25 research outputs found
Validation of two Elisa IGM tests for human leptospirosis in Colombia - 2013
No full textObjetivo: Validar las pruebas de ELISA en la detección de anticuerpos IgM para Leptospira spp., en muestras pareadas de pacientes provenientes del programa de diagnóstico de síndromes febriles del Grupo de Microbiología del INS, recibidas en el periodo comprendido entre enero de 2010 y julio de 2013. Materiales y métodos: Se determinaron las características sociodemográficas de los pacientes con infección por leptospirosis incluidos en el estudio y se determinaron los posibles factores de riesgo asociados. Se desarrolló un estudio de pruebas diagnósticas, en el que a todos los sujetos se les realizaron tres pruebas serológicas (ELISA IgM para Leptospira de marca Panbio®, ELISA IgM de marca Virion-serion® y la técnica de microaglutinación (MAT). Posteriormente, se evaluaron las características operativas de las pruebas de ELISA, mediante el patrón de oro MAT. Resultados: Un total de 443 pacientes fueron incluidos en el análisis, obteniéndose muestras pareadas de 108 pacientes positivos y 335 negativos. La sensibilidad y la especificidad en la fase aguda de la enfermedad para la prueba de ELISA IgM Panbio® fue de 69% y de 66% utilizando como punto de corte el valor correspondiente a 1,1. En la fase convaleciente se observó un incremento en la sensibilidad y especificidad, de valores de 88% y 62%, respectivamente. En contraste, la prueba de Virion/Serion® no mostró un rendimiento para la fase inicial de la enfermedad, lo cual replantea su uso como prueba rutinaria y de tamizaje. Conclusiones: La prueba de Elisa Panbio® obtuvo los mejores resultados y puede ser utilizada de manera rutinaria en los laboratorios modificando su punto de corte a 1,0. Sin embargo, presenta limitaciones por lo cual todos los casos positivos por esta prueba tienen que ser confirmados por la prueba MAT.Magíster en EpidemiologíaMaestríaObjective: Validate ELISA tests to detect IgM antibodies to Leptospira spp., In paired samples of patients from the diagnostic program febrile syndromes INS Microbiology Group, received in the period between January 2010 and July 2013. Methods: Sociodemographic characteristics of the patients were determined with leptospirosis infection in the study and possible associated risk factors were determined. A study of diagnostic tests, in which all subjects underwent three serological tests (ELISA IgM for leptospirosis Panbio®, IgM ELISA Virion-serion® and microscopic agglutination test (MAT). Subsequently, the operational characteristics of ELISA tests were evaluated using the gold standard MAT. Results: A total of 443 patients were included in the analysis, obtained paired samples of 108 positive and 335 negative patients. The sensitivity and specificity in the acute phase of the disease for Panbio® IgM ELISA test was 69% and 66% using as a cutoff value corresponding to 1.1. In the convalescent phase was observed an increase in sensitivity and specificity wit values of 88% and 62%, respectively. In contrast, the test Virion / Serion showed a yield for the initial phase of disease, which replanted use as routine testing and screening. Conclusions: ELISA Panbio test obtained the best results and can be used routinely in laboratories. However, it has limitations and therefore all positive cases for this test they must be confirmed by the MAT test
Validation of two Elisa IGM tests for human leptospirosis in Colombia - 2013
No full textObjetivo: Validar las pruebas de ELISA en la detección de anticuerpos IgM para Leptospira spp., en muestras pareadas de pacientes provenientes del programa de diagnóstico de síndromes febriles del Grupo de Microbiología del INS, recibidas en el periodo comprendido entre enero de 2010 y julio de 2013. Materiales y métodos: Se determinaron las características sociodemográficas de los pacientes con infección por leptospirosis incluidos en el estudio y se determinaron los posibles factores de riesgo asociados. Se desarrolló un estudio de pruebas diagnósticas, en el que a todos los sujetos se les realizaron tres pruebas serológicas (ELISA IgM para Leptospira de marca Panbio®, ELISA IgM de marca Virion-serion® y la técnica de microaglutinación (MAT). Posteriormente, se evaluaron las características operativas de las