Revista Cubana de Medicina Tropical最新文献

Introduction: Aedes and Culex are two mosquito genuses of epidemiological importance, being Aedes aegypti and Culex quinquefasciatus the predominant ones in urban areas. It is common to find both of them associated in the same breeding sites where they share a lot of things despite the literature.

Objective: To determine if there is inter-specific competence between these two species when they co-exist in a single reservoir under lab conditions.

Methods: First staging larvae, which had been kept in the insect storage deposit of the Vector Control Department, were used. The three bioassays used 2 000 mL, 1 000 mL and 500 mL of dechlorinated water. The larvae were daily fed on with 0.7 g of fish flour; temperature was 26 degrees C +/- 2 degrees C.

Results: The larval cycle for Aedes aegypti was 6 days in crossbreds and in controls whereas it was 8 days for Culex quinquefasciatus, regardless of variation in the number of individuals of each species and in each bioassay. The larvae of each species completely developed since food was always provided and the living space remained the same. It should be noticed that the water was not totally translucent but no pollution indicators were observed. The sexual index for each species was determined after adult vectors emerged, with 1:1 ratio for both sexes approximately.

Conclusions: Under lab conditions, these species did not compete one against the other for either food or living space and there was segregation of niche that favored their co-existence.

Introduction: Leishmaniasis is a disease caused by several species from Leishmania genus, which has been increasingly reported in the last few years. Several genetic, immunological factors and others related to this parasite have been associated to the outcome of the infection, and the occurrence of illness in varied clinical forms. All the aforementioned has an impact on the diagnostic method that should be used.

Methods: A basic and recent literature review was made, mainly focused on general aspects of leishmaniasis as epidemiological situation of disease, life cycle and transmission, vectors, clinical presentation and diagnosis; the latter shows information about the main methods used at present. The procedure followed by the Leishmania group at "Pedro Kourí" Institute of Tropical Medicine to support the diagnostic activities was presented as well.

Results: Updated practical information about the chosen topics was presented, with a practical guiding approach aimed at the health personnel that must face suspected leishmaniasis cases. Tables and figures summarized relevant aspects in an organized form, as well as the working algorithm of Institute concerning diagnosis was presented. The application of molecular diagnosis by this working team was particularly underlined.

Conclusions: As leishmaniasis is still out of control, opportune diagnosis remains a must. All the methods provide useful information for taking decisions on clinical management, treatment and epidemiology of this parasitosis; hence, a working algorithm was submitted in our lab based on the most useful methods under our present conditions and experience.

Introduction: Malaria is a serious public health problem at present; it affects almost half of the population from over 100 countries and poses a high risk of reintroduction in Cuba.

Objective: To identify the Culicidae species present in natural breeding sites located in three areas of Camagüey municipality, particularly anopheles.

Methods: Larval inspections were carried out in 66 natural breeding sites of Anopheles almimanus located in three areas of Camagüey municipality from May to June 2010, according the World Health Organization methodology. The preferential breeding sites of Anopheles albimanus and the association of this species with other Culicidae were ascertained.

Results: Presence of Culicidae in 28.78% of inspected breeding sites, being Anopheles albimanus the prevailing one with 63.51%. This species was captured together with Culex quinquefasciatus, Culex nigripalpus, Culex erraticus, Culex corniger, Psorophora confinnis, Psorophora howardii and Ochlerottatus scapularis, in low polluted water bodies such as lagoons (58.34%) and streams (25%), and in others more polluted such as ditches (8.33%) and narrow trails (8.33%).

Conclusions: The existence of species of medical and veterinary importance, particularly Anopheles albimanus, in the studied areas calls for constant monitoring of these species in order to draw up integrated strategies focused on the biological fight, and the involvement of the community in this process to help in preventing the emergence of cases or epidemic outbreaks of imported malaria.

Introduction: Antimicrobial resistance is one of the biggest problems facing global public health. The emergence of resistant clinical and environmental strains worsens the situation. Among the microorganisms with antimicrobial resistance, Escherichia coil species stands out due to its dual role as fecal contamination indicator and pathogen.

