Browsing by Autor "Alessandro Bartoloni"

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A Neuroepidemiological Survey in Rural Bolivia: Background and Methods
(Karger Publishers, 1998) Alessandra Nicoletti; A. Reggio; Alessandro Bartoloni; Gaetano Failla; Filippo Bartalesi; Mimmo Roselli; Herlan Gamboa; Esteban González Salazar; Franco Paradisi; G Tempera
A door-to-door survey was carried out in rural areas of the Cordillera province, Santa Cruz Department, Bolivia. A cluster sample of 10,124 inhabitants was selected. The aim was to determine the prevalence of the most common neurological diseases (epilepsy, stroke, parkinsonism and peripheral neuropathy) in this population using a modification of the World Health Organization screening instrument. 1,130 subjects screened positive and were then investigated by neurologists. In this paper we describe the background and methods of the survey and the characteristics of the population.
Anticuerpos contra Trichinella spiralis en la población rural de la provincia Cordillera, Bolivia
(Pan American Health Organization, 1999) Alessandro Bartoloni; Gabriella Cancrini; Filippo Bartalesi; Alessandra Nicoletti; Gerardo Méndez Prado; José Rosado; Mimmo Roselli; Franco Paradisi
A seroepidemiological study was conducted to determine the prevalence of antibodies to Trichinella spiralis among rural residents of Cordillera province, Santa Cruz Department, Bolivia. Using the enzyme-linked immunosorbent assay (ELISA), 234 serum samples were examined, and antibodies were detected in seven of the samples (3%). The results document for the first time the presence of human infestation with Trichinella in Bolivia and suggest the need to strengthen trichinelosis surveillance in the municipal slaughterhouses, to prevent the clandestine slaughter of animals, and particularly to ensure that residents and meat producers in the area become aware of the dangers of this zoonosis.
Canine Trypanosoma cruzi infection in the Bolivian Chaco
(BioMed Central, 2018) Simona Gabrielli; Michele Spinicci; Fabio Macchioni; David Rojo; Valentina Totino; Patricia Rojas; Mimmo Roselli; Herlan Gamboa; Gabriella Cancrini; Alessandro Bartoloni
A cross-sectional study on Trypanosoma cruzi was carried out in 2013 to evaluate the role of dogs as possible source of infection for humans in two rural communities of the highly endemic Bolivian Chaco (Bartolo, Chuquisaca Department, n = 57 dogs; and Ivamirapinta, Santa Cruz Department, n = 48 dogs). Giemsa-stained thick and thin smears, rapid immunochromatographic test (ICT) (Chagas Quick test, Cypress Diagnostic, Belgium) and polymerase chain reaction for T. cruzi on dried blood spots were performed. All smears proved negative by microscopic examination, whereas 23/103 (22%) were positive by ICT and 5/105 (5%) blood samples contained T. cruzi DNA, evidencing the potential role of dogs in the domestic transmission of the parasite.
Carriage of Antibiotic-Resistant <i>Escherichia coli</i> Among Healthy Children and Home-Raised Chickens: A Household Study in a Resource-Limited Setting
(Mary Ann Liebert, Inc., 2011) Eleonora Riccobono; Lucia Pallecchi; Antonia Mantella; Filippo Bartalesi; Ignacio Chavez Zeballos; Christian Trigoso; Ana Liz Villagrán; Alessandro Bartoloni; Gian María Rossolini
We have previously observed high rates of acquired antibiotic resistance in commensal Escherichia coli from healthy children living in urban areas of Bolivia and Peru, including resistance to tetracycline and quinolones, which are not routinely used in childhood. In this work we investigated acquired resistance in commensal E. coli from healthy children and home-raised chickens in 12 households from one of the previously surveyed urban area in Bolivia, to ascertain the possibility of human-animal exchange of resistant strains in similar settings. The resistance rates to ampicillin, tetracycline, chloramphenicol, streptomycin, and trimethoprim-sulphametoxazole were overall high (≥50%) and comparable between children and chickens, whereas those to quinolones were significantly higher in chickens (81% vs. 29% for nalidixic acid; 43% vs. 10% for ciprofloxacin). Molecular characterization of tetracycline- and quinolone-resistant isolates (n = 66) from children and chickens of three selected households revealed a remarkable clonal diversity and, in some cases, the presence of the same resistant strains among children or among chickens living in the same household, but not between children and chickens. Several resistance plasmids were characterized, but inter-clonal plasmid dissemination was not detected. Overall, the results from the present study suggested that cross-transmission between children and home-raised chickens could not represent a major spreading mechanism for resistant E. coli in households of resource-limited settings with high human-animal promiscuity.
