Revista Cubana de Medicina Tropical最新文献

Background: malaria was eradicated in Cuba in 1967; however, the worsening of this disease worldwide and the flow of people coming from endemic areas make the reintroduction of this disease possible.

Objectives: to determine presence, space and time distribution and larval density of Anopheles (N) albimanus in permanent and temporary breeding sites in one municipality of City of Havana procince.

Methods: the study was carried out in Boyeros municipality in 2008. The sampling frequency was weekly. The permanent surveyed breeding sites were dams, natural lagoons, oxidation lagoons, ditches, absorbing wells, activation ditches, Inhoff tanks, creeks, rivers, microdamps, sewage lagoons, small lakes, wells and temporary pools.

Results: a total number of 96 existing breeding sites were sampled; 34 of them were positive to An. albimanus (34.3%); Mulgoba was the area with more vectors. The most abundant types of breeding sites and, at the same time, those with the highest amount of vectors in the municipality were ditches with 28 (26.47%), natural lagoons, 21 (23.52%) and oxidation lagoons, 17 (17.64%). An. albimanus was present in the areas of this municipality throughout the year, but particularly increased in the July-September period.

Conclusions: An. albimanus larvae were present in the whole municipality throughout the year, therefore, being on the alert all the time must be one of the priority measures to be taken by the malarial surveillance system in this area.

Introduction: despite the Cuban government's efforts to exert control over the dengue vector Aedes aegypti, this mosquito is still present in several municipalities of the City of Havana and those of other provinces.

Objective: to find out some aspects related to the existence of Ae. aegypti in 2 Cuban regions.

Methods: a complete sampling was performed in Lisa municipality located in the western region and in Cienfuegos municipality on the south central part of the country from 2006 to 2008. Capturing methods of adult mosquitoes include human bait and capture at rest. The aspects for comparison were breeding reservoirs used by the mosquito, number of reservoirs full of larvae at a time, number of captured adult mosquitoes and ecological plasticity of the vector.

Results: water tanks on the ground were the most positive containers to the Ae. aegypti presence in both regions. In Lisa municipality, the second type of container in positivity was the can, whereas in Cienfuegos municipality, the group of assorted containers held the second place. Cienfuegos exhibited the highest number of reservoirs with Ae. aegypti in 2006, but Lisa recorded the highest figures in 2007 and 2008. Generally speaking, over 50% of positive containers to the mosquito were found in both municipalities during August through November.

Conclusions: Ae. aegypti showed similar behaviour with respect to the compared aspects in both regions; it was just different in the number of types of containers used by this species for breeding purposes.

Introduction: dengue is one of the most important vector-borne diseases in Las Americas due, among other factors, to the increase of Aedes aegypti populations.

Objective: to ascertain the space and time behaviour of Ae. aegypti in Cienfuegos municipality from 2006 to 2008.

Methods: the study was conducted in Cienfuegos municipality located on the central south part of Cuba. Larvae and adult mosquitoes were collected throughout the municipality in the 2006-2008 period using the methodology of the national dengue vector eradication program.

Results: twelve mosquito species were found; Culex quinquefasciatus, Ochlerotatus taeniorhynchus, Gymnometopa mediovittata and Aedes aegypti were the most abundant. The containers showing the highest positivity to Ae. aegypti presence were water tanks on the ground, various reservoirs, and larvitraps; the highest positive indexes were reported in August through November. The highest amounts of adult mosquitoes were captured in July through October. Of the 2 methods, capture at rest was more effective in collecting more adult mosquitoes with 134 (96.41%), 30 (96.78%) and 27 (100%), respectively and highly significant difference, p < 0.0001. According to the entomological stratification of the areas in the municipality, the areas 2 and 3 must be classified as high risk, the areas 1 and 5 as mild risk and the rest of the areas as low risk areas.

Conclusion: it is of vital importance to be permanently on the alert because Aedes aegypti is present throughout the year in the Cienfuegos municipality.

Introduction: Leptospira interrogans strains of Cuban vaccine vax-SPIRAL are preserved in Fletcher's semi-solid medium, which guarantees the preservation of the cell viability for a few months.

Objective: to evaluate the cryopreservation at liquid nitrogen of 6 different cryoprotectors as a long-term preservation method for Leptospira interrogans strains used as antigens in vaccine vax-SPIRAL against leptospirosis.

Methods: viability was systematically evaluated according to the cell yield of the recently thawed strains in EMJH medium. Virulence stability was estimated in hamsters and antigenicity was evaluated by microscopic agglutination test using reference antisera from vaccinal serogroups.

Results: the use of 2.5% and 5% dimethyl sulfoxide, and 2.5% glycerol allowed quick recovery of the three strains without virulence or antigenicity depletion after 19 months of cryopreservation.

Conclusions: the results showed the feasibility of the cryopreservation at liquid nitrogen using suitable cryoprotectant as a preservation method for vaccinal strains of Leptospira.

Introduction: in the last few years, the number of HIV Cuban patients expressing rapid clinical and immunologic deterioration has increased.

Objective: to find out the possible factors associated to rapid progression to AIDS.

Methods: a case-control study was carried out with the objective of determining possible factors associated with rapid progression to AIDS. Twenty six patients with rapid progression to AIDS, who were seen at "Pedro Kouri" Institute of Tropical Medicine from September 2007 to August 2008 together with two 20- patient control groups (A and B) were involved in the study. Social, demographic, clinical and laboratory variables were analyzed. By means of multivariate logistic analysis, the association between the exposure variables and the rapid progression to AIDS was determined.

