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Yang X, Zhu X, Wang H, Lu H. The treatment of syphilis infection in pregnant women and the follow-up investigation and analysis of syphilis infection in children after delivery in Huaian City. Panminerva Med 2022; 64:569-571. [PMID: 33565759 DOI: 10.23736/s0031-0808.21.04294-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Affiliation(s)
- Xiaoer Yang
- Unit of Population Health Information, Huai'an Women and Children's Hospital, Huai'an, China
| | - Xiaoqin Zhu
- Unit of Population Health Information, Huai'an Women and Children's Hospital, Huai'an, China
| | - Hui Wang
- Unit of Population Health Information, Huai'an Women and Children's Hospital, Huai'an, China
| | - Hongmei Lu
- Unit of Population Health Information, Huai'an Women and Children's Hospital, Huai'an, China -
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Cooper PJ, Anselmi M, Caicedo C, Lopez A, Vicuña Y, Cagua Ordoñez J, Rivera Bonilla J, Rodriguez A, Soto A, Guevara A. Yaws elimination in Ecuador: Findings of a serological survey of children in Esmeraldas province to evaluate interruption of transmission. PLoS Negl Trop Dis 2022; 16:e0010173. [PMID: 35613083 PMCID: PMC9132314 DOI: 10.1371/journal.pntd.0010173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 04/19/2022] [Indexed: 11/19/2022] Open
Abstract
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. 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.
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Affiliation(s)
- Philip J. Cooper
- Escuela de Medicina, Universidad Internacional del Ecuador, Quito, Ecuador
- Insititute of Infection and Immunity, St George’s University of London, London, United Kingdom
- * E-mail:
| | - Mariella Anselmi
- Centro de Epidemiologia Comunitaria y Medicina Tropical (CECOMET), Esmeraldas, Ecuador
| | - Cintia Caicedo
- Centro de Epidemiologia Comunitaria y Medicina Tropical (CECOMET), Esmeraldas, Ecuador
| | - Andrea Lopez
- Escuela de Medicina, Universidad Internacional del Ecuador, Quito, Ecuador
| | - Yosselin Vicuña
- Instituto de Biomedicina, Carrera de Medicina, Universidad Central, Quito, Ecuador
| | - Jaen Cagua Ordoñez
- Dirección Nacional de Estrategias de Prevención y Control, Ministerio de Salud Pública, Quito, Ecuador
- Instituto Ecuatoriano de Seguridad Social, Quito, Ecuador
| | - Julio Rivera Bonilla
- Dirección Nacional de Estrategias de Prevención y Control, Ministerio de Salud Pública, Quito, Ecuador
| | | | - Aida Soto
- Pan American Health Organization, Quito, Ecuador
| | - Angel Guevara
- Instituto de Biomedicina, Carrera de Medicina, Universidad Central, Quito, Ecuador
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Reina Ortiz M, Grunauer M, Gutierrez E, Izurieta R, Macis M, Phan P, Rosas C, Teran E. Financial Incentives, Not Behavioral Nudges, Led to Optimized HIV Testing among Pregnant Women in a High-Burden Urban Population in Ecuador. Am J Trop Med Hyg 2022; 106:tpmd210591. [PMID: 35405656 PMCID: PMC9209938 DOI: 10.4269/ajtmh.21-0591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 11/16/2021] [Indexed: 11/07/2022] Open
Abstract
Behavioral economic principles are increasingly being used in the fight against HIV, including improving voluntary testing in sub-Saharan Africa and South America. However, behavioral nudges have not been widely tested as a strategy to optimize HIV testing in pregnant women. Here, we assessed whether behavioral nudges or financial incentives were effective in optimizing HIV testing among pregnant women in a high-HIV burden setting. A randomized clinical trial was conducted between May 21 and Oct 5, 2018, to allocate pregnant women in Ecuador into three study arms: information only, soft commitment (i.e., a behavioral nudge), and financial incentives. All participants received an informational flyer, including the address of a testing location. Participants in the soft-commitment arm signed and kept a form on which they committed to get tested for HIV. Those in the financial incentive arm received a $10 incentive when tested for HIV. A stepwise logistic regression analysis estimated the effect of the study arms on HIV testing rate. Participants in the financial-incentive arm had higher odds of getting an HIV test (adjusted odds ratio 17.06, P < 0.001) as compared with information-only participants. Soft-commitment had the opposite effect (adjusted odds ratio 0.14, P = 0.014). Financial incentives might be useful in improving HIV testing among pregnant women, especially among those who might be at higher risk but who have not completed an HIV test.