Comic book-based educational program on epilepsy for high-school students: Results from a pilot study in the Gran Chaco region, Bolivia
(Elsevier BV, 2020) Calogero Edoardo Cicero; Loretta Giuliano; Valeria Todaro; Chiara Colli; Sandra Padilla; Estela Vilte; Elizabeth Blanca Crespo Gómez; Walter Mario Camargo Villarreal; Alessandro Bartoloni; Mario Zappia
Effect of a health education intervention on intestinal parasitic infections in Bolivian children
(Oxford University Press, 2020) Vieri Lastrucci; Michele Spinicci; Fabio Macchioni; Simona Gabrielli; Ana Liz Villagrán; H Gamboa; Christine Halleux; Piero Olliaro; M J Caldès; Alessandro Bartoloni
Abstract Backgrounds Intestinal parasitic infections (IPI) are a major health issue for children of low- and middle-income countries. Water, sanitation and hygiene (WASH) practices are crucial for preventing IPI. The aim of the study was to evaluate the effects of a school-based health education intervention on handwashing behavior and IPI prevalence in children Methods This is a randomized intervention trial in 8 primary schools in rural communities over the course of 3 school years; preliminary results from the first two years of the trial are here presented. Schools were randomly selected and assigned in a 1:1 ratio to intervention or control (no intervention) groups. For each school year, the intervention included 14 school-based educational sessions and 2 skit events, involving children aged 8-12 years. Knowledge, attitude and practice questionnaire and handwashing at key events was assessed at the beginning and end of each school year. IPI prevalence was assessed with repeated cross-sectional parasitology surveys 12 months apart, involving a minimum of 50 children for each school Results At baseline, no significant differences between intervention and control schools were present in the proportion of children who washed their hands at key events (7.2% vs 9.3%, p = 0.28), in IPI (79.4% vs 75.3%, p = 0.3) and multiple parasitic infections (MPI) prevalences (47.6 vs. 38.6; p = 0.051). At the end of the second year, the percentage of children who washed their hands at key events was significantly higher in the intervention schools (75.4% vs 12.1%, p &lt; 0.001), and the prevalence of IPI and MPI in the intervention schools were respectively about 25% and 15% lower than in the control schools (respectively, 42.9% vs 67.8%, p &lt; 0.001; 16.1% vs 31.6%, p &lt; 0.001) Conclusions A school-based health education intervention could achieve significant changes in hand-washing behaviors and reduction in the prevalence of IPI in children. The third year survey results are needed to confirm these findings Key messages An health education intervention on water, sanitation and hygiene (WASH) practices can reduce the risk of IPI infection in children. An health education intervention on water, sanitation and hygiene (WASH) practices could be configured as a sustainable long-term approach to intestinal parasitic infections control in children.
Epilepsy and neurocysticercosis in rural areas of the Bolivian Chaco: What has changed during the last 30 years?
(Wiley, 2023) Alessandra Nicoletti; Calogero Edoardo Cicero; Valeria Todaro; Chiara Colli; Francesco Cosmi; Mariella Anselmi; Cintia Caicedo; Estela Vilte; Walter Mario Camargo; Alessandro Bartoloni
Neurocysticercosis is still endemic in the Bolivian Chaco. The proportion of epilepsy attributable to neurocysticercosis is about 22%. Systematic efforts towards elimination of neurocysticercosis in these areas should be implemented.
Epilepsy and Neurocysticercosis in Rural Bolivia: A Population‐based Survey
(Wiley, 2005) Alessandra Nicoletti; Alessandro Bartoloni; Vito Sofia; Filippo Bartalesi; Josè Rosado Chavez; Rimberto Osinaga; Franco Paradisi; Jean‐Luc Dumas; Victor C. W. Tsang; A. Reggio
Our data confirm a high frequency of NCC among a well-defined prevalent cohort of epilepsy patients.