Results: the variables associated with rapid progression to AIDS using the punctual estimate of the Odds ratio (OR > or = 2) were: female (OR: 17.0), non-use of condom (OR: 3.24), percentage of TCD4+ lymphocytes at the moment of HIV diagnosis < or = 25% (OR: 8.0) and the absolute count < or = 400 cel/mm3 (OR: 3.27), oral candidiasis (OR: 66.20), and an HIV viral load > 10 000 UI/mL at the moment of the diagnosis (OR: 4.62). The age older than 30 years at HIV diagnosis, the toxic habits, the symptomatic syndrome of acute retrovirosis and the rest of the co-infections were not associated with rapid progression to AIDS.

Conclusions: besides those well-known viral and immunologic factors, there are other clinical and epidemiological factors associated with rapid progression to AIDS such as being female, non-use of condon, oral candiasis, T cell CD4+ count and viral load. All of them must be taken into account at the moment of initial patient assessment.

Introduction: Water tanks placed on the ground are an important drinking water container at home; however, Aedes aegypti is very frequently colonizing this kind of reservoirs in an urban health area of Camagüey province, Cuba.

Objectives: to determine the entomological contribution of these water tanks -widely distributed containers at community setting- to infestation by Aedes aegypti in an urban health area of Camagüey province.

Methods: Out of the total number of containers positive to Aedes aegypty, the amount of water tanks involved was estimated, in order to determine the specific container rate (sCR) together with the average of pupas per positive water tank on the ground. These tanks were characterized during the study of the house using an application form prepared to this end. Similarly, the average total number of hours that the tanks remained uncovered was estimated.

Results: It was found that 36.03 % of all positive containers were water tanks on the ground, which were mostly filled with water from the aqueduct outdoors; being the sCR = 2,69. Over 97% of them had faulty covers whereas 92.5% remained uncovered for 6 or 7 hours a day. Seventeen positive tanks sheltered 41 pupas for an average of 2.41 pupas per tank.

Conclusions: The contribution of water tanks on the ground to the presence of Aedes aegypti pupas in the area makes it necessary to give priority to the inspection and surveillance of such containers on the part of the population and the expert staff The supply of new covers will not represent the final solution to this problem if the behaviour of the dwellers in a house does not change. It is required to improve the information to be provided to the population so that the risk perception is changed and the level of knowledge on this topic is raised. In this way, it will be possible to involve the community more actively in this process as a key element to make it really sustainable.

Introduction: self-medication and use of several products as peliculicides seem to be common procedures for those persons living with schoolchildren, in order to eliminate head lice.

Objective: to analyze the deliberate use of several products by the people living with elementary school children, so as to control their pediculosis capitis.

Methods: a questionnaire- and exchange of opinion-based survey on the products used to control or eliminate head lice was administered to 896 people who lived with children aged 5 to 10 years. These children studied in 19 elementary schools in urban and suburban areas located in the western, central and eastern provinces of Cuba.

Results: the surveyed population mentioned more than 40 products. Among the most reported substances were alcohol, DDT and lindano which were previously rejected owing to their toxicity and ineffectiveness. There were also reports on products from agricultural, public health and veterinary medicine, including those devoted to plague control such as temephos, steladon, malathion, parathion, baytex; also oil derivatives like brake fluid, kerosene and gasoline.

Conclusions: the paper mentioned a number of toxic substances used in treating Pediculus capitis in children, the risks of which outweighted the expected benefits. The percentage of persons who manually remove lice from the head as the only treatment is low; however, this is the less harmful and more effective method.

Introduction: HIV-1 proviral DNA amplification is the preferential method for HIV diagnosis infection in infants and it has been used in Cuba since 1992. AMPLICOR HIV-1 DNA kit is an in vitro qualitative assay for the detection of HIV-1 proviral DNA in the whole blood.

Objective: this paper showed the results of the use of this kit for the first time in Cuba for the perinatal diagnosis of HIV-1 infection.

Methods: three hundred forty six whole blood samples from children of HIV seropositive women were analyzed by the AMPLICOR HIV-1 DNA kit in the period 2005-2007.

Results: among the tested samples, six were positive, and 340 negative.

Conclusions: the assay was reproducible under the Cuban conditions and the achieved results made the diagnosis and follow up of children of HIV-1 seropositive mothers possible.

Introduction: the infection caused by Paracapillaria philippinensis (Capillaria philippinensis) is clinically characterized as a progressive enteric illness with massive loss of proteins and a malabsorption syndrome that may become fatal. OBJECTlVE: the first report in Cuba of human infection with P. philippinensis.

Methods: the case of a Cuban male patient aged 21 years from the City of Havana, who had never been abroad, was described. This young man was admitted to the hospital because after having eaten one breadcrumb-covered fish, he started having diarrheic episodes that progressively increased up to more than 15 abundant diarrheas per day, without phlegm or blood, and a clinical picture of severe malnutrition and general symptoms of intensive asthenia and anorexia.

Results: the lab diagnosis confirmed the presence of P. philippinensis eggs in feces.

Conclusions: the clinical features of the patient and the finding of moderate eosinophilia in the hematological study agreed with published information. As far as we know, this is the first finding of a human infection caused by P. philippinensis in Cuba, and in the American continent as well. The epidemiological alert on the possible emergence of new cases of this parasitic infection in our geographic zone is important, mainly in those places where the habit of eating raw or undercooked fish is part of the local culture.

This paper presented the history and evolution of the antibodies since their discovery. It also elucidated their complex structure and function that have served at a given time as methodological basis for creating unimaginable paradigms such as fine recognition specificity, and also for destroying other apparently immutable ones as invariability and universality of the cellular genome. A review was made of the evolution of antigen-antibody reaction-based analytical systems up to the present, the situation of infectious diseases and the determining role that detection and monitoring of infectious agents play in their control. The extraordinary capability of antibodies to discriminate antigenically similar structures allows them to be fundamental tools in immunoassays and also in a well-established discipline at present, that is, immunotechnology.