Ana Haedo

Dynamics of transmission of Trypanosoma cruzi in a rural area of Argentina: III. Persistence of T. cruzi parasitemia among canine reservoirs in a two-year follow-up

A new cross-sectional survey of household- associated mongrel dogs as well as follow-up of previously parasitemic individuals was carried out in 1984 toy means of xenodiagnosis and serologic techniques to get a deeper insight into the relationship of T. cruzi parasitemia and age among canine hosts in a rural area of Argentina. Persistence of detectable parasitemia was age-independent, or at most, loosely related to age, confirming the pattern observed in 1982. Similarly no significant age-decreasing effect was recorded among seropositive dogs in: a) the probability of detecting parasites in a 2-year follow-up; b) their intensity of infectiousness (=infective force) for T. infestans 3rd-4th instar nymphs, as measured by the percentage of infected bugs observed in each dog xenodiagnosis. Moreover, not only was the infective force of seropositive dogs for bugs approximately constant through lifetime, but it was significantly higher than the one recorded for children in the present survey, and for human people by other researchers. Therefore, and since T. infestans field populations show high feeding frequencies on dogs, the latter are expected to make the greatest contribution to the pool of infected vectors in the rural household of Argentina. This characteristic should be sufficient to involve canine reservoirs definitely as a risk factor for human people residing in the same house. The increased severity of parasitemia observed among dogs in this survey may be related to the acute undernutrition characteristic of canine populations of poor rural areas in our country, which is expected to affect the ability of the host to manage the infection.

Social and environmental health determinants and their relationship with parasitic diseases in asymptomatic children from a shantytown in Buenos Aires, Argentina

Abstract Health inequities are a common problem for all countries and are the result of not only adverse social conditions but also poor public policies. Today chronic diseases represent the most relevant threats and are a current challenge. Parasitic infections, a leading cause of child morbidity affecting low-income populations, can be transmitted because of an unhealthy environment. Notwithstanding, scarce data have been published on the epidemiological profile of intestinal parasitoses in asymptomatic children living in shantytowns. Vulnerable populations settled in slums are growing in Argentina, particularly in Buenos Aires city. Consequently, this work intended to screen healthy carriers of enteric parasites and determine the epidemiologic profile in asymptomatic children residing in one of those communities, to explore risk factors associated with the transmission of parasites, and to initiate a basic health education campaign to promote healthy behavior in the community. Fecal samples (n = 138) were analyzed by conventional parasitological methods and a survey gathered data on symptoms, family composition, and environmental and hygiene-related variables. High prevalence of feco-orally-transmitted parasitoses (83·3%) and polyparasitism were remarkable findings. The main environmental health determinants were those related to excreta disposal and water provision. Health promotion actions were performed through the diffusion of a set of posters with iconic images and brief messages for health education. Results suggest the need for an environmental sanitation policy to complement health promotion actions. It is essential to spread the results of investigations that address inequities and social determinants of health in order to integrate data with local political processes and alert on acceptable actions for developing appropriate interventions.

Papel de la determinación de procalcitonina plasmática en el seguimiento postoperatorio de la duodenopancreatectomía cefálica

Resumen Introduccion La utilidad de la procalcitonina (PCT) es aceptada como marcador de gravedad de la sepsis y su evolucion. El proposito del presente trabajo es demostrar su utilidad en el diagnostico temprano de complicaciones infecciosas y no infecciosas en el postoperatorio inmediato de la duodenopancreatectomia cefalica (DPC). Pacientes y metodo Se analizo prospectivamente a 31 pacientes sometidos a una DPC programada. La poblacion se dividio en dos grupos, con y sin complicaciones postoperatorias. La concentracion plasmatica de PCT se determino mediante una prueba inmunocromatografica. Se examino: la correlacion entre las concentraciones del marcador y la presencia de complicaciones; la existencia de diferencias estadisticamente significativas en las concentraciones de PCT entre los dos grupos de pacientes; el valor predictivo de las concentraciones plasmaticas de PCT en la aparicion de complicaciones comparadas con otras variables bioquimicas (proteina C reactiva, acido lactico, exceso de base) y clinicas (criterios del sindrome de respuesta inflamatoria sistemica). Resultados Las concentraciones de PCT resultaron significativamente diferentes entre los grupos estudiados. Se observo una correlacion inversa entre los valores del marcador y la evolucion de los pacientes. Las concentraciones de PCT y la temperatura axilar fueron las variables que mejor predijeron la aparicion de complicaciones. Conclusiones La PCT plasmatica deberia tenerse en cuenta como marcador evolutivo del postoperatorio en el seguimiento de la DPC como tambien para complicaciones no infecciosas.