Objectives: To isolate and identify Escherichia coil isolates from water samples from polluted rivers located in La Habana, and to determine their antimicrobial in vitro susceptibility.

Methods: One hundred thirteen isolates of coliform bacteria isolated from 10 sampling stations in the capital's urban areas near Almendares, Quibú and Luyanó rivers were studied in the period of February 2008 to June 2010. The identification of isolates, the determination of antimicrobial susceptibility and the search for extended-spectrum beta-lactamase were all performed using VITEK automated method.

Results: One hundred thirteen environmental strains of Escherichia coli were identified. It showed that 23% of the isolates were resistant to at least one of the tested antimicrobials. The highest percentages of resistance were observed to ampicilline, sulfamethoxazole-trimethoprim and ciprofloxacin.

Conclusions: The presence of E. coil isolates with multiple antimicrobial resistances in these rivers clearly indicates the biological risk involving the use of their waters.

Introduction: HIV infection in young people is one of the main health problems at the present time, with significant mortality and morbidity indexes and considerable costs.

Objective: to identify the level of knowledge, the sources of information and the behaviours of young students at high school in order to take educational actions that raise their knowledge on this disease and promote more healthy lifestyles.

Methods: a quasi experimental study was designed to evaluate the results of an educational intervention in 200 adolescents of "Camilo Cienfuegos" Military School located in Arroyo Arenas, Havana, which was carried out in June, 2009. Demographic variables were analyzed and the effectiveness of the educational intervention was evaluated using ratio test for independent variable analysis.

Results: of the 200 studied students, 26.5% were female and 73.5% male, aged 14-17 years. The main sources of knowledge for information about HIV infection were TV, parents, professors and posters. They presented appropriate knowledge levels about transmission pathways, etiology and therapy of the HIV; however, they poorly knew about the clinical aspects and prevention. After the intervention, their general knowledge (73 to 92%) and the knowledge on clinical aspects significantly improved (15 to 72%),as well as the knowledge about transmission(92 to 94%) and prevention of the disease (77 to 80%).

Conclusions: the implementation of a strategy to teach young people about HIV improved the knowledge about the disease in this group of patients

Introduction: culture collections are responsible for providing the microbial resources for development of biological sciences. Storage in distilled water is one of the easiest and least expensive method for long-term fungal preservation.

Objective: to evaluate the usefulness of this preservation method in fungal culture of Histoplasma and Cryptococcus.

Methods: the preservation condition of the highest biological risk species from Histoplasma y Cryptococcus genera, included in the fungal culture collection of "Pedro Kouri" Institute of Tropical Medicine in Havana, was evaluated in this study. One hundred and two strains stored in distilled water, 92% of which had been preserved for more than 10 years, were analyzed.

Results: the percentages of recovered strains from H. capsulatum, C. neoformans and C. gattii were 64.3%; 79.1% and 100% respectively. This method of preservation proved to be satisfactory for fungal culture in labs with limited financial resources. A web-based database with interesting information about the collection was made. The importance of strict compliance with the biosafety measures in these collections, particularly with high risk pathogens.

Conclusions: preservation of fungal cultures in distilled water is a very useful method for laboratories with limited resources. Culture collections should be assumed as an essential activity in order to solve increasing challenges in the development of biomedical sciences.

Introduction: the clinical manifestations of brucellosis have been poorly researched on and the symptoms and possible complications have not been deeply studied either.

Objective: to report a case of infective endocarditis caused by brucellosis for the first time in Cuba.

Methods: a Caucasian male farmer aged 57 years was referred from Vertientes municipality to be admitted at "Manuel Ascunce Domenech" provincial hospital in Camaguey province in December, 2009. He had been presumptively diagnosed with infectious endocarditis caused by Brucella and with moderate aortic failure since he presented with fever, general malaise, fatigue, muscle and joint pains, arthritis, marked asthenia, anorexia, neurological signs, sweating and strong chest pain. In his previous hospitalization, he had been treated with antimicrobials after indication of supplementary tests such as slow serology for brucellosis; however, specific reagents were not available,so these tests were not performed until January 2010.The epidemiological history of this case included his direct contact with cows and pigs as well as wounds and minor traumas inflicted on his hands and feet resulting from his type of work. His farm is next to another farm where the cattle is also affected with brucellosis.