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Affiliation(s)
| | - Michelle Grunauer
- Escuela de Medicina, Colegio de Ciencias de la Salud, Universidad San Francisco de Quito, Quito, Ecuador
| | - Erika Gutierrez
- Laboratorio Clínico Microlab Diagnostic, Esmeraldas, Ecuador
| | - Ricardo Izurieta
- College of Public Health, University of South Florida, Tampa, Florida
| | - Mario Macis
- Johns Hopkins Carey Business School, Baltimore, Maryland
- National Bureau of Economic Research, Cambridge, Maryland
| | - Phillip Phan
- Johns Hopkins Carey Business School, Baltimore, Maryland
- Johns Hopkins Medicine Armstrong Institute for Patient Safety and Quality, Baltimore, Maryland
| | - Carlos Rosas
- Escuela de Medicina, Colegio de Ciencias de la Salud, Universidad San Francisco de Quito, Quito, Ecuador
| | - Enrique Teran
- Escuela de Medicina, Colegio de Ciencias de la Salud, Universidad San Francisco de Quito, Quito, Ecuador
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Lee GO, Eisenberg JNS, Uruchima J, Vasco G, Smith SM, Van Engen A, Victor C, Reynolds E, MacKay R, Jesser KJ, Castro N, Calvopiña M, Konstantinidis KT, Cevallos W, Trueba G, Levy K. Gut microbiome, enteric infections and child growth across a rural-urban gradient: protocol for the ECoMiD prospective cohort study. BMJ Open 2021; 11:e046241. [PMID: 34686548 PMCID: PMC8543627 DOI: 10.1136/bmjopen-2020-046241] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 09/29/2021] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION The functional consequences of the bacterial gut microbiome for child health are not well understood. Characteristics of the early child gut microbiome may influence the course of enteric infections, and enteric infections may change the composition of the gut microbiome, all of which may have long-term implications for child growth and development. METHODS AND ANALYSIS We are conducting a community-based birth cohort study to examine interactions between gut microbiome conditions and enteric infections, and how environmental conditions affect the development of the gut microbiome. We will follow 360 newborns from 3 sites along a rural-urban gradient in northern coastal Ecuador, characterising enteric infections and gut microbial communities in the children every 3 to 6 months over their first 2 years of life. We will use longitudinal regression models to assess the correlation between environmental conditions and gut microbiome diversity and presence of specific taxa, controlling for factors that are known to be associated with the gut microbiome, such as diet. From 6 to 12 months of age, we will collect weekly stool samples to compare microbiome conditions in diarrhoea stools versus stools from healthy children prior to, during and after acute enteric infections, using principal-coordinate analysis and other multivariate statistical methods. ETHICS AND DISSEMINATION Ethics approvals have been obtained from Emory University and the Universidad San Francisco de Quito institutional review boards. The findings will be disseminated through conference presentations and peer-reviewed journals.
