Browsing by Autor "Daniel Lozano"

Now showing 1 - 18 of 18

A strategy for scaling up access to comprehensive care in adults with Chagas disease in endemic countries: The Bolivian Chagas Platform
(Public Library of Science, 2017) María‐Jesús Pinazo; Jimy Pinto; Lourdes Ortiz; Jareth Sánchez; Wilson García; Ruth Saravia; Mirko Rojas Cortez; Silvia Moriana; Enric Grau; Daniel Lozano
This strategy provides a solution to unmet demands in the care of patients with CD, improving access to diagnosis and treatment. Further scaling up of diagnosis and treatment will be based on the expansion of the model of care to the NHS structures. Its sustainability will be ensured as it will build on existing local resources in Bolivia. Still human trained resources are scarce and the high staff turnover in Bolivia is a limitation of the model. Nevertheless, in a preliminary two-years-experience of scaling up this model, this limitations have been locally solved together with the health local authorities.
Caracterización de la infestación de viviendas por Aedes aegypti en el área metropolitana de Cochabamba, Bolivia: nuevos registros altitudinales
(2016) Evelin Aquino Rojas; Mirko Rojas Cortez; Jorge Espinoza; Efraín Vallejo; Daniel Lozano; Faustino Torrico
La rapida proliferacion del vector en areas de clima calido y baja altitud, como el oriente y la amazonia boliviana, genero la necesidad de analizar la adaptabilidad del A. aegypti en zonas templadas, tal es el caso de los valles mesotermicos de la ciudad metropolitana de Cochabamba. Objetivo : l a evaluacion entomologica se realizo en una muestra de 264 viviendas seleccionadas al azar en Abril del 2016. El area de estudio abarca zonas urbanas de seis municipios (Cercado, Sacaba, Colcapirhua, Tiquipaya, Quillacollo y Vinto) del departamento de Cochabamba. El diseno para el estudio fue epidemiologico, transversal de diagnostico comunitario . Metodos : de la muestra referida, 100 viviendas se encontraron larvas de A. aegypti , que corresponde a un 38% de infestacion larvaria y un Indice Breteau de 1,0. Las llantas, turriles y recipientes desechables son un factor de riesgo para la propagacion y adaptacion del vector en nuestra region. Resultados : los hallazgos confirman la dispersion del A. aegypti con algunas regiones con mayor prevalencia (zona sud de cercado urbano, Colcapirhua y Quillacollo en el valle bajo). Tambien se evidencio por primera vez que la dispersion y colonizacion de larvas de A. aegypti en el area de estudio alcanzo una altura minima de 2 538 m/s/n/m. y una altura maxima de 2 623 m.s.n.m. Conclusiones : La prevencion y el control de A. aegypti , en la metropoli de Cochabamba va a requerir un trabajo mancomunado integral e intersectorial enfocados en una estrategia de intervencion de gestion socioambiental de corresponsabilidad y participacion comunitaria, generando como resultado un Manejo Integrado del Vector. Palabras claves : Aedes aegypti , epidemiologia, infestacion, Bolivia .
Clinical and immunological characteristics of tegumentary leishmaniasis cases in Bolivia
(Public Library of Science, 2021) Cristina Ballart; Mary Cruz Torrico; Gisela Vidal; Faustino Torrico; Daniel Lozano; Montserrat Gállego; Lilian Pinto; Ernesto Rojas; Ruth Aguilar; Carlota Dobaño
In Bolivia, parasitological diagnosis remains the reference standard in diagnosis of leishmaniasis because of its high specificity, whereas the sensitivity varies over a wide range leading to loss of cases. Until more accurate tools are implemented, all patients should be tested by both smears and culture of lesion aspirates to minimize the risk of false negatives. Our results showed higher concentrations of several cytokines in MCL compared to CL, but no differences were observed between CL and no-cases. In addition, none of the cytokines differed between primary and secondary infections. These results highlight the need of further research to identify biomarkers of susceptibility and disease progression, in addition to looking at the local cellular immune responses in the lesions.
