV-infected individuals indicates that both viruses are circulating in certain high-risk population groups. HTLV-I/II was detected in intravenous drug users (2.56%-21.7%), homosexual men (0.5-1.33%), prostitutes (0.8%), and hemophiliacs (2.8%). In conclusion, HTLV-I/II infection is circulating in low- and high-risk populations in Argentina, and these findings would support the view that selective screening for HTLV-I/II should be implemented to reduce the spread of infection.

Argentina↗

Alcohol and the economic crisis in Argentina: recent findings.

AIMS: In 2002 Argentina participated in the GENACIS project (Gender, Alcohol, and Culture: An International Study) as one of the countries funded by the World Health Organization. Four questions about the current economic crisis in Argentina were added to the original GENACIS questionnaire in order to find out the opinions of the general population in relation to alcohol and the economic crisis. METHODS: Gender differences in the answers to these questions were examined. Logistic regression was used to identify demographic, drinking pattern and drinking problems variables related significantly to responses to the economic crisis questions. FINDINGS: During the economic crisis people stopped or reduced going to bars and instead drank at home or at friends' homes. A large number of respondents also reported that people had changed to cheaper or lower-quality alcoholic drinks. Women were more likely to agree with statements that the economic crisis had increased 'escape' drinking and required reductions in money spent on alcohol; men were more likely to agree that the crisis had led to less drinking in bars and to the purchase of cheaper or lower-quality alcoholic beverages. Respondents who reported having significant others with drinking-related problems were more likely to endorse all four statements about effects of the economic crisis on drinking behaviour. A qualitative approach was used to discuss themes in the general comments that were recorded by the interviewers while collecting data. A strongly moralistic attitude towards alcohol was present in these comments, especially among women. CONCLUSION: The findings suggest that the economic crisis in Argentina led to major changes in patterns of drinking that differed according to gender roles and other demographic variables. The long-term effects of these changes remain to be determined as economic circumstances improve.

Adolescent↗

A successful approach for the detection of Fabry patients in Argentina.

Fabry disease is an X-linked lysosomal disorder caused by the deficiency of the lysosomal enzyme alpha-galactosidase A (alpha-Gal A). In males, the laboratory diagnosis is based on the demonstration of decreased levels of alpha-Gal A activity, while in females, the disease is diagnosed by the identification of a mutation in alpha-Gal A gene. Fabry disease in Argentina is underdiagnosed. To date, no comprehensive screening study of Fabry disease in our country has been reported. The present study aimed at developing a targeted screening for the detection of Fabry patients from Argentina based on the set of typical signs and symptoms. We received 121 blood samples from probable Fabry patients for enzymatic and genetic assay. We diagnosed six Fabry patients from six unrelated families, representing a yield of detection of 4.96%. The mutations detected in five of the families analysed were missense mutations: p.Leu243Trp, p.Asp155His, p.Leu415Pro, p.Cys94Tyr and p.Leu191Pro. After the detection of a Fabry patient, his/her relatives were also screened. In the course of these family studies, other 64 Fabry patients, 29 males and 35 females, were detected. To our knowledge, this is the first comprehensive screening of Fabry disease in Argentina. We detected 70 patients in a period of 2.5 years. The development of targeted protocols and the constitution of interdisciplinary groups for the identification of patients with Fabry disease are recommended to obtain a higher yield in the process.

Adult↗

Health care for older persons in Argentina: a country profile.

Argentina is a large country situated at the southern end of the Americas. It is highly urbanized, and almost one-third of the population lives in the capital city and its surrounding area (Buenos Aires). The population is composed of heterogeneous groups, formed primarily by descendants of European immigration who constitute 85% of the inhabitants. In the last 30 years, Argentina has witnessed a growth in the elderly population from less than 7% to nearly 10% of the total population. Additionally, in Buenos Aires City, more than 17% are aged 65 or older. The healthcare systems for the elderly lack nationwide coverage. The Programa de Atención Médica Integral (PAMI) is the largest program for elderly care. It is a state-run program for disabled and senior citizens. PAMI serves 65% of the approximately 3.6 million older people in Argentina. The quality of PAMI healthcare delivery has decreased in the last 2 decades and has largely declined since the Argentinean economic crisis of late 2001. The rehabilitation and long-term care services are relatively underdeveloped, and fewer than 2% of senior citizens live in residential or nursing homes. Recently, the government has proposed a system of care built up from the primary care resources of the community.

Aged↗

Cytogenetic variability within and across populations of Cebus apella in Argentina.

Two geographically separated populations of Cebus apella are found in Argentina. We have found important differences in the phenotypic characteristics of these populations, despite marked karyotypic similarity. Two well-distinguished phenotypes were established. Individuals from the northwest of Argentina are phenotypically similar to the Paraguayan populations and are recognized as C. apella paraguayanus. This subspecies is also found in the northeast of Argentina. Other specimens from the northeast are more similar phenotypically to the Brazilian subspecies C. apella nigritus and C. apella libidinosus and are designated as C. apella vellerosus. The two subspecies C. apella paraguayanus and C. apella vellerosus share the same diploid number of chromosomes (2n = 54). Cytogenetic comparisons using G-, Q- and R-banding techniques and C-banding methods with the chromosomes carrying large heterochromatic blocks (No. 3, 5, 11, 12, 13, 19) showed differences between the subspecies. The presence of different polymorphisms and even of heteromorphisms in the same chromosomic pair across geographically isolated populations of the same subspecies is illustrated with Argentinian and Paraguayan specimens.