pruebas de ELISA, mediante el patrón de oro MAT. Resultados: Un total de 443 pacientes fueron incluidos en el análisis, obteniéndose muestras pareadas de 108 pacientes positivos y 335 negativos. La sensibilidad y la especificidad en la fase aguda de la enfermedad para la prueba de ELISA IgM Panbio® fue de 69% y de 66% utilizando como punto de corte el valor correspondiente a 1,1. En la fase convaleciente se observó un incremento en la sensibilidad y especificidad, de valores de 88% y 62%, respectivamente. En contraste, la prueba de Virion/Serion® no mostró un rendimiento para la fase inicial de la enfermedad, lo cual replantea su uso como prueba rutinaria y de tamizaje. Conclusiones: La prueba de Elisa Panbio® obtuvo los mejores resultados y puede ser utilizada de manera rutinaria en los laboratorios modificando su punto de corte a 1,0. Sin embargo, presenta limitaciones por lo cual todos los casos positivos por esta prueba tienen que ser confirmados por la prueba MAT.Magíster en EpidemiologíaMaestríaObjective: Validate ELISA tests to detect IgM antibodies to Leptospira spp., In paired samples of patients from the diagnostic program febrile syndromes INS Microbiology Group, received in the period between January 2010 and July 2013. Methods: Sociodemographic characteristics of the patients were determined with leptospirosis infection in the study and possible associated risk factors were determined. A study of diagnostic tests, in which all subjects underwent three serological tests (ELISA IgM for leptospirosis Panbio®, IgM ELISA Virion-serion® and microscopic agglutination test (MAT). Subsequently, the operational characteristics of ELISA tests were evaluated using the gold standard MAT. Results: A total of 443 patients were included in the analysis, obtained paired samples of 108 positive and 335 negative patients. The sensitivity and specificity in the acute phase of the disease for Panbio® IgM ELISA test was 69% and 66% using as a cutoff value corresponding to 1.1. In the convalescent phase was observed an increase in sensitivity and specificity wit values of 88% and 62%, respectively. In contrast, the test Virion / Serion showed a yield for the initial phase of disease, which replanted use as routine testing and screening. Conclusions: ELISA Panbio test obtained the best results and can be used routinely in laboratories. However, it has limitations and therefore all positive cases for this test they must be confirmed by the MAT test
Comportamiento de la vigilancia epidemiológica de la leptospirosis humana en Colombia, 2007-2011
No full textIntroducción. La leptospirosis es una zoonosis reemergente de distribución mundial causada por una espiroqueta del género Leptospira. Durante los últimos años en Colombia aumentó el número de casos en humanos y animales.
Objetivo. Caracterizar epidemiológicamente los casos de leptospirosis notificados al Sistema Nacional de Vigilancia en Salud Pública de Colombia y hacer una aproximación para conocer los serogrupos que circulan en el país.
Materiales y métodos. Se diseñó un estudio observacional de corte retrospectivo, con registros del proceso de vigilancia de los casos reportados por el software Sivigila y muestras enviadas al Grupo de Microbiología de la Red Nacional de Laboratorios, durante el periodo 2007 a 2011. Se registraron variables de tipo sociodemográficas y se analizaron 17 serogrupos de Leptospira. En el análisis seutilizaron medidas de frecuencia, tendencia central y dispersión.
Resultados. Se procesaron 11.786 registros, confirmándose 4.621 casos de leptospirosis. Las entidades territoriales con mayor registro fueron Valle del Cauca, Antioquia, Risaralda, Atlántico y Barranquilla; y las de incidencia más alta fueron Guaviare, Risaralda, San Andrés, Santa Marta y Barranquilla. El mayor número de casos reportados perteneció al área urbana, con mayor frecuencia de hombres (77 %), estudiantes (19,4 %) y amas de casas (13,6 %), con una mediana por edad de 29 años (rango intercuartílico: 45-19). Se evidenció la circulación de 17 serogrupos en el país; los más frecuentes fueron Australis (24,89 %), Hebdomadis (9,33 %) y Sejroe (8,0 %).
Conclusión. En Colombia se ha mejorado la notificación y clasificación final de los casos, lo que ha permitido identificar al serogrupo Australis como el de mayor circulación.
