Posts filed under ‘Antiparasitarios’

2018 European Guideline on the organization of a consultation for Sexually Transmitted Infections.

J Eur Acad Dermatol Venereol. August 2019 V.33 N.8 P.1452-1458.

Gamoudi D, Flew S, Cusini M, Benardon S, Poder A, Radcliffe K.

This is an update of the 2012 IUSTI guideline. In this new version, we have expanded the sections on sexual history taking to include PEP and PrEP use, intimate partner and gender‐based violence, chemsex, swinging and psychosexual problems. We highlight the potential for the use of technology in the context of sexual health to facilitate sexual history taking and partner notification. We have explained the principle of safeguarding young and other vulnerable people who may present to services.

This guideline is primarily aimed at services provided in mainstream clinic/office environments, but increasingly many countries are seeing an era of rapid transition of sexual health services in which satellite clinics and online service provision are centre stage. Services are moving away from the main hospitals/clinics into smaller peripheral sites and various non‐traditional or outreach type settings such as saunas, brothels, bars, clubs, educational facilities, prisons and gay pride events. The advantage of such services is that it might allow hard‐to‐reach groups to be engaged with clinical services.1 We need a cohesive, multiagency approach to addressing the challenges associated with this style of service provision, if we are to harness the potential for decentralization of sexual health services while safeguarding the most vulnerable and remaining true to the founding principles of sexual health care.

FULL TEXT

https://onlinelibrary.wiley.com/doi/full/10.1111/jdv.15577

PDF

https://onlinelibrary.wiley.com/doi/pdf/10.1111/jdv.15577

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August 14, 2019 at 3:49 pm

Building an innovative Chagas disease program for primary care units, in an urban non- endemic city

BMC Public Healthvolume 19, Article number: 904 (2019

Background

On an absolute basis, Argentina is the country with the largest affected population with Chagas Disease (ChD). This constitutes a significant public health issue. As a consequence of Argentina’s migratory patterns, there has been a significant increase of affected population in urban centers. An innovative project for early diagnosis and timely treatment of ChD was designed for Municipal Primary Care Facilities of La Plata City, a non- endemic area, in line with a proposal from the Pan-American Health Organization. The project was a public –private intervention. The objectives of this study were to demonstrate the feasibility of the primary healthcare level for early diagnosis and timely treatment of ChD; to design and implement a tailor made program and to innovate in a public-private association.

Methods

The healthcare barriers for early diagnosis and timely treatment for the population with ChD of La Plata were analyzed. The four dimensions described by Peters et al. (Ann N Y Acad Sci 1136:161–71, 2008) were used. The baseline was measured during a previous pilot project and the same items were evaluated at the end of 2017. The model from Damschroder et al. (Implement Sci 4:50, 2009) was used during the implementation process.

Results

With all the information gathered during this investigation, a “patient-centered” model was designed. During the program, 17,894 people were serologically tested for ChD, 1,394 were positive and 1,035 were treated. Additionally, 3,750 children from 46 public schools were evaluated for risk factors of ChD.

Conclusions

This project showed the feasibility of the primary healthcare level for early diagnosis and timely treatment of ChD. Tailor made programs and public-private associations should be considered for vulnerable populations in emerging economies in order to enhance efforts and obtain better results. This program may be replicated in other countries of Latin America were Chagas is a main public health issue and, with the corresponding adaptations, for other neglected diseases as well.

FULL TEXT

https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-019-7248-5

PDF

https://bmcpublichealth.biomedcentral.com/track/pdf/10.1186/s12889-019-7248-5

July 24, 2019 at 8:15 am

Cryptosporidiosis Outbreaks — United States, 2009–2017

MMWR  June 28, 2019  V.68 N.25 P.568–572

Radhika Gharpure, DVM1,2; Ariana Perez, MPH1,3; Allison D. Miller, MPH1,4; Mary E. Wikswo, MPH5; Rachel Silver, MPH1,3; Michele C. Hlavsa, MPH1

Summary

What is already known about this topic?

Cryptosporidium is the leading cause of outbreaks of diarrhea linked to water and the third leading cause of diarrhea associated with animal contact in the United States.

What is added by this report?

During 2009–2017, 444 cryptosporidiosis outbreaks, resulting in 7,465 cases were reported by 40 states and Puerto Rico. The number of reported outbreaks has increased an average of approximately 13% per year. Leading causes include swallowing contaminated water in pools or water playgrounds, contact with infected cattle, and contact with infected persons in child care settings.

What are the implications for public health practice?

To prevent cryptosporidiosis outbreaks, CDC recommends not swimming or attending child care if ill with diarrhea and recommends hand washing after contact with animals….

FULL TEXT

https://www.cdc.gov/mmwr/volumes/68/wr/mm6825a3.htm#contribAff

PDF

https://www.cdc.gov/mmwr/volumes/68/wr/pdfs/mm6825a3-H.pdf

 

July 1, 2019 at 11:03 am

American trypanosomiasis and Chagas disease – Sexual transmission

International Journal of Infectious Diseases April 2019 V.81 N.4 P.81-84

Clever Gomes, Adriana B. Almeida, Ana C. Rosa, Perla F. Araujo, Antonio R.L. Teixeira

Highlights

  • Trypanosoma cruzi infection can be transmitted sexually from males and females to naïve mates.
  • T. cruzi parasites were detected in semen ejaculates from individuals with Chagas disease by nucleic acid techniques.
  • Semen aliquots from humans with Chagas disease instilled into the vagina of naïve female mice resulted in T. cruzi infections.
  • Breeding T. cruzi-infected male and female mice vertically transmitted the infection to progeny mice.

