Revista Peruana de Medicina de Experimental y Salud Publica最新文献

Background: Motivation for the study. This study aimed to analyze the prevalence and distribution of the V genotypes of dengue virus type 1 (DENV-1) and the cosmopolitan genotype DENV-2 in Peru, in order to understand their expansion in different regions; since these viruses can cause important outbreaks in the country. Main findings. A rapid spread and wide distribution of the cosmopolitan DENV-2 genotype was reported in Peru in 2022, following its initial introduction in 2019. DENV-1 genotype V, present in Peru since the 1990s, has now expanded to new Peruvian regions, after previously being restricted to rural and jungle areas in the north of the country. Implications. The results highlight the urgent need to strengthen epidemiological and genomic surveillance systems to monitor and control the spread of these genotypes in Peru, allowing a more rapid response and controlling their potential spread to other regions of the Americas.

Objectives.: This study aimed to evaluate the prevalence and distribution of dengue virus genotype V serotype 1 (DENV-1) and cosmopolitan genotype serotype 2 (DENV-2) in Peru between 2019 and 2022.

Materials and methods.: The envelope (E) gene region was amplified from 79 serum samples by polymerase chain reaction (PCR) and sequenced by next-generation sequencing (NGS) technology. The obtained sequences were subsequently analyzed with bioinformatics tools.

Results.: The study generated envelope gene sequences of DENV-1 and DENV-2 serotypes. Our study revealed a rapid dispersal and wide distribution of the cosmopolitan DENV-2 genotype in several regions of Peru in 2022, as well as the spread of DENV-1 genotype V to new Peruvian regions, along with the cosmopolitan DENV-2 genotype.

Conclusions.: Our findings suggest the urgent need to strengthen epidemiological and genomic surveillance systems to understand and control the spread of circulating DENV genotypes in Peru. This will allow a more rapid response, as well as the monitoring of its potential dissemination to other countries in the Americas.

Motivation for the study. There is a need for information on population adherence to colon cancer screening. Main findings. Adherence to screening in health insurance increased to a maximum of 47.1% in December 2022, which is below desirable targets. The most commonly used method was colonoscopy. Public health implications. This information could contribute to the design of a multicomponent intervention to improve adherence to colon cancer screening. In order to evaluate adherence to colorectal cancer (CRC) screening among members of the Health Plan of the Hospital Italiano de Buenos Aires in Argentina, we conducted a retrospective cohort study using secondary data from the electronic medical record. We included all members over 50 years of age during the period 2008-2022. We assessed the number and type of screening tests performed and the proportion of members covered for screening. We analyzed 112,112 participants, with a median age of 58.6 years and a follow-up time of 8.6 years. Colonoscopy was the most commonly used test. The maximum coverage reached was 47.1% in December 2022. In conclusion, adherence to CRC screening was suboptimal, as was the method used. This information can be used for the design of a multicomponent intervention.

Motivation for the study. Cystic echinococcosis is a neglected disease associated with contact between dogs, humans and sheep. In countries such as Peru, control programs include vaccination of sheep; however, vaccination in dogs is a late control strategy to eliminate the adult parasite or to avoid infection with eggs in the environment. Main findings. We were able to clone and express a recombinant protein (tropomyosin) of the adult parasite in a bacterial system with immunogenic properties. Implications. Obtaining the tropomyosin recombinant protein from E. granulosus allows the development of vaccine candidates in dogs and the exploration of diagnostic tests in hosts. This study aimed to clone, express and produce the recombinant Echinococcus granulosus tropomyosin isoform A protein (EgTrpA) that maintains its antigenic and immunogenic properties as a potential vaccine candidate for dogs and sheep. The Echinococcus granulosus tropomyosin protein (EgTrp) gene was cloned into two vectors: Tropo/His-tag [pET28a (+)] and Tropo/GST-tag (pGEX6P-1). It was then expressed in E. coli BL21. Protein identity was determined by two-dimensional electrophoresis. Immunogenicity and antigenicity were verified by immunizing rabbits with each recombinant protein and assessed by western blot and ELISA. Two-dimensional electrophoresis identified the recombinant EgTrp protein as isoform A. The recombinant proteins showed recognition reactions on Western Blot and serum from immunized rabbits showed an increase in Tropo/His-tag IgG antibodies similar to Tropo/GST-tag. The recombinant EgTrpA protein showed antigenic and immunogenic characteristics in laboratory animals.

Motivation for the study. Discrimination as a negative social determinant for health entails limitations in several areas, even affecting people's quality of life. Its research is mainly aimed at the racial context. Studies on other types of discrimination are scarce in the scientific literature. Main findings. People with mental disorders perceived discrimination due to different sociodemographic conditions and had lower quality of life scores. Implications. Discrimination as exclusionary behavior is facilitated and becomes more complex in people with some vulnerability. In order to determine the relationship between perceived discrimination and quality of life, we carried out a cross-sectional analytical study of secondary sources. Data from three cities in the Peruvian highlands were analyzed. The sample of 3889 adults was grouped into participants with mental disorders (n=1499) and without mental disorders (n=2390). We used statistical tests of independence and independent group comparison for complex samples. The lowest quality of life was found in the group of participants with mental disorders who perceived themselves discriminated in the last year by sex (p<0.001), age (p<0.001), weight (p<0.001), dress (p<0.001), economic or social status (p<0.001), educational level (p<0.001), religion (p=0.008), friendships (p=0.005) and height (p=0.008). In conclusion, people with a mental disorder in the cities of Ayacucho, Cajamarca and Huaraz who perceived discrimination during the last year had lower quality of life averages than those without a mental disorder.