Epilepsy-associated stigma in Bolivia: A community‐based study among the Guarani population
(Elsevier BV, 2012) Elisa Bruno; Alessandro Bartoloni; Vito Sofia; Florentina Rafael; Donata Magnelli; Sandra Padilla; Graziella Quattrocchi; Filippo Bartalesi; Higinio Segundo; Mario Zappia
Evaluation of a rapid screening method for detection of antimicrobial resistance in the commensal microbiota of the gut
(Oxford University Press, 2005) Alessandro Bartoloni; Marta Benedetti; Lucia Pallecchi; Mattias Larsson; Antonia Mantella; Marianne Strohmeyer; Filippo Bartalesi; Connie Fernandez; Elisa Guzmán; Yolanda Vallejos
The assessment of antimicrobial resistance among commensal bacteria is an indicator of the spread of antimicrobial resistance. Rapid screening methods for detection of antimicrobial-resistant faecal Escherichia coli directly on MacConkey plates have been successfully adopted but suffer from lack of standardisation. The purpose of this study was to evaluate a direct plating method (DPM) for detection of antimicrobial-resistant faecal E. coli and to compare it with a conventional method. Faecal samples were collected from 71 healthy children from Peru and Bolivia. In the DPM, a faecal swab was directly plated onto a MacConkey agar plate and antimicrobial disks were applied onto the seeded plate. Raw data were obtained by direct reading of the plate and were subjected to confirmatory analysis. Good concordance between the DPM and a conventional method was observed in detecting carriage of resistant E. coli, with a higher sensitivity for the DPM. Analysis of the results allowed interpretive criteria to be defined for DPM raw data. The DPM showed good sensitivity and specificity at very low cost (ten times cheaper than the conventional method) to investigate the faecal carriage of drug-resistant E. coli. It may represent a useful tool to conduct large-scale resistance surveillance studies and to monitor resistance control programmes cost effectively, particularly in low-resource countries.
Feasibility of a combined mobile-health electrocardiographic and rapid diagnostic test screening for Chagas-related cardiac alterations
(Oxford University Press, 2020) Niccolò Maurizi; Carlo Fumagalli; Michele Spinicci; Enrico Guglielmi; Matteo Rosselli; H Gamboa; Roberto Vargas; M. Strohmeyer; Alessandro Bartoloni; Iacopo Olivotto
Abstract Background Chronic Chagas cardiomyopathy (CChC) is the most common cause of death related to Chagas disease (CD), and it develops in 20–30% of infected individuals. However, access to both CD testing and basic cardiac care is often limited in rural deprived areas, hyperendemic for CD. Purpose To assess the feasibility of a combined mobile-health (m-Health) electrocardiographic (ECG) and rapid diagnostic test (RDT) screening for Chagas-related cardiac alterations in a remote rural village of the Bolivian Chaco, where a high prevalence of CChC is expected. Methods A representative sample of 140 healthy volunteers were consecutively enrolled in a rural Bolivian Community in February 2019. Demographic and clinical data were recorded through a standardized questionnaire. All patients performed an ECG by D-Heart, a validated low-cost hospital grade 8 and 12 lead smartphone portable ECG, and a serologic testing by Chagas Stat-Pak® (CSP). RDTs were read locally while ECGs were sent to a Cardiology clinic which transmitted reports within 24 hours from recording. Results Among 140 people (54 men, median age of 38 [23–54] years), 98 (70%, 95% CI 62.4–77.6) were positive for T. cruzi infection with CSP, with a linear, age-dependent, increasing trend (p&lt;0.001). Overall, 25 individuals (18%) showed ECG abnormalities, compatible with CD. Prevalence of ECG abnormalities was significantly higher in T. cruzi infected individuals (22 vs 7%, p=0.032). None of the study participants had performed an ECG test prior to enrolment. ECG abnormalities included Bundle Branch Blocks (n=8), 1st Degree Atrioventricular blocks (n=3), rhythm disturbances (n=5), pathologic Q waves (n=2), fragmented QRS (n=5) and low QRS voltage (n=2). Twenty-two patients with a positive CSP testing and possible CD-related ECG abnormalities were recalled from Camiri Community and referred to Gutierrez Hospital for chest X-ray and treatment initiation. At multivariate analysis, positive CSP results (OR 4.75, 95% CI 1.08–20.96, p=0.039) and smoking habit (OR 4.20, 95% CI 1.18–14.92, p=0.027) were confirmed as independent predictors of ECG abnormalities. For 6-day screening for a community of 150 inhabitants, the overall start-up amount was projected to 4.82$/patient and to 8.23$/patient when operative costs (i.e. on-site nurse and healthcare assistant with remote physician on call) were included. Conclusions Combined D-Heart® ECG and RDTs screening proved a reliable and effective low-cost strategy to identify patients at high risk of disease and in need of further cardiologic assessment, in a rural, highly endemic environments of the Bolivian Chaco. Onsite and m-Health programmes should be encouraged to support early diagnosis of CD and CChC and provide access to targeted therapy to maximize treatment benefits prior to advanced cardiac involvement. Funding Acknowledgement Type of funding source: None
High Prevalence of Acquired Antimicrobial Resistance Unrelated to Heavy Antimicrobial Consumption
(Oxford University Press, 2004) Alessandro Bartoloni; Filippo Bartalesi; Antonia Mantella; Emanuela Dell’Amico; Mimmo Roselli; Marianne Strohmeyer; Herlan Gamboa Barahona; Virgilio Prieto Barrón; Franco Paradisi; Gian María Rossolini
In a very remote rural Bolivian community where the use of antimicrobials has been minimal and where exchanges with the exterior are very limited, 67% of subjects were found to be carriers of fecal Escherichia coli with acquired resistance to >/=1 antimicrobial agent(s); the highest rates were observed for tetracycline (64%), ampicillin (58%), trimethoprim-sulfamethoxazole (50%), and chloramphenicol (41%). The most relevant implication of these findings is that, in certain settings, the spread and maintenance of antimicrobial resistance can occur, regardless of whether selective pressure generated by the use of antimicrobials is present.
