The WHO roadmap for neglected tropical diseases includes yaws eradication requiring certification of elimination of transmission in all endemic and formerly endemic countries worldwide. A ...community-based programme for yaws control was considered to have achieved elimination of the infection in the endemic focus in Ecuador after 1993. We did a serosurvey of children in this focus to provide evidence for interruption of transmission.
Survey of serum samples collected from children aged 2 to 15 years living in the formerly endemic and in geographically contiguous areas. A convenience sample of sera collected between 2005 were 2017 from non-yaws studies, were analyzed using immunochromatic rapid tests to screen (OnSite Syphilis Ab Combo Rapid Test) for Treponema pallidum-specific antibodies and confirm (DPP Syphilis Screen and Confirm) seroreactivity based on the presence antibodies to treponemal and non-treponemal antigens.
Seroreactivity was confirmed in 6 (0.14%, 95% CI 0.06-0.30) of 4,432 sera analyzed and was similar in formerly endemic (0.11%, (95% CI 0.01-0.75) and non-endemic (0.14%, 95% CI 0.06-0.34) communities. All seroreactors were of Afro-Ecuadorian ethnicity and most were male (4/6) and aged 10 or more years (5/6), the latter possibly indicating venereal syphilis. Only 1 seroreactor lived in a community in the Rio Santiago, that was formerly hyperendemic for yaws.
We observed very low levels of treponemal transmission in both formerly endemic and non-endemic communities which might be indicative of congenital or venereal syphilis and, if yaws, would likely be insufficient to maintain transmission of this endemic childhood infection. Additional surveys of children aged 1 to 5 years are planned in Rio Santiago communities to exclude yaws transmission.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
La Enfermedad de Chagas es una parasitosis crónica y sistémica causada por el protozoario hemoflagelado Trypanosoma cruzi y transmitida, fundamentalmente, por insectos de la subfamilia Triatominae. ...Actualmente, se reconocen al menos 151 especies de Triatominae, con especies de los géneros, Triatoma, Rhodnius y Panstrongylus, con un importante papel epidemiológico en la transmisión de la enfermedad. En Ecuador es difícil conocer la verdadera situación epidemiológica de esta enfermedad, sus implicaciones y la situación sobre su gestión de prevención y control. Se realizó una revisión de los datos epidemiológicos de la enfermedad de Chagas, publicadas en el Subsistema de Vigilancia Epidemiológica del Ministerio de Salud Pública desde el 2013 al 2019. La revisión sistemática de las especies de triatominos fue realizada a partir de investigaciones originales publicadas en base de datos de acceso público. La revisión realizada reportó 439 casos confirmados de Chagas con una alta incidencia en los últimos dos años. La prevalencia se ha observado ligeramente en mujeres con un grupo etario prevalente de 20 a 49 años. En el Ecuador se registra 17 especies de triatominos. Las especies Triatoma dimidiata y Rhodnius ecuadoriensis son los principales vectores de la enfermedad, con una alta densidad en las provincias de Loja y Manabí debido a su alta capacidad de adaptación y la colonización de nuevos hábitats.
Background The WHO roadmap for neglected tropical diseases includes yaws eradication requiring certification of elimination of transmission in all endemic and formerly endemic countries worldwide. A ...community-based programme for yaws control was considered to have achieved elimination of the infection in the endemic focus in Ecuador after 1993. We did a serosurvey of children in this focus to provide evidence for interruption of transmission. Methods Survey of serum samples collected from children aged 2 to 15 years living in the formerly endemic and in geographically contiguous areas. A convenience sample of sera collected between 2005 were 2017 from non-yaws studies, were analyzed using immunochromatic rapid tests to screen (OnSite Syphilis Ab Combo Rapid Test) for Treponema pallidum-specific antibodies and confirm (DPP Syphilis Screen and Confirm) seroreactivity based on the presence antibodies to treponemal and non-treponemal antigens. Results Seroreactivity was confirmed in 6 (0.14%, 95% CI 0.06–0.30) of 4,432 sera analyzed and was similar in formerly endemic (0.11%, (95% CI 0.01–0.75) and non-endemic (0.14%, 95% CI 0.06–0.34) communities. All seroreactors were of Afro-Ecuadorian ethnicity and most were male (4/6) and aged 10 or more years (5/6), the latter possibly indicating venereal syphilis. Only 1 seroreactor lived in a community in the Rio Santiago, that was formerly hyperendemic for yaws. Conclusion We observed very low levels of treponemal transmission in both formerly endemic and non-endemic communities which might be indicative of congenital or venereal syphilis and, if yaws, would likely be insufficient to maintain transmission of this endemic childhood infection. Additional surveys of children aged 1 to 5 years are planned in Rio Santiago communities to exclude yaws transmission. Author summary Yaws, caused by infection with the spirochete, Treponema pallidum pertenue, causes a chronic debilitating condition of skin, cartilage, and bone, and is transmitted during childhood through skin-to-skin contact. Yaws has been targeted for eradication as part of the WHO roadmap for control of neglected tropical diseases, requiring certification of elimination in all endemic and formerly endemic regions. Yaws in Ecuador has been restricted to a geographically isolated focus in a rainforest region of Esmeraldas Province in northern coastal Ecuador. Following a strategy of repeated 5-yearly clinical and serological surveys with mass-treatment and surveillance between surveys, yaws was assumed to have been eliminated by 1998. To provide the evidence base to certify the elimination of transmission in Ecuador, this study presents an analysis of stored sera collected from 4,432 children between 2005 and 2017 from formerly endemic and non-endemic communities. Screening and confirmation of seroreactors was done using two validated rapid tests for T. pallidum. Seroreactivity was observed in 6 samples (0.14%) and was similar in formerly endemic (0.11%) and non-endemic (0.14%) communities, possibly explained by background rates of congenital or venereal syphilis. Only 1 active infection was detected in formerly endemic communities. To our knowledge, this is the first study of yaws from the Americas to evaluate the elimination of transmission. Our data indicate that active yaws transmission is unlikely to be occurring in formerly endemic communities. Additional surveys of young children may be required to confirm interruption of transmission.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Introducción: Este estudio describe la incidencia de enfermedades transmitidas por vectores (ETVs) en Ecuador entre 2015 y 2019, destacando el papel de la gestión integrada de vectores. A través de ...un diseño ecológico de datos secundarios de vigilancia epidemiológica y registros demográficos, se identifica una tendencia disminuida en la incidencia de arbovirosis, pero con variabilidad cantonal significativa. Métodología: Con base en los datos reportados por el sistema de vigilancia epidemiológica del Ministerio de Salud Pública, registros del INEC y cartografía del Instituto Geográfico Militar, se calculó la incidencia acumulada ajustada por población y altitud, excluyendo áreas por encima de 1680 msnm para minimizar clasificaciones erróneas. Resultados: Se reportaron 113,474 casos de arbovirosis, con una reducción en la incidencia desde 464,17 casos por 100,000 habitantes en 2015 a 25,9 en 2019. La variabilidad a nivel de cantones muestra áreas con tasas persistentemente altas de infección. Conclusiones: A pesar de la disminución generalizada en la incidencia de ETVs, la variabilidad de los resultados por cantones resalta la complejidad del manejo de estas patologías y la necesidad de estrategias multidimensionales. Los futuros esfuerzos de investigación deberían centrarse en un análisis más detallado de los determinantes ambientales y sociales para mejorar las intervenciones de prevención y control, especialmente en áreas con altas tasas de infección.
