Margarita Cabral

Local and systemic cytokine expression during experimental chronic Trypanosoma cruzi infection in a Cebus monkey model.

Cebus apella is an acceptable model for chronic chagasic cardiomyopathy (CCC), since it is possible to experimentally induce cardiac lesions after 1 year of Trypanosoma cruzi infection. The T. cruzi Y strain, shown previously to produce CCC in C. apella monkeys, was used to experimentally infect 10 monkeys. Parasitological, serological and clinical parameters were monitored during a 19‐month follow‐up, and systemic cytokine responses were assessed sequentially in five monkeys selected according to the differential parasitemia pattern exhibited. Ten additional monkeys, infected with the same strain for 5, 10 and 12 years, were analysed cross‐sectionally. Three monkeys/time point and one uninfected control animal were sacrificed for gross pathology, histology, presence of parasites, and local cytokine gene expression. Elevated expression of interleukin (IL)‐4 was observed throughout the study in monkeys that had persistent, high parasitemias, whereas a high level of interferon (IFN)‐γ was seen in monkeys that controlled parasitemias soon after infection. Chronically infected monkeys expressed a nonpolarized, Th0‐type response. Cardiac tissue collected from a monkey that succumbed to acute infection had elevated levels of proinflammatory cytokine [IL‐1β, IL‐6, tumour necrosis factor‐α] and interstitial cell adhesion molecule (ICAM)‐1, platelet‐derived growth factor (PDGF)‐α, transforming growth factor (TGF)‐β and IL‐10 transcripts. Cytokine production in cardiac tissue of chronically infected monkeys was also characterized by elevated expression of ICAM‐1, PDGF‐α and TGF‐β, which correlated with the detection of T. cruzi DNA by polymerase chain reaction.

Epidemiological Surveillance Using Information Technologies in Paraguay

This article presents the early work on a project in Paraguay for epidemiological surveillance using information technologies. This project is a response of our university to a governmental request to establish links of cooperation and development between academic public sectors of Spain and Paraguay. The overall project objective is the promotion ofa healthy citizenry through the application of information and communication technologies to the monitoring of populations vulnerable to febrile syndromes (FS). The goal of this project is to create the infrastructure that will allow the population of the country to easily communicate with health centers and provide information on cases of FS. The telephone network will be the main physical support for this communication. The project was formally initiated in January 2009 with the implementation of the prototype system. During the first half of 2010, the pilot project will be implemented in Asunción, Paraguay.

Exploring the Implementation of e-Health Practices in a Low Income Country

In low income countries like Paraguay, broad segments of the population have only limited access to health services and lack sufficient human and financial resources as well as infrastructure for an appropriate health service delivery. At the same time, access to information and communication technologies (ICTs) varies across countries and population groups.

P1-104 Community syndromic surveillance system using information and communication technology in Paraguay

The objective of syndromic surveillance is to identify illness clusters early and to mobilise a rapid response, thereby reducing morbidity and mortality. Objective To describe the system named Bonis, which uses Information and Communication Technology to prevent, warn, monitor and control the spread of febrile syndromes and influenza like illness (ILI) at the community level. Methods Bonis has a kernel free software application; Asterisk, a phone center with VoIP service, PHP as Script language and Mysql as data base management. The system was implemented in a primary healthcare. Results The developed system has the ability to record, classify, and prioritise automatically through the Interactive Voice Response the suspected cases. It has been programmed in a PHP language script AGI to improve the functionality of the Asterisk, in a way that during the user call to report a possible case, the system feeds a database, through the manager module based in a web application developed in PHP. The system, to which the users access from a mobile or fixed telephone, automatically receives the call with 9 questions on signs and symptoms. The system is working since May 2010 and records the phone calls correctly; follow-ups of these patients are performed by the teams within a period of 24 h. Conclusion The developed system is allowing the community to notify and register events that require surveillance, and the community health agents is prioritising visits to those homes from where fever cases are reported for sooner and more appropriate interventions.