Human and Porcine Hepatitis E Viruses, Southeastern Bolivia
(Centers for Disease Control and Prevention, 2012) Michael A. Purdy; Maria Chiara Dell’Amico; José L. Gonzáles; Higinio Segundo; Francesco Tolari; Maurizio Mazzei; Alessandro Bartoloni; Yury Khudyakov
To the Editor: Hepatitis E virus (HEV) genotypes 3 and 4 are considered to be primarily zoonotic (1). However, recent data indicate that both genotypes can be transmitted among humans through other routes (2,3). Observations of genetic distinctiveness between swine and human HEV strains circulating within the same region argue against exclusivity of zoonotic transmission (4). A recent report presented a remarkable example of such distinction between genotype 3 isolates in rural communities in southeastern Bolivia (5). We examined HEV sequences obtained in that study to show the independent genetic origin of swine and human variants. Findings suggest disjunction between human and swine HEV strains in this epidemiologic setting, despite the potential for extensive cross-species exposure. Using reference sequences from Lu et al. (6), we conducted subtype analysis of HEV open reading frame 2 sequences at nucleotide positions 826–1173 (GenBank accession no. {type:entrez-nucleotide,attrs:{text:AF060668,term_id:4321753}}AF060668) from isolates from 2 rural communities in southeastern Bolivia (5). Analysis showed that swine sequences belonged to subtype 3i and that the human sequences belonged to 3e. We collected all available GenBank genotype 3 sequences covering this genomic region for which the dates of collection were documented. Sequences were used to estimate the time from the most recent common ancestor (tMRCA) by using BEAST version 1.6.1 (7). Estimated tMRCA for GenBank sequences was longer than for sequences from Bolivia alone (Table) or for all genotype 3 sequences together (Table). Table Model estimates of time to most common recent ancestor for HEV ORF2 nucleotide sequences, southeastern Bolivia* To reduce the effect of close relatedness among human or swine HEV sequences from Bolivia on the tMRCA estimate, we used only 1 representative sequence per species from each community in the final analysis. This analysis identified an estimated tMRCA similar to that seen for GenBank sequences alone (Table, model F vs. model D). This estimate indicates that human and swine HEV isolates from southeastern Bolivia last shared a common ancestor ≈275 years ago (Table, model F). Thus, swine HEV strains from both rural communities belonged to subtype 3i, and the human HEV strains identified from the community of Bartolo, Bolivia, belonged to subtype 3e and shared an ancestor with swine strains almost 3 centuries ago. This finding is surprising because the community of Bartolo has several potential risk factors for zoonotic transmission of HEV. There are ≈200 humans and ≈70 swine in Bartolo (8). Residents are mainly native Quechua and Guarani with some of mixed Spanish ancestry who subsist at a low socioeconomic level. Their main livelihood activities are agriculture and breeding of animals. Free-range pig farms are family owned. Because of its impoverished state, the community has no running water, and few houses have toilets. No facilities are suitable for safely slaughtering animals (5,9). These conditions appear to create a setting in which zoonotic transmission of HEV should be common, and infection should be caused by a strain shared between swine and humans. However, the data suggest host-specific infection with distinct HEV subtypes. Although specimens were collected from 172 humans (≈86%) and 67 swine (≈96%) in Bartolo (8), zoonotically transmitted isolates may have been missed because of the sample-pooling technique used (5). Nevertheless, detection of distinct HEV strains in human and swine populations indicates possible nonzoonotic, human-to-human transmission in this community. Detection of antibodies against HEV among 7% of residents and HEV genomes in persons without serologic markers of HEV infection indicate a higher HEV prevalence in Bartolo (5). Subclinical infection detected by PCR among Bartolo residents (5), rapid decrease of HEV antibody, and uncertain sensitivity of commercial serologic assays (10) suggest that the reported extent of HEV infection is most likely an underestimate. High prevalence may generate conditions in this community that effectively prevent cross-species transmission because of frequent exposure to HEV early in life when contacts between humans and animals are limited, thus promoting host-specific transmission. This supposition is supported by the higher seropositivity seen among children 1–5 years of age and adults 41–50 years of age in Bartolo (5). Implications of these observations for understanding HEV evolution and epidemiology of HEV infections warrant further research on genetic heterogeneity of HEV strains in this region and other epidemiologic settings.