Development and Evaluation of a Three-Dimensional Printer–Based DNA Extraction Method Coupled to Loop Mediated Isothermal Amplification for Point-of-Care Diagnosis of Congenital Chagas Disease in Endemic Regions
(Elsevier BV, 2020) Diana P. Wehrendt; Julio Alonso-Padilla; Bo Liu; Lizeth Rojas Panozo; Silvia Rivera Nina; Lilian Pinto; Daniel Lozano; Albert Picado; Marcelo Abril; María‐Jesús Pinazo
ESTIGMA Y DISCRIMINACIÓN DE PERSONAS QUE VIVEN CON VIH-SIDA EN EL SISTEMA DE SALUD ECUATORIANA
(Associação Sul-Rio-Grandense de Pesquisadores em História da Educação (ASPHE), 2024) Patricia Granja; Andrés Wilson Peña Sotomayor; Ángela Cristina Yánez Corrales; M. Molina; Daniel Lozano
Introducción: El Estigma y la discriminación de las personas que viven con VIH-SIDA (PVVS) durante la atención sanitaria es un problema de salud pública, que aun persiste en la sociedad ecuatoriana. Para comprender esta situación se analiza la situación de las PVVS a través de un modelo causa efecto construido con base a la aplicación de la teoria fundamentada. Objetivo: Describir las percepciones sobre estigma y discriminación en el sistema de salud del Ecuador, tanto de profesionales de salud como en PPVS. Método: Se utilizó el cuestionario estándar para medir el estigma y discriminación de Policy Health Project 2015, aplicándose a personal de salud, estudiantes de Enfermería con atención directa y PVVS. Con la finalidad de profundizar en las causas/factores de la discriminación se efectuaron talleres mixtos entre personal de salud y PVVS y, mediante triangulación por consenso de actores, se plantearon estrategias para minimizar el impacto del estigma y la discriminación. Debido a la pandemia por COVID-19 se emplearon medios telemáticos para el desarrollo de talleres, la cual contó con actores de Ecuador y Bolivia (estudio paralelo) y un ScienceShop final con 350 participantes, para determinar líneas de intervención. Resultados: Se identificó una mejora en la calidad de la atención brindada por los servicios de salud en los últimos años en Ecuador, aunque el estigma y la discriminación aún se perciben y se relacionan con tres grupos de factores: prestación de servicios, capacitación y actualización, y sistemas de creencias y valores. Conclusión: Analizar las causas del estigma y la discriminación contra las PVVS en el sistema de salud ecuatoriano es una poderosa estrategia para reducir actitudes estigmatizantes y discriminatorias por parte de los profesionales de la salud.
Evaluation and validation of a PrintrLab-based LAMP assay to identify Trypanosoma cruzi in newborns in Bolivia: a proof-of-concept study
(Elsevier BV, 2024) Lizeth Rojas Panozo; Silvia Rivera Nina; Diana P. Wehrendt; Aina Casellas; Lilian Pinto; Susana Méndez; Chi-Wei Kuo; Daniel Lozano; Lourdes Ortiz; María‐Jesús Pinazo
Inter-American Development Bank.