Animals↗

Role of drug injection in the spread of HIV in Argentina and Brazil.

Drug injectors' have become the second largest HIV transmission category in Argentina and Brazil, as is the case in many pattern I countries, making up more than one-quarter of all AIDS cases reported by 1991. HIV seroprevalence data suggest that the expanding proportion of AIDS cases attributable to drug injection stems from an absolute increase in the number of AIDS cases among drug injectors, and is not merely reflective of a decline in the proportion of cases reported in other transmission categories. Results of a review of studies in Argentina and Brazil indicate that HIV seroprevalence is increasing rapidly, contrary to the situation in some pattern I countries in which HIV seroprevalence among drug injectors is either stably high or increasing only slightly. Also contrary to most pattern I countries, cocaine rather than heroin is the injected drug of choice in Argentina and Brazil. Given that injectors of cocaine are more likely to be HIV infected than are heroin injectors, differences in the type of drug injected between countries may have distinct epidemiological consequences on the spread of HIV.

Acquired Immunodeficiency Syndrome↗

Asbestos banned in Argentina.

In 1997, Argentina gave priority to asbestos in its National Plan for the Sound Management of Chemicals, and it was the subject of a Technical Task Force on Occupational Cancer. After five years of public hearings in which government, workers, industry advocates, environmentalists, clinicians, scientists, and consumers participated, it was agreed that asbestos exposure is a risk factor for both workers and the general population, and that Argentina should provide to its people the same protections adopted by many developed countries. Pressure from asbestos industry groups initially delayed the inclusion of chrysotile asbestos in the proposed ban, but on January 1, 2003, the mining and import of all forms of asbestos were banned in Argentina.

Argentina↗

Survival in acidic and alcoholic medium of Shiga toxin-producing Escherichia coli O157:H7 and non-O157:H7 isolated in Argentina.

BACKGROUND: In spite of Argentina having one of the highest frequencies of haemolytic uraemic syndrome (HUS), the incidence of Escherichia coli O157:H7 is low in comparison to rates registered in the US. Isolation of several non-O157 shiga toxin-producing Escherichia coli (STEC) strains from cattle and foods suggests that E. coli O157:H7 is an uncommon serotype in Argentina. The present study was undertaken to compare the survival rates of selected non-O157 STEC strains under acidic and alcoholic stress conditions, using an E. coli O157:H7 strain as reference. RESULTS: Growth at 37 degrees C of E. coli O26:H11, O88:H21, O91:H21, O111:H-, O113:H21, O116:H21, O117:H7, O157:H7, O171:H2 and OX3:H21, was found to occur at pH higher than 4.0. When the strains were challenged to acid tolerance at pH as low as 2.5, viability extended beyond 8 h, but none of the bacteria, except E. coli O91:H21, could survive longer than 24 h, the autochthonous E. coli O91:H21 being the more resistant serotype. No survival was found after 24 h in Luria Bertani broth supplemented with 12% ethanol, but all these serotypes were shown to be very resistant to 6% ethanol. E. coli O91:H21 showed the highest resistance among serotypes tested. CONCLUSIONS: This information is relevant in food industry, which strongly relies on the acid or alcoholic conditions to inactivate pathogens. This study revealed that stress resistance of some STEC serotypes isolated in Argentina is higher than that for E. coli O157:H7.

Acids↗

Comparative study of scientific publications in Ophthalmology and Visual Sciences in Argentina, Brazil, Chile, Paraguay and Uruguay (1995-2004).

PURPOSE: The study aimed to measure the scientific production in Ophthalmology and Vision (O&V) in Argentina, Brazil, Chile, Paraguay and Uruguay over a period of 10 years (1995-2004), in order to find out temporal evolution and variations in this field of research. METHODS: PubMed / Medline was used to retrieve records on O&V research literature. The search strategy included keywords, country in the affiliation field and publication date. Data were extracted from each citation and recorded in a spreadsheet. Subsequent analysis focused on type and main topic of publication, journals where articles had been published, and evolution of research done on animals and humans. RESULTS: A total of 1,216 citations were retrieved. Brazil had the largest number of authored publications with an average annual production of 82.4, followed by Argentina with 31.0, Chile 6.4, Uruguay 1.6, and Paraguay 0.2. The ratio of articles on O&V relative to publications involving Health Science ranged from 1.0 to 2.3. The frequency of publications almost tripled from 1995 to 2004. Research on humans showed a significant increase in Argentina and Brazil. CONCLUSIONS: Results provide initial benchmarks on O&V publication rates in countries in South America that may be useful to follow research trends.

Animals↗