Background: Motivation for the study. There is an increase in obesity and diabetes mellitus cases in Cuba, so it is necessary to provide easy to use, fast and inexpensive tools for the identification of people with dysglycemia. Main findings. For the first time in CUBA, the optimal cut-off point for FINDRISC, LA-FINDRISC and modified FINDRISC for Cuba (CUBDRISC) questionnaires was established with its own anthropometric parameters to identify people with dysglycemia. Implications. The use of the CUBDRISC scale as a simple, fast and low-cost tool for the active screening of people with dysglycemia in Cuban population will be useful to establish timely intervention strategies for people with risk score to develop dysglycemia.

Objectives.: To evaluate the Finnish Diabetes Risk Score (FINDRISC) modified for Cuba as a tool for the detection of prediabetes and undiagnosed diabetes in Cuban population.

Materials and methods.: An analytical cross-sectional and secondary source epidemiological study was conducted in 3737 adults aged 19 years and older with at least one risk factor for diabetes, they did not have previous diagnosis of prediabetes and diabetes mellitus and underwent oral glucose tolerance test for the diagnosis of dysglycemia. We applied the FINDRISC and the FINDRISC modified for Latin America (LA-FINDRISC) and Cuba (CUBDRISC), each with their own anthropometric parameters. The ROC curve was used to establish the cut-off point of each scale for the diagnosis of dysglycemia. Sensitivity, specificity, predictive values and likelihood ratios were calculated. The concordance between scales was calculated with Cohen's Kappa coefficient.

Results.: We found that 34.5% (n=1289) of the subjects were diagnosed with dysglycemia (28.1% had prediabetes and 6.4% had type 2 diabetes without previous diagnosis). The LA-FINDRISC and CUBDRISC scales showed an almost perfect concordance with the FINDRISC scale for the different cut-off values from 11 to 16 (0.882-0.890 and 0.910-0.922, respectively). The optimal cutoff point for detecting persons with dysglycemia was ≥ 13 for the FINDRISC and CUBDRISC scales (sensitivity was 63.6% and 61.6%; specificity was 84.3% and 86.0%, respectively) and ≥11 for LA-FINDRISC (sensitivity 58.0% and specificity 88.0%).

Conclusions.: We found almost perfect concordance between the diabetes risk scales. The FINDRISC score modified for Cuba proved to be a useful tool to identify persons with prediabetes and diabetes with a cut-off point of 13 in a Cuban population.

Background: Motivation for the study. To contribute to the immunogenic character of soluble and excretion/secretion antigens of Leishmania braziliensis and Leishmania peruviana with the aim of identifying proteins with diagnostic potential.

Background: Main findings. The soluble antigen of Leishmania braziliensis has a sensitivity in the detection of ATL of 87.7%, specificity of 100% and a false positive rate of 20% against sera from patients with Chagas disease and 8.3% with mycosis.

Background: Implications. Immunoblot can improve the resolution capacity in the serological diagnosis of American tegumentary Leishmaniasis, particularly in patients where the length of the disease and the clinical form make difficult the diagnosis by parasitological methods.

Background: This study aimed to determine the performance of Leishmania braziliensis and Leishmania peruviana antigens in the detection of ATL by using serum samples obtained between 2013 - 2016. The obtained soluble and excretion/secretion antigens were transferred to membrane nitrocellulose by immunoblot assay. The evaluation was carried out against sera confirmed for ATL, at a confidence level of 95%, determining that the soluble antigen of Leishmania braziliensis had a sensitivity of 87.7%, specificity of 100% and area under the curve of 0.95; on the other hand, Leishmania peruviana showed values of 92.3%, 95.7% and 0.94, respectively. According to the results, we recommend that the reported immunogenic regions should be characterized and analyzed in order to continue with the development of recombinant and synthetic proteins, aimed at improving the efficiency of the serological diagnosis of the disease.

Background: Motivation for the study. In Peru, the knowledge level of patients about their cardiovascular health is unknown at the first level of care, which receives 85% of the population, and where primary disease prevention activities are carried out.

Background: Main findings. More than 70% of people had an inadequate level of knowledge about their own cardiovascular health.

Background: Implications. Our results highlight the need to improve the education of people on cardiovascular health issues at the first level of care, taking into account that these diseases are increasingly frequent in the population.

Background: This study aimed to determine the level of knowledge about cardiovascular diseases in people in a primary healthcare center (PHCC). A descriptive and cross-sectional study was carried out by surveying people who attended a PHCC in Lima, Peru. A score less than 6 was considered inadequate knowledge. A total of 400 people were surveyed, 66.3% were women and the mean age was 46.8 ± 16.2 years. The average score was 4.52 +/- 1.85. We found that 71% of those surveyed had an inadequate level of knowledge, regardless of age, gender or education level. Our findings show that the level of knowledge about risk factors and cardiovascular disease was inadequate in the primary care population. It is necessary to achieve proper specific education in cardiovascular risk factors in order to reduce the impact of these diseases.