HIV and Chagas Disease: An Evaluation of the Use of Real-Time Quantitative Polymerase Chain Reaction to Measure Levels of Trypanosoma cruzi Parasitemia in HIV Patients in Cochabamba, Bolivia
(American Society of Tropical Medicine and Hygiene, 2021) Melissa Reimer-McAtee; Carolina Mejía; Taryn Clark; Jules Terle; Mónica J. Pajuelo; Jeanne Cabeza; Meredith H Lora; Edward Valencia; Rosario Castro; Daniel Lozano
This cross-sectional study evaluated epidemiologic characteristics of persons living with HIV (PWH) coinfected with Trypanosoma cruzi in Cochabamba, Bolivia, and estimated T. cruzi parasitemia by real-time quantitative polymerase chain reaction (qPCR) in patients with and without evidence of reactivation by direct microscopy. Thirty-two of the 116 HIV patients evaluated had positive serology for T. cruzi indicative of chronic Chagas disease (27.6%). Sixteen of the 32 (50%) patients with positive serology were positive by quantitative polymerase chain reaction (qPCR), and four of the 32 (12.5%) were positive by direct microscopy. The median parasite load by qPCR in those with CD4+ < 200 was 168 parasites/mL (73-9951) compared with 28.5 parasites/mL (15-1,528) in those with CD4+ ≥ 200 (P = 0.89). There was a significant inverse relationship between the degree of parasitemia estimated by qPCR from blood clot and CD4+ count on the logarithmic scale (rsBC= -0.70, P = 0.007). The correlation between T. cruzi estimated by qPCR+ blood clot and HIV viral load was statistically significant with rsBC = 0.61, P = 0.047. Given the significant mortality of PWH and Chagas reactivation and that 57% of our patients with CD4+ counts < 200 cells/mm3 showed evidence of reactivation, we propose that screening for chronic Chagas disease be considered in PWH in regions endemic for Chagas disease and in the immigrant populations in nonendemic regions. Additionally, our study showed that PWH with advancing immunosuppression have higher levels of estimated parasitemia measured by qPCR and suggests a role for active surveillance for Chagas reactivation with consideration of treatment with antitrypanosomal therapy until immune reconstitution can be achieved.
Intradomiciliary and peridomiciliary captures of sand flies (Diptera: Psychodidae) in the leishmaniasis endemic area of Chapare province, tropic of Cochabamba, Bolivia
(Elsevier BV, 2015) Cristina Ballart; Gisela Vidal; Albert Picado; Mirko Rojas Cortez; Faustino Torrico; Mary Cruz Torrico; Rodrigo Espíndola Godoy; Daniel Lozano; Montserrat Gállego
Molecular detection and parasite load of Trypanosoma cruzi in digestive tract tissue of Chagas disease patients affected by megacolon
(Elsevier BV, 2022) Lilian Pinto; Alejandro G. Schijman; Julio Alonso-Padilla; Daniel Lozano; Mary Cruz Torrico; Pietro Gamba; Margarita Torrez; Vania Lozada; Karina Cartagena; Jareth Sánchez
Multiprimer PCR System Diagnosis of Pulmonary Tuberculosis in Cochabamba, Bolivia
(American Society for Microbiology, 2007) Rudy Parrado; Daniel Lozano; Lineth García; Mary Cruz Torrico; Raúl Delgado; Faustino Torrico; Monica Laserna; Richard Reithinger
Bolivia has one of the highest incidence rates of tuberculosis (TB) in the Americas. An estimated 15,000 new cases per year are detected ([1][1]), which corresponds to an incidence rate of 112 cases per 100,000 population; 1,600 deaths due to TB are reported to occur annually ([10][2]). The actual
New chemotherapy regimens and biomarkers for Chagas disease: the rationale and design of the TESEO study, an open-label, randomised, prospective, phase-2 clinical trial in the Plurinational State of Bolivia
(BMJ, 2021) Cristina Alonso‐Vega; Julio A. Urbina; Sergi Sanz; María‐Jesús Pinazo; Jimy Pinto; Virginia Gonzalez; Gimena Rojas; Lourdes Ortiz; Wilson García; Daniel Lozano
NCT03981523.
Results and evaluation of the expansion of a model of comprehensive care for Chagas disease within the National Health System: The Bolivian Chagas network
(Public Library of Science, 2022) María‐Jesús Pinazo; Mirko Rojas Cortez; Ruth Saravia; Wilson Garcia-Ruiloba; Carlos Alberto do Nascimento Ramos; Jimy Pinto; Lourdes Ortiz; Mario Castellon; Nilce Mendoza-Claure; Daniel Lozano
After being recognized by the Chagas National Programme as a healthcare model aligned with national laws and priorities, the Bolivian platform of Chagas as an innovation, includes attributes that they have made it possible to expand the strategy at the national level and could also be adapted in other countries.
