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Buenos Aires, Argentina

A systematic review of surveys performed between 1980 and 2011 (published in MEDLINE/Pubmed and/or LILACS indexed journals, available in the baseline data from a Mass Deworming National Program (MDNP, 2005) was used to identify the prevalence, distribution and detection of risk areas for soil transmitted helminth infections (STH) in Argentina. We found 310 publications in the database using the pre-defined key-words (medical subject headings) for research purposes. Only 24 articles with 26 surveillance sites in 8 provinces and a total of 5495 surveyed individuals fulfilled the inclusion criteria. Frequency rates for STH had a wide range: Ascaris lumbricoides: 0-67%, hookworms: 0-90%, Trichuris trichiura: 0-24.6 and Strongyloides stercoralis: 0-83%. The estimated combined incidence varied from 0.8% to 88.6%. Baseline surveys from the MDNP reporting on 1943 children from 12 provinces confirmed the heterogeneity, with combined STH frequency rates ranging from 0 to 42.7%. Surveys included in this review showed that the distribution of STH in Argentina is not homogeneous, with areas of high incidence (> 20%) in the northeastern and northwestern provinces where mass deworming activities would be highly beneficial. In several surveys, the high overall incidence was mostly due to hookworms and S. stercoralis, a situation to be considered when selecting diagnostic and therapeutic control strategies. The scarcity or absence of data from various provinces and the availability of less than 8000 surveyed individuals should be considered. Source

Alvarez M.G.,Hospital Interzonal General de Agudos Eva Peron | Hernandez Y.,Instituto Nacional Of Parasitologia Dr Mario Fatala Chaben | Bertocchi G.,Hospital Interzonal General de Agudos Eva Peron | Fernandez M.,Instituto Nacional Of Parasitologia Dr Mario Fatala Chaben | And 8 more authors.
Antimicrobial Agents and Chemotherapy | Year: 2016

There is a clinical need to test new schemes of benznidazole administration that are expected to be at least as effective as the current therapeutic scheme but safer. This study assessed a new scheme of benznidazole administration in chronic Chagas disease patients. A pilot study with intermittent doses of benznidazole at 5 mg/kg/day in two daily doses every 5 days for a total of 60 days was designed. The main criterion of response was the comparison of quantitative PCR (qPCR) findings prior to and 1 week after the end of treatment. The safety profile was assessed by the rate of suspensions and severity of adverse effects. Twenty patients were analyzed for safety, while qPCR was tested for 17 of them. The average age was 43 ± 7.9 years; 55% were female. Sixty-five percent of treated subjects showed detectable qPCR results prior to treatment of 1.45 (0.63 to 2.81) and 2.1 (1.18 to 2.78) parasitic equivalents per milliliter of blood (par.eq/ml) for kinetoplastic DNA (kDNA) qPCR and nuclear repetitive sequence satellite DNA (SatDNA) qPCR, respectively. One patient showed detectable PCR at the end of treatment (1/17), corresponding to 6% treatment failure, compared with 11/17 (65%) patients pretreatment (P = 0.01). Adverse effects were present in 10/20 (50%) patients, but in only one case was treatment suspended. Eight patients showed mild adverse effects, whereas moderate reactions with increased liver enzymes were observed in two patients. The main accomplishment of this pilot study is the promising low rate of treatment suspension. Intermittent administration of benznidazole emerges a new potential therapeutic scheme, the efficacy of which should be confirmed by long-term assessment posttreatment. Copyright © 2016, American Society for Microbiology. All Rights Reserved. Source

Garelli F.M.,Laboratorio Of Eco Epidemiologia | Espinosa M.O.,Fundacion Mundo Sano | Gurtler R.E.,Laboratorio Of Eco Epidemiologia
Journal of Medical Entomology | Year: 2012

Understanding the processes that affect Aedes aegypti (L.) (Diptera: Culicidae) may serve as a starting point to create and /or improve vector control strategies. For this purpose, we performed statistical modeling of three entomological surveys conducted in Clorinda City, northern Argentina. Previous 'basic' models of presence or absence of larvae and/or pupae (infestation) and the number of pupae in infested containers (productivity), mainly based on physical characteristics of containers, were expanded to include variables selected a priori reflecting water use practices, vector-related context factors, the history of chemical control, and climate. Model selection was performed using Akaike's Information Criterion. In total, 5,431 water-holding containers were inspected and 12,369 Ae. aegypti pupae collected from 963 positive containers. Large tanks were the most productive container type. Variables reflecting every putative process considered, except for history of chemical control, were selected in the best models obtained for infestation and productivity. The associations found were very strong, particularly in the case of infestation. Water use practices and vector-related context factors were the most important ones, as evidenced by their impact on Akaike's Information Criterion scores of the infestation model. Risk maps based on empirical data and model predictions showed a heterogeneous distribution of entomological risk. An integrated vector control strategy is recommended, aiming at community participation for healthier water use practices and targeting large tanks for key elements such as lid status, water addition frequency and water use. © 2012 Entomological Society of America. Source

Polop F.J.,CONICET | Polop F.J.,National University of Rio Cuarto | Provensal M.C.,National University of Rio Cuarto | Pini N.,Instituto Nacional Of Enfermedades Virales Humanas Inevh | And 7 more authors.
EcoHealth | Year: 2010

Andes virus (AND) is a hantavirus hosted by the sigmodontine rodent Oligoryzomys longicaudatus in southern Argentina, where it is responsible for most cases of hantavirus pulmonary syndrome (HPS). Our study provides data about the spatial variation in abundance of the rodent host of AND hantavirus. We report results of a longitudinal study performed in a locality of the Andean region of Chubut Province. From November 2003 (spring) to July 2006 (winter), O. longicaudatus was the most common species captured (63%) and it showed significant differences in abundance among habitats and seasons. Most antibody-positive rodents were O. longicaudatus (9.2%), followed by A. longipilis (3.6%) and A. olivaceus (1.5%). The highest number of antibody-positive animals was observed for males that belonged to the heaviest mass classes. Antibody-positive O. longicaudatus were more abundant in brush habitats. We found low richness of rodents and abundance of O. longicaudatus in areas affected by anthropogenic activity. The infection seems to be regionally persistent, but the risk to humans in a landscape would be localized. To develop accurate models for predicting HPS outbreaks, further research is needed to characterize rodent movement patterns across the landscape. © 2010 International Association for Ecology and Health. Source

Garelli F.M.,University of Buenos Aires | Espinosa M.O.,Fundacion Mundo Sano | Gurtler R.E.,University of Buenos Aires
Acta Tropica | Year: 2013

The objective of this study was to analyze the spatio-temporal patterns of Aedes aegypti immatures based on four entomological surveys that inspected over 6000 households in a large neighborhood of the city of Clorinda between 2007 and 2008. Global and local spatial point pattern analyses of immature presence or absence, habitat quality (estimated using a previously obtained statistical model) and pupal production were performed. Global analyses showed aggregation of both infestation and habitat quality up to 10 times bigger than previously described, ranging from 150 to 400. m between surveys. Pupal production was also clustered but at smaller scales than infestation presence/absence. The location of the clusters was temporally unstable between surveys. There was no spatial structure related to the control strategy; lots treated with temephos and lots uninspected (i.e., closed or refusing) were randomly distributed. These results suggest a combination of exogenous (the aggregation of better quality habitats) and endogenous (dispersal) processes explaining the observed patterns of larger-scale infestation. A spatial targeting strategy at the neighborhood scale would not be as cost-effective in Clorinda as in other sites where stable smaller-scale clusters permit the identification of key premises. © 2013 Elsevier B.V. Source

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