doi: http://dx.doi.org/10.7705/biomedica.v33i0.160
Serologically Confirmed Human Leptospirosis in Colombia, 2015–2020
No full textLeptospirosis, a bacterial infection transmitted through contact with infected animals or contaminated water sources, imposes a substantial health burden in Colombia. Since 2007, the National Institute of Health (INS) has mandated the notification and confirmation of all suspected leptospirosis cases. This passive surveillance program employs the microscopic agglutination test (MAT) on serum samples to ascertain confirmed cases of leptospirosis infection. However, the absence of a robust surveillance system has hindered our comprehensive understanding of the morbidity, mortality, geographical distribution, species/serovars, and strains responsible for severe disease. Our study aimed to provide an epidemiological overview of MAT-confirmed human leptospirosis cases reported over 6 years (2015–2020) in Colombia. In addition, we offer insights into the status of leptospirosis in the country, focusing on risk factors and proposing potential improvements for diagnosis and disease management. During the 6-year surveillance period, the laboratory at the INS received 3,535 serum samples from suspected human leptospirosis cases, with 880 (25%) confirmed through MAT. The incidence of leptospirosis was calculated at 1.9 cases per 100,000 people, with a higher prevalence among men (82.1%). Furthermore, 54 (6.1%) deaths were confirmed as leptospirosis, and cases were documented across nearly all regions of Colombia. Our findings emphasize the urgent need to strengthen leptospirosis laboratory surveillance, implement effective prevention measures, and enhance diagnostic capabilities in Colombia. The analysis conducted in this study provides the groundwork for estimating the impact of leptospirosis and raises awareness of its significance in public health.Agencia Nacional de Investigación y Desarrollo ANIDPontificia Universidad Católica de ChileCanadian Institute for Advanced Research CIFARFONDAPFondo Nacional de Desarrollo Científico y Tecnológico FONDECY
Demographic and clinical risk factors associated with severity of lab-confirmed human leptospirosis in Colombia, 2015–2020
No full textLeptospirosis is a neglected tropical disease and a public health concern worldwide. Infection in humans usually occurs through direct or indirect contact with the urine of infected animals. Most leptospirosis cases are mild, but between 5–15% of cases can be severe and even fatal, primarily due to delays in diagnosis, misrecognition, inadequate treatment, or pathogenicity of some strains. The factors associated with severity could be used to support triaging and avoid preventable medical complications or death. Colombia is an endemic country for leptospirosis, with mandatory laboratory surveillance. Our objective was to determine the demographic and clinical risk factors associated with severe leptospirosis. We used a unique dataset of 201 lab-confirmed leptospirosis cases notified to the National Reference Laboratory with a reported clinical history from several regions in Colombia. The cases presented severe illness (43.3%), ICU admission (30.3%), and fatal (8.5%). Severe leptospirosis was associated with dyspnea, tachycardia, and rash; fatal cases were associated with jaundice. We hope these results raise awareness among healthcare workers and support clinicians in avoiding preventable medical complications or death in human leptospirosis in Colombia and elsewhere
Demographic characteristics of human leptospirosis cases with diagnostic laboratory confirmation (MAT) in Colombia, 2015–2020 (n = 201).
No full textDemographic characteristics of human leptospirosis cases with diagnostic laboratory confirmation (MAT) in Colombia, 2015–2020 (n = 201).</p
Univariate and multivariate analysis of the factors for severe leptospirosis, admission to the intensive care unit ICU, and fatal cases.
No full textUnivariate and multivariate analysis of the factors for severe leptospirosis, admission to the intensive care unit ICU, and fatal cases.</p
Epidemiological human Leptospirosis form.
No full textBackgroundLeptospirosis is a common zoonoses and is a major global public health threat. Most cases are mild, typically presenting as a non-specific acute febrile illness. However, leptospirosis can have life-threatening manifestations, including pulmonary hemorrhage syndrome, and acute kidney injury. In Colombia, notification and lab-confirmation of suspected human cases are mandatory. However, little is known about the demographic and clinical factors associated with severe leptospirosis, which could help to reduce clinical complications and mortality. Our aim was to identify risk factors associated with severe leptospirosis, intensive care unit (ICU) admission, and mortality in lab-confirmed cases in Colombia, 2015–2020.Methods and findingsWe analyzed 201 lab-confirmed human leptospirosis cases by microagglutination test. We used a logistic regression to identify the demographic and clinical risk factors associated with severe leptospirosis, admission to ICU, and death. Most leptospirosis confirmed cases occurred in men (85.6%); the mean age was 36.7 years. We classified severe cases (43.3%) by clinical manifestations as renal (29.9%) and liver (27.4%) failure, multiple-organ failure (24.4%), septic shock (24.4%), Weil syndrome (18.4%), pulmonary hemorrhage (18.4%), and meningitis (2.5%), admitted to the ICU (30.3%), and fatal (8.5%). Clinical conditions associated with severe leptospirosis were dyspnea (OR: 5.54; 95% CI: 1.46 to 20.98), tachycardia (OR:9.69; 95% CI: 15.96 to 58.8), and rash (OR: 10.25; 95% CI: 25.01 to 42.08).ConclusionsWe identified demographic characteristics and clinical symptoms associated with severe leptospirosis in Colombia. We hope these results can support clinicians in providing timely treatment to leptospirosis patients to avoid preventable medical complications or deaths.</div
ROC curve for severe leptospirosis.