Social determinants in the access to health care for Chagas disease: A qualitative research on family life in the “Valle Alto” of Cochabamba, Bolivia
(Public Library of Science, 2021) Irène Jimeno; Nilce Mendoza; F. Zapana; Luis De La Torre; Faustino Torrico; Daniel Lozano; Claire Billot; María‐Jesús Pinazo
Intersectional disease management and community involvement are essential for deciding the most appropriate and effective actions. Education, detection, health care, and social programs engaging family units ought to be the pillars of a promising approach.
Tegumentary leishmaniasis by <i>Leishmania braziliensis</i> complex in Cochabamba, Bolivia including the presence of <i>L. braziliensis</i> outlier
(Wiley, 2021) Mary Cruz Torrico; Anna Fernández‐Arévalo; Cristina Ballart; Marco Solano; Ernesto Rojas; Eva Ariza; Sílvia Tebar; Daniel Lozano; Alba Abràs; Joaquím Gascón
Leishmaniasis is caused by protozoans of the Leishmania genus, which includes more than 20 species capable of infecting humans worldwide. In the Americas, the most widespread specie is L. braziliensis, present in 18 countries including Bolivia. The taxonomic position of the L. braziliensis complex has been a subject of controversy, complicated further by the recent identification of a particular subpopulation named L. braziliensis atypical or outlier. The aim of this study was to carry out a systematic analysis of the L. braziliensis complex in Bolivia and to describe the associated clinical characteristics. Forty-one strains were analyzed by sequencing an amplified 1245 bp fragment of the hsp70 gene, which allowed its identification as: 24 (59%) L. braziliensis, 16 (39%) L. braziliensis outlier, and one (2%) L. peruviana. In a dendrogram constructed, L. braziliensis and L. peruviana are grouped in the same cluster, whilst L. braziliensis outlier appears in a separate branch. Sequence alignment allowed the identification of five non-polymorphic nucleotide positions (288, 297, 642, 993, and 1213) that discriminate L. braziliensis and L. peruviana from L. braziliensis outlier. Moreover, nucleotide positions 51 and 561 enable L. peruviana to be discriminated from the other two taxa. A greater diversity was observed in L. braziliensis outlier than in L. braziliensis-L. peruviana. The 41 strains came from 32 patients with tegumentary leishmaniasis, among which 22 patients (69%) presented cutaneous lesions (11 caused by L. braziliensis and 11 by L. braziliensis outlier) and 10 patients (31%) mucocutaneous lesions (eight caused by L. braziliensis, one by L. braziliensis outlier, and one by L. peruviana). Nine patients (28%) simultaneously provided two isolates, each from a separate lesion, and in each case the same genotype was identified in both. Treatment failure was observed in six patients infected with L. braziliensis and one patient with L. peruviana.
Tegumentary leishmaniasis by Leishmania braziliensis complex in Bolivia: the presence of L. braziliensis outlier
(2021) Mary Cruz Torrico; Anna Fernández‐Arévalo; Cristina Ballart; Marco Solano; Ernesto Rojas; Eva Ariza; Sílvia Tebar; Daniel Lozano; Alba Abràs; Joaquím Gascón
Leishmaniasis is caused by protozoans of the Leishmania genus, which includes more than 20 species capable of infecting humans worldwide. In the Americas, the most widespread specie is L. braziliensis , present in 18 countries, including Bolivia. The taxonomic position of the L. braziliensis complex has been a subject of controversy, complicated further by the recent identification of a particular subpopulation named L. braziliensis atypical or outlier. The aim of this study was to carry out a systematic analysis of the L. braziliensis complex in Bolivia and to describe the associated clinical characteristics. Forty-one strains were analyzed by sequencing an amplified 1245 bp fragment of the hsp70 gene, which allowed its identification as: 24 (59%) L. braziliensis , 16 (39%) L. braziliensis outlier and one (2%) L. peruviana . In a dendrogram constructed, L. braziliensis and L. peruviana are grouped in the same cluster, whilst L. braziliensis outlier appears in a separate branch. Sequence alignment allowed the identification of five non-polymorphic nucleotide positions (288, 297, 642, 993 and 1213) that discriminate L. braziliensis and L. peruviana from L. braziliensis outlier. Moreover, nucleotide positions 51 and 561 enable L. peruviana to be discriminated from the other two taxa. A greater diversity, was observed in L . braziliensis outlier than in L. braziliensis - L. peruviana . The 41 strains came from 32 patients with tegumentary leishmaniasis, among which 22 patients (69%) presented cutaneous lesions (11 caused by L. braziliensis and 11 by L. braziliensis outlier) and ten patients (31%) mucocutaneous lesions (eight caused by L. braziliensis , one by L. braziliensis outlier and one by L. peruviana ). Nine patients (28%) simultaneously provided two isolates, each from a separate lesion, and in each case the same genotype was identified in both. Treatment failure was observed in six patients infected with L. braziliensis and one patient with L. peruviana .