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Affiliation(s)
- Gwenyth O Lee
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Joseph N S Eisenberg
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Jessica Uruchima
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Gabriela Vasco
- Instituto de Microbiología, Universidad San Francisco de Quito, Quito, Pichincha, Ecuador
- Facultad de Ciencias Médicas, Universidad Central del Ecuador, Quito, Ecuador
| | - Shanon M Smith
- Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, Georgia, USA
| | - Amanda Van Engen
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Courtney Victor
- Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, Georgia, USA
| | - Elise Reynolds
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Rebecca MacKay
- Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, Georgia, USA
| | - Kelsey J Jesser
- Department of Environmental and Occupational Health Sciences, University of Washington School of Public Health, Seattle, Washington, USA
| | - Nancy Castro
- Carrera de Nutrición y Dietética, Universidad San Francisco de Quito, Quito, Pichincha, Ecuador
| | - Manuel Calvopiña
- Carrera de Medicina, Universidad de Las Americas Facultad de Ciencias de la Salud, Quito, Pichincha, Ecuador
| | | | - William Cevallos
- Instituto de Biomedicina, Facultad de Ciencias Médicas, Universidad Central del Ecuador, Quito, Ecuador
| | - Gabriel Trueba
- Instituto de Microbiología, Universidad San Francisco de Quito, Quito, Pichincha, Ecuador
| | - Karen Levy
- Department of Environmental and Occupational Health Sciences, University of Washington School of Public Health, Seattle, Washington, USA
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Prevalence of Curable Sexually Transmitted Infections in Pregnant Women in Low- and Middle-Income Countries From 2010 to 2015: A Systematic Review. Sex Transm Dis 2017; 43:450-8. [PMID: 27322048 DOI: 10.1097/olq.0000000000000460] [Citation(s) in RCA: 82] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Current literature comparing the prevalence rates of curable sexually transmitted infections (STIs) in pregnant women in various global regions is limited. As a result, antenatal screening practices for curable STIs in pregnant women, specifically Treponema pallidum (syphilis), Neisseria gonorrhoeae (NG), Chlamydia trachomatis (CT), and Trichomonas vaginalis (TV) vary around the world, differing by country and particular STI. METHODS We conducted a systematic review of publications on STI prevalence among pregnant women in 30 different low- and middle-income countries. We searched PubMed for studies reporting prevalence of syphilis, CT, NG, and TV in pregnant women. English language studies published between January 1, 2010, and March 1, 2015, were included. The adjusted mean STI prevalence by region was calculated via multivariable linear regression adjusting for health care setting, women's mean age, study sample size, and sensitivity of diagnostic test. RESULTS We identified 75 studies that met inclusion criteria, providing 116 point prevalence estimates for curable STIs among 3,489,621 pregnant women. Adjusted mean prevalence for NG ranged from 1.2% (95% confidence interval [CI], 1.0-1.3) in Latin America to 4.6% (95% CI, 4.0-5.2) in Southern Africa; syphilis prevalence ranged from 1.1% (95% CI, 0.5-1.6) in Asia to 6.5% (95% CI, 4.7-6.3) in Southern Africa; CT ranged from 0.8% (95% CI, 0.4-1.1) in Asia to 11.2% (95% CI, 6.0-16.4) in Latin America; and TV ranged from 3.9% (95% CI, 2.2-5.6) in Latin America to 24.6% (95% CI, 17.9-31.4) in Southern Africa. CONCLUSIONS Although we observed a wide variation in STI burden in pregnancy after adjusting for age, test, and health care setting, further valid comparison may depend on adjustment for access to care and screening practices.