Increasing Resistance in Commensal<i>Escherichia coli</i>, Bolivia and Peru
(Centers for Disease Control and Prevention, 2008) Alessandro Bartoloni; Lucia Pallecchi; Costanza Fiorelli; Tiziana Di Maggio; Connie Fernandez; Ana Liz Villagrán; Antonia Mantella; Filippo Bartalesi; Marianne Strohmeyer; Angela Bechini
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Intestinal parasitic infections and associated epidemiological drivers in two rural communities of the Bolivian Chaco
(Open Learning on Enteric Pathogens, 2016) Fabio Macchioni; Higinio Segundo; Valentina Totino; Simona Gabrielli; Patricia Rojas; Mimmo Roselli; Grover Adolfo Paredes; Mario Masana; Alessandro Bartoloni; Gabriella Cancrini
These results highlight the need for the promotion of access to clean water, improved sanitation and better hygiene, thus reducing the frequency of preventive chemotherapy for STHs while continuing to monitor the population for possible recrudescence.
Knowledge and attitudes towards epilepsy among nonmedical health workers in rural Bolivia: Results after a long-term activity in the Chaco region
(Elsevier BV, 2018) Loretta Giuliano; Calogero Edoardo Cicero; Sandra Padilla; Mário E. Camargo; Vito Sofia; Mario Zappia; Alessandro Bartoloni; Elizabeth Blanca Crespo Gómez; Alessandra Nicoletti
Knowledge, attitudes, and practices towards epilepsy among general practitioners in rural Bolivia: Results before and after a training program on epilepsy
(Elsevier BV, 2018) Loretta Giuliano; Calogero Edoardo Cicero; Sandra Padilla; Mário E. Camargo; Vito Sofia; Mario Zappia; Alessandro Bartoloni; Elizabeth Blanca Crespo Gómez; Alessandra Nicoletti
Knowledge, stigma, and quality of life in epilepsy: Results before and after a community-based epilepsy awareness program in rural Bolivia
(Elsevier BV, 2019) Loretta Giuliano; Calogero Edoardo Cicero; Sandra Padilla; David Rojo Mayaregua; Walter Mario Camargo Villarreal; Vito Sofia; Mario Zappia; Alessandro Bartoloni; Elizabeth Blanca Crespo Gómez; Alessandra Nicoletti
Lifetime Prevalence of Bell’s Palsy in Rural Bolivia: A Door-to-Door Survey
(Karger Publishers, 2002) Alessandra Nicoletti; Vito Sofia; Alessandro Bartoloni; Filippo Bartalesi; C Marletta; Maria Luisa Lo Bartolo; José Rosado; Francesco Le Pira; A. Reggio
We carried out a door-to-door survey in rural areas of the Cordillera Province, Bolivia, to determine the prevalence of the most common neurological diseases in a sample of about 10,000 inhabitants. A team of non-doctor health workers administered a standard screening instrument for neurological diseases, a slightly modified version of the World Health Organization protocol. All subjects found positive at the screening phase underwent a complete neurological examination. On screening, we found 1,130 positive subjects, of whom 909 were aged 15 years and above. After the neurological examination, we found 52 cases who had experienced Bell's palsy during their life in the population aged 15 years and above. The lifetime prevalence on November 1, 1994 was 11.1/1,000 (95% confidence interval 7.8-14.5) for the population aged 15 years and above. The prevalence was higher in women than in men (13.7 and 8.7/1,000, respectively) and increased with age, reaching a peak in the group aged 65 years or more (31.7/1,000). Only 3 cases (5.8%) had received medical therapy.
Low prevalence of methicillin-resistant Staphylococcus aureus nasal carriage in urban and rural community settings in Bolivia and Peru
(Elsevier BV, 2012) Alessandro Bartoloni; Lucia Pallecchi; Connie Fernandez; Antonia Mantella; Eleonora Riccobono; Donata Magnelli; Dario Mannini; Marianne Strohmeyer; Filippo Bartalesi; Higinio Segundo
This study provides an insight into the epidemiology of MRSA in community settings of Bolivia and Peru. Reliable, time-saving, and low-cost methods should be implemented to encourage continued surveillance of MRSA dissemination in resource-limited countries.