No full textBackgroundLeptospirosis is a common zoonoses and is a major global public health threat. Most cases are mild, typically presenting as a non-specific acute febrile illness. However, leptospirosis can have life-threatening manifestations, including pulmonary hemorrhage syndrome, and acute kidney injury. In Colombia, notification and lab-confirmation of suspected human cases are mandatory. However, little is known about the demographic and clinical factors associated with severe leptospirosis, which could help to reduce clinical complications and mortality. Our aim was to identify risk factors associated with severe leptospirosis, intensive care unit (ICU) admission, and mortality in lab-confirmed cases in Colombia, 2015–2020.Methods and findingsWe analyzed 201 lab-confirmed human leptospirosis cases by microagglutination test. We used a logistic regression to identify the demographic and clinical risk factors associated with severe leptospirosis, admission to ICU, and death. Most leptospirosis confirmed cases occurred in men (85.6%); the mean age was 36.7 years. We classified severe cases (43.3%) by clinical manifestations as renal (29.9%) and liver (27.4%) failure, multiple-organ failure (24.4%), septic shock (24.4%), Weil syndrome (18.4%), pulmonary hemorrhage (18.4%), and meningitis (2.5%), admitted to the ICU (30.3%), and fatal (8.5%). Clinical conditions associated with severe leptospirosis were dyspnea (OR: 5.54; 95% CI: 1.46 to 20.98), tachycardia (OR:9.69; 95% CI: 15.96 to 58.8), and rash (OR: 10.25; 95% CI: 25.01 to 42.08).ConclusionsWe identified demographic characteristics and clinical symptoms associated with severe leptospirosis in Colombia. We hope these results can support clinicians in providing timely treatment to leptospirosis patients to avoid preventable medical complications or deaths.</div
Diagnóstico de micosis oportunistas en pacientes con VIH/sida: un estudio de casos en Colombia Diagnosis of fungal opportunistic infections in HIV/AIDS patients: A cases study in Colombia
No full textObjetivos. Identificar las micosis oportunistas que afectan a los pacientes con VIH/sida, y determinar sus características demográficas, socioeconómicas y su relación con el número de células T CD4+. Métodos. Se trata de un estudio descriptivo de serie de casos basado en los participantes de un estudio diseñado para determinar el tipo y la frecuencia de las enfermedades oportunistas en pacientes con VIH/sida. Un caso se definió como un paciente con VIH/sida a quien se le diagnosticó una micosis oportunista, entre octubre de 2007 y mayo de 2010. Los pacientes elegibles estaban siendo tratados en dos instituciones médicas de Bogotá. Se recolectaron muestras respiratorias, de líquido cefalorraquídeo, de sangre y de raspado de lesión orofaríngea, para determinar la presencia de Histoplasma capsulatum, Paracoccidioides brasiliensis, Cryptococcus neoformans o Candida spp. Se utilizaron proporciones para resumir las variables cualitativas y medianas para las cuantitativas. Resultados. En 33 (9,8 %) pacientes con VIH/sida del estudio base (n=336), se diagnosticó una o más de las micosis evaluadas. El 75 % tenía entre 23 y 42 años. La frecuencia de estas infecciones fueron: H. capsulatum (n=1; 3,0 %), P. brasiliensis (n=1; 3,0 %), C. neoformans (n=25; 75,8 %), y Cándida spp. (n=7; 21,2 %). Los valores medianos de células T CD4+ fueron de 176 o menos, independientemente de sus manifestaciones clínicas. Conclusión. Se necesitan estudios adicionales para identificar los factores que podrían estar determinando la presencia de las micosis oportunistas en estos pacientes.Objectives: To identify the opportunistic fungal infections affecting patients with HIV/AIDS, to determine their demographic and socioeconomic characteristics and the number of CD4+ T cells. Materials and methods: This is a descriptive case series study based on a major study aimed at determining the type and frequency of opportunistic diseases in HIV/AIDS patients. A case was defined as an HIV/AIDS patient who had evidence of fungal infection at baseline. Eligible patients were being treated at two clinical institutions located in Bogotá, Colombia, between October 2007 and May 2010. Respiratory, cerebrospinal fluid and blood samples and scrapping/swabs of oral lesions were collected in order to determine the presence of Histoplasma capsulatum, Paracoccidioides brasiliensis, Cryptococcus neoformans or Candida spp. Proportions were used for qualitative variables and medians for quantitative variables. Results: Overall, 33 (10,2%) patients were diagnosed as having one or more of the evaluated fungal infections , out of 336. Seventy five per cent of them were between the ages of 23 and 42. The frequencies of these fungal infections were: H. capsulatum (n=1; 3.0%), P. brasiliensis (n=1; 3.0%), C. neoformans (n=25; 75.8%), and Candida spp. (n=7; 21.2%). The median values of CD4+ T cells were 176 or less, independently of clinical manifestations. Conclusion: Further studies are required to identify factors contributing to the presence of fungal opportunistic infections in these patients