The need for culture in tegumentary leishmaniasis diagnosis in Bolivia: A comparative evaluation of four parasitological techniques using two sampling methods
(Elsevier BV, 2023) Mary Cruz Torrico; Cristina Ballart; Anna Fernández‐Arévalo; Marco Solano; Ernesto Rojas; Alba Abràs; Fabiola Gonzales; Yercin Mamani Ortiz; Albert Arnau; Daniel Lozano
Trypanosoma cruzi-infected Panstrongylus geniculatus and Rhodnius robustus adults invade households in the Tropics of Cochabamba region of Bolivia
(BioMed Central, 2016) Mirko Rojas Cortez; María‐Jesús Pinazo; Lineth García; Mery Arteaga; Liliana Uriona; Seyla Gamboa; Carolina Mejía; Daniel Lozano; Joaquím Gascón; Faustino Torrico
The results presented here highlight the risk of Chagas disease transmission in a region previously thought not to be endemic, indicating that the Tropics of Cochabamba should be placed under permanent entomological and epidemiological surveillance.
Use of rapid diagnostic tests (RDTs) for conclusive diagnosis of chronic Chagas disease – field implementation in the Bolivian Chaco region
(Public Library of Science, 2019) Daniel Lozano; Lizeth Rojas; Susana Méndez; Aina Casellas; Sergi Sanz; Lourdes Ortiz; María‐Jesús Pinazo; Marcelo Abril; Joaquím Gascón; Faustino Torrico
Chagas disease, caused by the parasite Trypanosoma cruzi, is the neglected tropical disease with a highest burden in Latin America. Its acute stage is mostly asymptomatic and goes unnoticed. Symptoms appear at the chronic stage, which is when diagnosis is usually made. This is based on the agreement of two conventional serological tests such as Enzyme-Linked Immunosorbent Assays (ELISAs). There are commercial kits with good sensitivity and specificity but their use is impractical in many highly endemic regions with poorly equipped laboratories. Luckily, several rapid diagnostic tests (RDTs) are available for the detection of anti-T. cruzi immunoglobulins. They are easy to operate, require no cold storage, provide fast turnaround of results, and some can work with a tiny volume of whole blood as sample. With the aim to field validate their use we compared an alternative algorithm based on a combination of RDTs with the standard based on ELISAs. In both cases a third test was available in case of discordance. RDTs were implemented by mobile teams in field campaigns to detect chronic T. cruzi-infections in the Chaco region of Bolivia. ELISAs were made in the reference laboratories located in the main hospitals of Yacuiba and Villa Montes, two major cities of the region. We enrolled 685 subjects who voluntarily participated in the study and had not been treated against the disease before. The agreement between the two main RDTs was 93.1% (638/685) (kappa index = 0.86; CI 95% 0.83-0.90). In comparison to the ELISAs algorithm, the combined use of the RDTs provided a sensitivity of 97.7% and a specificity of 96.1%. These results support the use of RDTs for the diagnosis of chronic Chagas disease in the studied region, and encourage their evaluation in other regions of Bolivia and other endemic countries.