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Estrategia de educación popular para promover la participación comunitaria en la prevención del dengue en Cuba
No full textOBJECTIVES: To document the process and analyze the results of implementing a strategy aimed at increasing community participation in the fight against the dengue mosquito vector. METHODS: From May 2002 to May 2004, an intervention was implemented to advance social action against dengue in three districts of the municipality of Playa, La Habana, Cuba. A learning group and community working groups (CWG) were organized in each location. A community education model was followed that combines putting the plan of action into practice, with sessions to reflect and learn from the results, and then reworking of the actions for subsequent stages. Diagnostic tools were developed for communities, preventative actions, communication, surveillance, and evaluation. Changes in participation were identified by applying the content analysis technique to the documents and through interviews with key informants. RESULTS: The community work advanced at a pace relative to the abilities and interests of each community with different areas of focus: healthy community, environmental risk, and entomological risk. Positive changes in the concept of participation were obtained, according to the five areas evaluated: leadership, needs assessment, organization, management, and mobilization of resources. At the end of two years of intervention, the rate of Aedes aegypti larvae and pupae deposits found per 100 households had declined 79% and cases of dengue were not detected in any of the districts. CONCLUSIONS: This strategy reduced mosquito vector infestation levels by increasing community participation in decision-making and strengthening the competencies of the medical teams and CWGs so that they lead participative processes in the community and raised confidence in their ability to achieve change with the appropriate resources and intersectoral support
HTLV-1 infection is associated with a history of active tuberculosis among family members of HTLV-1-infected patients in Peru
No full textThe purpose of this study was to assess the association between human T-lymphotropic virus 1
(HTLV-1) and a lifetime history of active tuberculosis (TB) among relatives of HTLV-1-infected
patients. We reviewed clinical charts of all relatives of HTLV-1-infected index cases who attended
our institute in Lima from 1990–2004. The data of 1233 relatives was analysed; 394 (32.0%) were
HTLV-1 positive. Eighty-one subjects (6.6%) had a history of active TB, including 45/394
(11.4%) HTLV-1-positive and 36/839 (4.3%) HTLV-1-negative relatives (P<0.001). On
multivariate analysis, three factors were associated with TB history : HTLV-1 infection (adjusted
OR 2.5, 95% CI 1.6–3.9), age (adjusted OR 1.3, 95% CI 1.1–1.5 per 10-year age increase) and
relation to the index case (adjusted OR 2.6, 95% CI 1.3–5.1, for siblings vs. spouses of index
cases). In conclusion, HTLV-1 infection may increase the susceptibility to active TB. In
populations where both infections are frequent, such an association could affect the dynamics
of TB
Drug-resistant TB and HIV in resource-limited settings: what TB/HIV programmes can learn from each other
No full textThe definitive version is available at www3.interscience.wiley.comAlthough management of drug resistance in tuberculosis (TB) and HIV in poor settings is in its infancy,
lessons learned from TB may be relevant to HIV and vice versa. The experience with HIV has shown that
rapid scale-up and lower drug pricing are achievable goals. The current prerequisites for obtaining
drugs to treat multidrug-resistant TB (MDR-TB) may be too stringent given the immediacy of the
MDR-TB problem. We call for a more rapid roll-out of treatment for MDR-TB with fewer
administrative encumbrances and a greater sense of urgency in national TB control programmes. On the
other hand, antiretroviral roll-out programmes should learn from the genesis of the MDR-TB problem;
laboratory monitoring should be enhanced and compliance optimized to avoid the acquisition of
additional drug resistance in HIV
Climate change and animal health in Africa
No full textClimate change is expected to have direct and indirect impacts on African livestock. Direct impacts include increased ambient temperature, floods and droughts. Indirect impacts are the result of reduced availability of water and forage and changes in the environment that promote the spread of contagious diseases through increased contact between animals, or increased survival or availability of the agent or its intermediate host. The distribution and prevalence of vector-borne diseases may be the most significant effect of climate change. The potential vulnerability of the livestock industry will depend on its ability to adapt to such changes. Enhancing this adaptive capacity presents a practical way of coping with climate change. Adaptive capacity could be increased by enabling the African livestock owner to cope better with animal health problems through appropriate policy measures and institutional support. Developing an effective and sustainable animal health service, associated surveillance and emergency preparedness systems and sustainable disease control and prevention programmes is perhaps the most important strategy for dealing with climate change in many African countries
Use of ProteinChip technology for identifying biomarkers of parasitic diseases: the example of porcine cysticercosis (Taenia solium)
No full textTaenia solium cysticercosis is a significant public health problem in endemic countries. The current serodiagnostic techniques are not able to differentiate between infections with viable cysts and infections with degenerated cysts. The objectives of this study were to identify specific novel biomarkers of these different disease stages in the serum of experimentally infected pigs using ProteinChip technology (Bio-Rad) and to validate these biomarkers by analyzing serum samples from naturally infected pigs. In the experimental sample set 30 discriminating biomarkers (p<0.05) were found, 13 specific for the viable phenotype, 9 specific for the degenerated phenotype and 8 specific for the infected phenotype (either viable or degenerated cysts). Only 3 of these biomarkers were also significant in the field samples; however, the peak profiles were not consistent among the two sample sets. Five biomarkers discovered in the sera from experimentally infected pigs were identified as clusterin, lecithin-cholesterol acyltransferase, vitronectin, haptoglobin and apolipoprotein A-I
MURIGA in Guinea: an experience of community health insurance focused on obstetric risks
No full textLes leçons apprises pour mieux intervenir dans le futur: comment réduire les barrières financières aux soins obstétricaux dans les pays à faibles ressources
No full textNeutralization patterns and evolution of sequential HIV type 1 envelope sequences in HIV type 1 subtype B-infected drug-naive individuals
No full textTo design a vaccine that will remain potent against HIV-1, the immunogenic regions in the viral envelope that tend to change as well as those that remain constant over time must be identified. To determine the neutralization profiles of sequential viruses over time and study whether neutralization patterns correlate with sequence evolution, 12 broadly neutralizing plasmas from HIV-1 subtype B-infected individuals were tested for their ability to neutralize sequential primary HIV-1 subtype B viruses from four individuals. Three patterns of neutralization were observed, including a loss of neutralization sensitivity by viruses over time, an increase in neutralization sensitivity by sequential viruses, or a similarity in the sensitivity of sequential viruses to neutralization. Seven to 11 gp160 clones from each sequential virus sample were sequenced and analyzed to identify mutational patterns. Analysis of the envelope sequences of the sequential viruses revealed changes characteristic of the neutralization patterns. Viruses that evolved to become resistant to neutralizing antibodies also evolved with diverse sequences, with most of the changes being due to nonsynonymous mutations occurring in the V1/V2, as well as in the constant regions (C2, C3, C4), the most changes occurring in the C3. Viruses from the patient that evolved to become more sensitive to neutralization exhibited less sequence diversity with fewer nonsynonymous changes that occurred mainly in the V1/V2 region. The V3 region remained constant over time for all the viruses tested. This study demonstrates that as viruses evolve in their host, they either become sensitive or resistant to neutralization by antibodies in heterologous plasma and mutations in different envelope regions account for these changes in their neutralization profiles