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Obure CD, Gaitan-Duarte H, Losada Saenz R, Gonzalez L, Angel-Muller E, Laverty M, Perez F. A comparative analysis of costs of single and dual rapid HIV and syphilis diagnostics: results from a randomised controlled trial in Colombia. Sex Transm Infect 2017; 93:482-486. [PMID: 28495681 PMCID: PMC5739853 DOI: 10.1136/sextrans-2016-052961] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Revised: 03/28/2017] [Accepted: 04/18/2017] [Indexed: 11/15/2022] Open
Abstract
Background HIV and congenital syphilis are major public health burdens contributing to substantial perinatal morbidity and mortality globally. Although studies have reported on the costs and cost-effectiveness of rapid diagnostic tests (RDTs) for syphilis screening within antenatal care in a number of resource-constrained settings, empirical evidence on country-specific cost and estimates of single RDTs compared with dual RDTs for HIV and syphilis are limited. Methods A cluster randomised controlled study design was used to compare the incremental costs of two testing algorithms: (1) single RDTs for HIV and syphilis and (2) dual RDTs for HIV and syphilis, in 12 health facilities in Bogota and Cali, Colombia. The costs of single HIV and syphilis RDTs and dual HIV and syphilis RDTs were collected from each of the health facilities. The economic costs per woman tested for HIV and syphilis and costs per woman treated for syphilis defined as the total costs required to test and treat one woman for syphilis were estimated. Results A total of 2214 women were tested in the study facilities. Cost per pregnant woman tested and cost per woman treated for syphilis were US$10.26 and US$607.99, respectively in the single RDT arm. For the dual RDTs, the cost per pregnant woman tested for HIV and syphilis and cost per woman treated for syphilis were US$15.89 and US$1859.26, respectively. Overall costs per woman tested for HIV and syphilis and cost per woman treated for syphilis were lower in Cali compared with Bogota across both intervention arms. Staff costs accounted for the largest proportion of costs while treatment costs comprised <1% of the preventive programme. Conclusions Findings show lower average costs for single RDTs compared with dual RDTs with costs sensitive to personnel costs and the scale of output at the health facilities. Trial registration number NCT02454816; results.
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Affiliation(s)
- Carol Dayo Obure
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Hernando Gaitan-Duarte
- Obstetrics and Gynecology Department, Universidad Nacional de Colombia, Bogotá, Colombia
| | - Ricardo Losada Saenz
- Obstetrics and Gynecology Department, Universidad Nacional de Colombia, Bogotá, Colombia
| | - Lina Gonzalez
- Obstetrics and Gynecology Department, Universidad Nacional de Colombia, Bogotá, Colombia
| | - Edith Angel-Muller
- Obstetrics and Gynecology Department, Universidad Nacional de Colombia, Bogotá, Colombia
| | - Maura Laverty
- Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Freddy Perez
- Communicable Diseases and Health Analysis Department, HIV, Hepatitis, Tuberculosis and Sexually Transmitted Infections Unit, Pan American Health Organization, Washington DC, USA
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Beckman AL, Wilson MM, Prabhu V, Soekoe N, Mata H, Grau LE. A qualitative view of the HIV epidemic in coastal Ecuador. PeerJ 2016; 4:e2726. [PMID: 27904814 PMCID: PMC5126616 DOI: 10.7717/peerj.2726] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Accepted: 10/27/2016] [Indexed: 11/25/2022] Open
Abstract
In 2013 approximately 37,000 people were living with HIV in Ecuador (prevalence 0.4%), representing a generalized epidemic where most new infections arise from sexual interactions in the general population. Studies that examine attitudes towards people living with HIV (PLWH), individual risk perception of acquiring HIV amongst Ecuadorians, and the ways in which levels of risk perception may affect risk behaviors are lacking. This qualitative study aimed to fill this gap in the literature by investigating these issues in the rural, coastal community of Manglaralto, Ecuador, which has among the highest incidence of HIV in Ecuador. We conducted interviews with 15 patients at Manglaralto Hospital. Analysis of interview transcripts revealed widespread negative attitudes towards PLWH, prevalent risk behaviors such as multiple sex partners and lack of condom use, and low individual risk-perception of contracting HIV. These findings underscore the need for increased efforts to prevent further growth of the HIV epidemic in Ecuador.
