Graciela Giménez

Distribution of HPV-16 variants among isolates from Paraguayan women with different grades of cervical lesion

To determine the distribution of HPV‐16 variants among Paraguayan women with different grades of cervical lesions.

Distribution of human papillomavirus (HPV) genotypes and bacterial vaginosis presence in cervical samples from Paraguayan indigenous

OBJECTIVE To determine the frequency of human papillomavirus (HPV) types and to assess bacterial vaginosis (BV) possible associations with cervical infections in indigenous Paraguayan women of the Department of Presidente Hayes. METHODS This study included 181 sexually active women without cervical lesions. HPV typing was performed by polymerase chain reaction with primers PGMY 09/11 followed by reverse line hybridization. BV was diagnosed by the Nugent criteria using the results from a Gram stain smear. RESULTS Sixteen percent of women were positive for at least one high risk HPV type (HR-HPV). The most frequent genotypes were HPV 16 (4.4%), followed by HPV 58 (3.3%), HPV 45 (3.3%), HPV 53 (2.8%) and HPV 11 (2.8%). A significant association between HR-HPV and BV was observed (p=0.01). In addition, women with BV had a higher frequency of Chlamydia trachomatis (p=0.0007), Trichomonas vaginalis (p=0.00009), Mycoplasma hominis (p=0.001). CONCLUSIONS A large variety of HPV genotypes was detected and showed a slightly different pattern from previous studies on urban women in Paraguay, with the predominance of HR-HPV. Furthermore, the information of co-infections involved in BV could be useful for the improvement of national prevention programs, as well as for laboratory surveillance of these genital infections.

Evaluación de la Atención Primaria de Salud en un contexto urbano: percepción de actores involucrados - Bañado Sur - Paraguay, 2011

En Paraguay, desde 2008 se procesa la reforma de la Atencion Primaria de Salud, buscando reducir inequidades. Con el objetivo de conocer el rol de la Atencion Primaria de Salud en la reordenacion del sistema de salud, se utilizo la herramienta Primary Care Assessment Tool para estudiar los Equipos de Salud Familiar en Asuncion. Fueron entrevistados 360 usuarios y 36 profesionales. Los resultados cubren las dimensiones acceso, puerta de entrada, vinculo, integralidad, coordinacion, enfoque familiar, orientacion a la comunidad, y formacion profesional. Se observa que usuarios y profesionales tienen percepciones diferentes, pero convergen que el acceso es un punto debil y la formacion profesional uno fuerte. Se concluye que hay una importante inversion en la Atencion Primaria de Salud, pero la poblacion aun no se esta apropiando de toda su potencialidad.

Deteccion del virus del papiloma humano de alto riesgo por captura hibrida II segun hallazgos citologicos en mujeres tratadas por lesiones escamosas intraepiteliales de cuello uterino, periodo 2006/2010

OBJECTIVE: To determinate the frequency of high risk human papillomavirus (HR-HPV) by hybrid capture II (r) (CH II(r)), according cytology results in women treated for squamous intraepithelial lesions of the cervix (SIL). MATERIAL AND METHODS: A descriptive cross-sectional study of a series of cases that included 122 women treated, 79 (75%) for low grade SIL (LSIL) and 43 (35%) for high grade SIL (HSIL) attending at the HPV Laboratory at the Health Sciences Research Institute (IICS), National University of Asuncion (UNA), for post-treatment control during period 2006/2010. RESULTS: A total of 28% (34/122) of women treated for SIL were positive for HR-HPV, detecting viral infection in 20% of women with no SIL (NSIL) (22/108), in 83% of women with LSIL (10/12) and in 100% of women with HSIL (2/2). Of 34 women positive for HR-HPV, 10 women (29%) had high values (100 pg / mL or more) of relative viral load, detecting an increase of positive cases with severity of the lesion (28% NSIL, 30% LSIL, 50% HSIL). CONCLUSION: HR-HPV detection by CH II(r) and high relative viral load values especially in women with NSIL could help to identify treated women at risk of developing recurrence, thereby contributing to strengthening the cervical cancer prevention program.