Objective

To contribute to the discussion on the research findings indicating the sexual transmission of American trypanosomiasis and Chagas disease in humans.

Methods

A review of the literature was performed to investigate the routes of transmission of Trypanosoma cruzi parasites and to evaluate the distribution of Chagas disease, which is now found across five continents.

Results

The epidemiological profile of American trypanosomiasis, which is still considered a neglected disease of the poor people of Latin America, has changed over time. A family-based study demonstrated that the blood protozoan T. cruzi can be transmitted sexually from infected males and females to naïve mates.

Conclusions

Evidence that Chagas disease can be transmitted sexually, coupled with the migration of individuals with Chagas disease to previously non-endemic countries and increased travel to endemic countries, has implications for public health. Improved screening of blood supplies and prenatal care are required to prevent congenital spread.

FULL TEXT

https://www.ijidonline.com/article/S1201-9712(19)30032-3/fulltext

PDF

https://www.ijidonline.com/article/S1201-9712(19)30032-3/pdf

June 30, 2019 at 12:18 pm

Disminución del nivel de conciencia, fiebre y disnea en una paciente infectada con HIV.

Revista Argentina de Microbiologia 2014 V.46 N.3 P.271-272

Carta al Editor

Shock séptico con meningitis debido a la bacteriemia por Klebsiella pneumoniae y falla multiorgánica en el contexto de un síndrome de hiperinfección por Strongyloides stercoralis,

PDF

https://www.redalyc.org/pdf/2130/213032482015.pdf

March 24, 2019 at 5:31 pm

Infección por Strongyloides stercoralis: estudio epidemiológico, clínico, diagnóstico y terapéutico en 30 pacientes

Revista Chilena de Infectologia Junio 2011 V.28 N.3

Marcelo Corti, María F. Villafañe, Norberto Trione, Daniel Risso, Juan Carlos Abuín y Omar Palmieri

Hospital de Enfermedades Infecciosas Francisco J. Muñiz, Buenos Aires, Argentina

Antecedentes

Strongyloides stercoralis, parásito endémico de áreas tropicales y subtropicales del planeta, en sujetos inmunodeprimidos puede cursar con formas graves y aun mortales como el síndrome de hiperinfestación y la enfermedad diseminada.

Métodos

Análisis retrospectivo de las características epidemiológicas, manifestaciones clínicas, co-infección por virus de inmunodeficiencia humana (VIH), hallazgos microbiológicos y evolución de 30 pacientes con estrongiloidiasis, atendidos en el Hospital de Enfermedades Infecciosas F. J. Muñiz de Buenos Aires, entre enero 2004 y diciembre 2008.

Resultados

Se incluyeron en la evaluación 20 hombres y 10 mujeres con una mediana de edad de 33 años. Co-infección por VIH hubo en 21 pacientes (70%); la mediana de linfocitos T CD4+ en ellos al momento del diagnóstico de la parasitosis fue de 50 céls/mm3 (rango 7 a 355), (media de 56 céls/mm3). En los pacientes seronegativos para VIH, se comprobaron las siguientes co-morbilidades: tuberculosis (n: 3) y un caso de cada una de las siguientes afecciones: alcoholismo crónico, diabetes mellitus, reacción lepromatosa bajo corticotera-pia, y psoriasis en tratamiento inmunosupresor. Hubo dos pacientes sin aparentes enfermedades de base. Diecisiete pacientes presentaron enfermedad intestinal crónica con diarrea (57%), era asintomática y fue sospechada por la eosinofilia periférica (n: 7, 23%) y se clasificó como síndrome de hiperinfestación (n: 6, 20%) diagnosticado por la identificación de larvas en la materia fecal y secreciones broncopulmonares. Diecisiete pacientes (57%) presentaron eosinofilia periférica. El diagnóstico se efectuó por la visualización directa de las larvas en muestras de heces en fresco mediante la técnica de concentración de Baer-man (n: 20); por el examen copro-parasitológico seriado (n: 2) y por ambos métodos (n: 1); en líquido duodenal y materia fecal (n: 1) y por la identificación de larvas en materia fecal y secreciones respiratorias (n: 6). Letalidad global: 20% (6/30). Los pacientes con eosinofilia tuvieron una menor letalidad que aquellos sin esta respuesta (p < 0,001). No hubo correlación estadística entre la edad y la supervivencia. Sí fue significativa la correlación entre el recuento de CD4 y la letalidad, incluyendo 18 de los 21 pacientes seropositivos para VIH (p: 0,03). Finalmente, la correlación seropositividad para VIH y letalidad también fue significativa. Veintidós pacientes respondieron a la terapia antiparasitaria con ivermectina y evolucionaron favorablemente.

PDF

https://scielo.conicyt.cl/pdf/rci/v28n3/art03.pdf

March 24, 2019 at 5:28 pm

Toxoplasmosis: The Heart of the Diagnosis

OPEN FORUM INFECTIOUS DISEASES January 2019 V.6 N.1

James H England; Samuel S Bailin; Jeffrey R Gehlhausen; Donald H Rubin

Toxoplasma gondii is a common parasite that infects warm-blooded animals, including humans, and is a foodborne pathogen. We report a case of acute toxoplasmosis in a 76-year-old man after ingestion of the undercooked heart of a white-tailed deer (Odocoileus virginianus) in Tennessee. The patient’s adult grandson, who also consumed part of the heart, became ill with nearly identical symptoms, though he did not seek medical care. This case highlights important public health concerns about deer-to-human transmission of Toxoplasma.

FULL TEXT

https://academic.oup.com/ofid/article/6/1/ofy338/5250666

PDF (CLIC en PDF)

January 20, 2019 at 12:17 pm

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