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Affiliation(s)
| | - Magdalena M Wilson
- Department of Social and Behavioral Sciences, Yale School of Public Health , New Haven , CT , United States
| | | | - Nicola Soekoe
- Department of Ethics, Politics and Economics, Yale University , New Haven , CT , United States
| | | | - Lauretta E Grau
- Center for Interdisciplinary Research on AIDS and the Department of Epidemiology of Microbial Disease, Yale School of Public Health , New Haven , CT , United States
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Sánchez-Gómez A, Jacobson JO, Montoya O, Magallanes D, Bajaña W, Aviles O, Esparza T, Soria E, González MA, Morales-Miranda S, Tobar R, Riera C. HIV, STI and Behavioral Risk Among Men Who have Sex with Men in a Setting of Elevated HIV Prevalence Along Ecuador's Pacific Coast. AIDS Behav 2015; 19:1609-18. [PMID: 25432875 DOI: 10.1007/s10461-014-0956-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
We assessed HIV and STI prevalence, risk behaviors and factors associated with HIV infection in men who have sex with men (MSM) in Guayaquil, Ecuador. Respondent-driven sampling was used to recruit 400 MSM in 2011-2012. Participants completed a computer-assisted self-interview and provided blood samples. Statistical analysis accounted for differential probability of selection and for recruitment patterns. HIV prevalence was 11.3 %, HSV-2 30.2 %, active syphilis 6.9 % and hepatitis B 1.2 %. In the previous 12 months, 84 % of MSM reported casual male sex partners and 25 % sex work. Only 48 % of MSM consistently used condoms with male partners and 54 % had ever been tested for HIV. Of 17 % of MSM reporting a female partner, consistent condom use was 6 %. HIV infection was associated with age 25 or older, active syphilis and homosexual self-identification. Findings suggest continuing HIV risk and a need to strengthen prevention and testing among MSM.
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Luu M, Ham C, Kamb ML, Caffe S, Hoover KW, Perez F. Syphilis testing in antenatal care: Policies and practices among laboratories in the Americas. Int J Gynaecol Obstet 2015; 130 Suppl 1:S37-42. [PMID: 25979116 PMCID: PMC6756481 DOI: 10.1016/j.ijgo.2015.04.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Objective: To asses laboratory syphilis testing policies and practices among laboratories in the Americas. Methods: Laboratory directors or designees from PAHO member countries were invited to participate in a structured, electronically-delivered survey between March and August, 2014. Data on syphilis tests, algorithms, and quality control (QC) practices were analyzed, focusing on laboratories receiving specimens from antenatal clinics (ANCs). Results: Surveys were completed by 69 laboratories representing 30 (86%) countries. Participating laboratories included 36 (52%) national or regional reference labs and 33 (48%) lower-level laboratories. Most (94%) were public sector facilities and 71% reported existence of a national algorithm for syphilis testing in pregnancy, usually involving both treponemal and non-treponemal testing (72%). Less than half (41%) used rapid syphilis tests (RSTs); and only seven laboratories representing five countries reported RSTs were included in the national algorithm for pregnant women. Most (83%) laboratories serving ANCs reported using some type of QC system; 68% of laboratories reported participation in external QC. Only 36% of laboratories reported data to national/local surveillance. Half of all laboratories serving ANC settings reported a stockout of one or more essential supplies during the previous year (median duration, 30 days). Conclusion: Updating laboratory algorithms, improving testing standards, integrating data into existing surveillance, and improved procurement and distribution of commodities may be needed to ensure elimination of MTCT of syphilis in the Americas.
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Affiliation(s)
- Minh Luu
- Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Cal Ham
- Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Mary L Kamb
- Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Sonja Caffe
- Communicable Diseases and Health Analysis Department, HIV, Hepatitis, Tuberculosis and Sexually Transmitted Infections Unit, Pan American Health Organization, Washington DC, USA
| | - Karen W Hoover
- Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Freddy Perez
- Communicable Diseases and Health Analysis Department, HIV, Hepatitis, Tuberculosis and Sexually Transmitted Infections Unit, Pan American Health Organization, Washington DC, USA.