Results: the lab tests were positive with high serological titres, and although it was not possible to isolate the etiologic agent through culturing, the disease and the infective endocarditis were serologically confirmed as additional complication; this required antimicrobial treatment and drugs for the heart disease. These complications from brucellosis are barely diagnosed in the international literature, and in Cuba, this is the first report of the disease.

Conclusions: the description of this case is an alert to diagnosis of infective endocarditis that may be associated with epidemiological history of brucellosis.

Introduction: SD Dengue Duo (Standard Diagnosis) commercial kit is an immunochromatographic rapid test that detects NS1 protein and IgG/IgM dengue antibodies simultaneously.

Objective: to evaluate the operational and functional characteristics of this system for the detection of virological and serological markers.

Methods: sera panel was made up by 161 samples, 113 from patients with clinically and serologically confirmed dengue caused by any of the four dengue virus serotypes and 48 negative samples. All these samples were tested by SD Dengue Duo Kit and by Platelia Dengue NSI Ag, IgM Capture ELISA and ELISA Inhibition Method used as reference assays.

Results: the evaluated kit showed a 57.75% sensitivity for the detection of NS1 protein, false negatives were detected in samples collected 5 days or more after fever onset in secondary infection cases. IgM detection showed 96.0% sensitivity and 98.4% specificity. Furthermore, high agreement (95.7%) in classifying dengue infection types (primary or secondary infections) was observed. The global study of the 3 markers, the sensitivity rose to 100%.

Conclusions: SD Dengue Duo is a simple, easy and rapid assay; it does not require additional equipment, can be used for acute and convalescence serum samples and offers a good alternative for dengue diagnosis in those laboratories where a complete dengue virus diagnosis is difficult to perform.

Introduction: among the intestinal parasites, the helminthiasis occupies a prominent position in Brazil, since it worsens malnutrition and the gives rise to neurovegetative disorders. Helminths like Ascaris lumbricoides, Enterobius vermicularis, hookworm, Trichuris trichiura and Strongyloides stercoralis stand out due to several factors that modulate the immune response of individuals. Among the protozoa are Giardia lamblia, Entamoeba histolytica. E. dispar. Parasitic helminth antigens are important to stimulate the production of cytokines such as interleukin-4 and interleukin-5, which act through the induction of IgE synthesis and activation of eosinophils. Eosinophilia is usually detectable in pre-patent period of parasitism, initially linked to B lymphocytes, under the command of Th-2 lymphokines (IL-4 and IL-5), producing IgE in response to initial exposure to an antigen or allergen. Serum IgE high levels occur in tissue migration of larvae or harboring of parasites in tissues.

Objective: to determine the presence of eosinophils and IgE elevation in children with intestinal parasites.

Methods: high levels of IgE and eosinophils were observed in groups infected and not infected (allergic) to calculate the relative risk of intestinal parasites presumptive differentiated between protozoa and helminths and check what values of these indicators are observed in the epidemiological profile of the surveyed population.

Results: the values obtained by calculating the relative risk for eosinophilia, compared with helminths and allergies was 11.71, but when examined by giardiasis compared with other diseases, the relative risk was 0.75. Since the comparison of helminths and giradiase, the relative risk was 27.33. Since IgE and its parameters were appropriate commit Helminth relative risk 0.39; Giardiasis had relative risk 8, 18 and Helminths compared with giardiasis had 0.03.

Conclusion: in this study it was possible to observe that helminthiasis is connected with cases of eosinophilia with alteration of IgE, which in turn contributes to the presence of IgE eosionofilia and has an effector response against helminths that provides the expulsion of its larvae.