Browsing by Autor "Eduardo Gotuzzo"

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Arboviral Etiologies of Acute Febrile Illnesses in Western South America, 2000–2007
(Public Library of Science, 2010) Brett M. Forshey; Carolina Guevara; V. Alberto Laguna-Torres; Manuel Céspedes; Jorge Vargas; Alberto Gianella; Efraín Vallejo; César Madrid; Nicolás Aguayo; Eduardo Gotuzzo
Our data provide a better understanding of the geographic range of arboviruses in South America and highlight the diversity of pathogens in circulation. These arboviruses are currently significant causes of human illness in endemic regions but also have potential for further expansion. Our data provide a basis for analyzing changes in their ecology and epidemiology.
Correlation of Serotype-Specific Dengue Virus Infection with Clinical Manifestations
(Public Library of Science, 2012) Eric S. Halsey; Morgan A. Marks; Eduardo Gotuzzo; Víctor Fiestas Solórzano; Luis Suárez; Jorge Vargas; Nicolás Aguayo; César Madrid; Carlos Vimos; Tadeusz J. Kochel
Specific clinical manifestations, as well as groups of clinical manifestations, are often overrepresented by an individual DENV serotype.
Cost-effectiveness of active case-finding of household contacts of pulmonary tuberculosis patients in a low HIV, tuberculosis-endemic urban area of Lima, Peru
(Cambridge University Press, 2017) Lisa Shah; Marlene Rojas; Oscar Mori; Carlos Zamudio; Jay S. Kaufman; Larissa Otero; Eduardo Gotuzzo; Carlos Seas; Timothy F. Brewer
We compared the cost-effectiveness (CE) of an active case-finding (ACF) programme for household contacts of tuberculosis (TB) cases enrolled in first-line treatment to routine passive case-finding (PCF) within an established national TB programme in Peru. Decision analysis was used to model detection of TB in household contacts through: (1) self-report of symptomatic cases for evaluation (PCF), (2) a provider-initiated ACF programme, (3) addition of an Xpert MTB/RIF diagnostic test for a single sputum sample from household contacts, and (4) all strategies combined. CE was calculated as the incremental cost-effectiveness ratio (ICER) in terms of US dollars per disability-adjusted life years (DALYs) averted. Compared to PCF alone, ACF for household contacts resulted in an ICER of $2155 per DALY averted. The addition of the Xpert MTB/RIF diagnostic test resulted in an ICER of $3275 per DALY averted within a PCF programme and $3399 per DALY averted when an ACF programme was included. Provider-initiated ACF of household contacts in an urban setting of Lima, Peru can be highly cost-effective, even including costs to seek out contacts and perform an Xpert/MTB RIF test. ACF including Xpert MTB/RIF was not cost-effective if TB cases detected had high rates of default from treatment or poor outcomes.
Could clinical audit improve the diagnosis of pulmonary tuberculosis in Cuba, Peru and Bolivia?
(Wiley, 2008) Kamran Siddiqi; Anna Volz; Luisa Armas; Larissa Otero; R Ugaz; Edilberto González Ochoa; Eduardo Gotuzzo; Faustino Torrico; James Newell; John Walley
Clinical audit may drive improvements in the quality of clinical care in resource-poor settings. It is likely to be more effective if integrated within and supported by the local TB programmes. We recommend developing and evaluating an integrated model of quality improvement including clinical audit.
Cutaneous Mycobacterial Infections
(American Society for Microbiology, 2018) Carlos Franco‐Paredes; Luis A. Marcos; Andrés F. Henao‐Martínez; Alfonso J. Rodríguez‐Morales; Wilmer E. Villamil‐Gómez; Eduardo Gotuzzo; Alexandro Bonifáz
Humans encounter mycobacterial species due to their ubiquity in different environmental niches. In many individuals, pathogenic mycobacterial species may breach our first-line barrier defenses of the innate immune system and modulate the activation of phagocytes to cause disease of the respiratory tract or the skin and soft tissues, sometimes resulting in disseminated infection. Cutaneous mycobacterial infections may cause a wide range of clinical manifestations, which are divided into four main disease categories: (i) cutaneous manifestations of Mycobacterium tuberculosis infection, (ii) Buruli ulcer caused by Mycobacterium ulcerans and other related slowly growing mycobacteria, (iii) leprosy caused by Mycobacterium leprae and Mycobacterium lepromatosis, and (iv) cutaneous infections caused by rapidly growing mycobacteria. Clinically, cutaneous mycobacterial infections present with widely different clinical presentations, including cellulitis, nonhealing ulcers, subacute or chronic nodular lesions, abscesses, superficial lymphadenitis, verrucous lesions, and other types of findings. Mycobacterial infections of the skin and subcutaneous tissue are associated with important stigma, deformity, and disability. Geography-based environmental exposures influence the epidemiology of cutaneous mycobacterial infections. Cutaneous tuberculosis exhibits different clinical phenotypes acquired through different routes, including via extrinsic inoculation of the tuberculous bacilli and dissemination to the skin from other sites, or represents hypersensitivity reactions to M. tuberculosis infection. In many settings, leprosy remains an important cause of neurological impairment, deformity, limb loss, and stigma. Mycobacterium lepromatosis, a mycobacterial species related to M. leprae, is linked to diffuse lepromatous leprosy of Lucio and Latapí. Mycobacterium ulcerans produces a mycolactone toxin that leads to subcutaneous tissue destruction and immunosuppression, resulting in deep ulcerations that often produce substantial disfigurement and disability. Mycobacterium marinum, a close relative of M. ulcerans, is an important cause of cutaneous sporotrichoid nodular lymphangitic lesions. Among patients with advanced immunosuppression, Mycobacterium kansasii, the Mycobacterium avium-intracellulare complex, and Mycobacterium haemophilum may cause cutaneous or disseminated disease. Rapidly growing mycobacteria, including the Mycobacterium abscessus group, Mycobacterium chelonei, and Mycobacterium fortuitum, are increasingly recognized pathogens in cutaneous infections associated particularly with plastic surgery and cosmetic procedures. Skin biopsies of cutaneous lesions to identify acid-fast staining bacilli and cultures represent the cornerstone of diagnosis. Additionally, histopathological evaluation of skin biopsy specimens may be useful in identifying leprosy, Buruli ulcer, and cutaneous tuberculosis. Molecular assays are useful in some cases. The treatment for cutaneous mycobacterial infections depends on the specific pathogen and therefore requires a careful consideration of antimicrobial choices based on official treatment guidelines.
Research Priorities for Neglected Infectious Diseases in Latin America and the Caribbean Region
(Public Library of Science, 2010) Jean‐Claude Dujardin; Sócrates Herrera; Virgilio do Rosario; Jorge Arévalo; Marleen Boelaert; H. Carrasco; Rodrigo Corrêa‐Oliveira; Lineth García; Eduardo Gotuzzo; Theresa W. Gyorkos
Americanae nace como un proyecto conjunto que surge dentro de la Red Europea de Información y Documentación sobre América Latina (REDIAL), y que ha afrontado la Biblioteca de la Agencia Española de Cooperación Internacional para el Desarrollo (AECID). Esta nueva biblioteca virtual hace más accesibles los libros digitales de tema americanista a los investigadores y usuarios interesados de cualquier parte del mundo.