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Costales JA, Sánchez-Gómez A, Silva-Aycaguer LC, Cevallos W, Tamayo S, Yumiseva CA, Jacobson JO, Martini L, Carrera CA, Grijalva MJ. A national survey to determine prevalence of Trypanosoma cruzi infection among pregnant women in Ecuador. Am J Trop Med Hyg 2015; 92:807-10. [PMID: 25667052 DOI: 10.4269/ajtmh.14-0562] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Accepted: 12/05/2014] [Indexed: 11/07/2022] Open
Abstract
A nationwide survey was conducted to obtain an estimate of Chagas disease prevalence among pregnant women in Ecuador. As part of a national probability sample, 5,420 women seeking care for delivery or miscarriage at 15 healthcare facilities were recruited into the study. A small minority of participants reported knowing about Chagas disease or recognized the vector. A national seroprevalence of 0.1% (95% confidence interval [95% CI] = 0.0-0.2%) was found; cases were concentrated in the coastal region (seroprevalence = 0.2%; 95% CI = 0.0-0.4%). No cases of transmission to neonates were identified in the sample. Seropositive participants were referred to the National Chagas Program for evaluation and treatment. Additional studies are necessary to determine if areas of higher prevalence exist in well-known endemic provinces and guide the development of a national strategy for elimination of mother-to-child transmission of Chagas disease in Ecuador.
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Affiliation(s)
- Jaime A Costales
- Center for Infectious Disease Research, Pontificia Universidad Católica del Ecuador, Quito, Ecuador; Pan American Health Organization, Quito, Ecuador; National School of Public Health, Havana, Cuba; National STI/HIV-AIDS Program, Ministry of Public Health, Quito, Ecuador; Pan-American Health Organization, Bogotá, Colombia; Instituto Nacional de Salud Pública e Investigación (INSPI), Guayaquil, Ecuador; Biomedical Center, Central University of Ecuador, Quito, Ecuador; Department of Biomedical Sciences, Tropical Disease Institute, Heritage College of Osteopathic Medicine, Ohio University, Athens, Ohio
| | - Amaya Sánchez-Gómez
- Center for Infectious Disease Research, Pontificia Universidad Católica del Ecuador, Quito, Ecuador; Pan American Health Organization, Quito, Ecuador; National School of Public Health, Havana, Cuba; National STI/HIV-AIDS Program, Ministry of Public Health, Quito, Ecuador; Pan-American Health Organization, Bogotá, Colombia; Instituto Nacional de Salud Pública e Investigación (INSPI), Guayaquil, Ecuador; Biomedical Center, Central University of Ecuador, Quito, Ecuador; Department of Biomedical Sciences, Tropical Disease Institute, Heritage College of Osteopathic Medicine, Ohio University, Athens, Ohio
| | - Luis C Silva-Aycaguer
- Center for Infectious Disease Research, Pontificia Universidad Católica del Ecuador, Quito, Ecuador; Pan American Health Organization, Quito, Ecuador; National School of Public Health, Havana, Cuba; National STI/HIV-AIDS Program, Ministry of Public Health, Quito, Ecuador; Pan-American Health Organization, Bogotá, Colombia; Instituto Nacional de Salud Pública e Investigación (INSPI), Guayaquil, Ecuador; Biomedical Center, Central University of Ecuador, Quito, Ecuador; Department of Biomedical Sciences, Tropical Disease Institute, Heritage College of Osteopathic Medicine, Ohio University, Athens, Ohio
| | - William Cevallos
- Center for Infectious Disease Research, Pontificia Universidad Católica del Ecuador, Quito, Ecuador; Pan American Health Organization, Quito, Ecuador; National School of Public Health, Havana, Cuba; National STI/HIV-AIDS Program, Ministry of Public Health, Quito, Ecuador; Pan-American Health Organization, Bogotá, Colombia; Instituto Nacional de Salud Pública e Investigación (INSPI), Guayaquil, Ecuador; Biomedical Center, Central University of Ecuador, Quito, Ecuador; Department of Biomedical Sciences, Tropical Disease Institute, Heritage College of Osteopathic Medicine, Ohio University, Athens, Ohio
| | - Susana Tamayo
- Center for Infectious Disease Research, Pontificia Universidad Católica del Ecuador, Quito, Ecuador; Pan American Health Organization, Quito, Ecuador; National School of Public Health, Havana, Cuba; National STI/HIV-AIDS Program, Ministry of Public Health, Quito, Ecuador; Pan-American Health Organization, Bogotá, Colombia; Instituto Nacional de Salud Pública e Investigación (INSPI), Guayaquil, Ecuador; Biomedical Center, Central University of Ecuador, Quito, Ecuador; Department of Biomedical Sciences, Tropical Disease Institute, Heritage College of Osteopathic Medicine, Ohio University, Athens, Ohio
| | - César A Yumiseva
- Center for Infectious Disease Research, Pontificia Universidad Católica del Ecuador, Quito, Ecuador; Pan American Health Organization, Quito, Ecuador; National School of Public Health, Havana, Cuba; National STI/HIV-AIDS Program, Ministry of Public Health, Quito, Ecuador; Pan-American Health Organization, Bogotá, Colombia; Instituto Nacional de Salud Pública e Investigación (INSPI), Guayaquil, Ecuador; Biomedical Center, Central University of Ecuador, Quito, Ecuador; Department of Biomedical Sciences, Tropical Disease Institute, Heritage College of Osteopathic Medicine, Ohio University, Athens, Ohio
| | - Jerry O Jacobson
- Center for Infectious Disease Research, Pontificia Universidad Católica del Ecuador, Quito, Ecuador; Pan American Health Organization, Quito, Ecuador; National School of Public Health, Havana, Cuba; National STI/HIV-AIDS Program, Ministry of Public Health, Quito, Ecuador; Pan-American Health Organization, Bogotá, Colombia; Instituto Nacional de Salud Pública e Investigación (INSPI), Guayaquil, Ecuador; Biomedical Center, Central University of Ecuador, Quito, Ecuador; Department of Biomedical Sciences, Tropical Disease Institute, Heritage College of Osteopathic Medicine, Ohio University, Athens, Ohio
| | - Luiggi Martini
- Center for Infectious Disease Research, Pontificia Universidad Católica del Ecuador, Quito, Ecuador; Pan American Health Organization, Quito, Ecuador; National School of Public Health, Havana, Cuba; National STI/HIV-AIDS Program, Ministry of Public Health, Quito, Ecuador; Pan-American Health Organization, Bogotá, Colombia; Instituto Nacional de Salud Pública e Investigación (INSPI), Guayaquil, Ecuador; Biomedical Center, Central University of Ecuador, Quito, Ecuador; Department of Biomedical Sciences, Tropical Disease Institute, Heritage College of Osteopathic Medicine, Ohio University, Athens, Ohio
| | - Caty A Carrera
- Center for Infectious Disease Research, Pontificia Universidad Católica del Ecuador, Quito, Ecuador; Pan American Health Organization, Quito, Ecuador; National School of Public Health, Havana, Cuba; National STI/HIV-AIDS Program, Ministry of Public Health, Quito, Ecuador; Pan-American Health Organization, Bogotá, Colombia; Instituto Nacional de Salud Pública e Investigación (INSPI), Guayaquil, Ecuador; Biomedical Center, Central University of Ecuador, Quito, Ecuador; Department of Biomedical Sciences, Tropical Disease Institute, Heritage College of Osteopathic Medicine, Ohio University, Athens, Ohio
| | - Mario J Grijalva
- Center for Infectious Disease Research, Pontificia Universidad Católica del Ecuador, Quito, Ecuador; Pan American Health Organization, Quito, Ecuador; National School of Public Health, Havana, Cuba; National STI/HIV-AIDS Program, Ministry of Public Health, Quito, Ecuador; Pan-American Health Organization, Bogotá, Colombia; Instituto Nacional de Salud Pública e Investigación (INSPI), Guayaquil, Ecuador; Biomedical Center, Central University of Ecuador, Quito, Ecuador; Department of Biomedical Sciences, Tropical Disease Institute, Heritage College of Osteopathic Medicine, Ohio University, Athens, Ohio
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