Browsing by Autor "Tinajeros, Freddy"

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Early identification of patients with Chagas disease at risk of developing cardiomyopathy using 2-D speckle tracking strain: Win, Miranda prediction of Chagas cardiomyopathy
(IJC Heart & Vasculature, 2025) Win, Sithu; Miranda-Schaeubinger, Monica; Durán Saucedo, Ronald Gustavo; Carballo Jimenez, Paula; Flores, Jorge; Mercado Saavedra, Brandon; Camila Telleria, Lola; Raafs, Anne; Verastegui, Manuela; Bern, Caryn; Tinajeros, Freddy; Heymans, Stephane; Marcus, Rachel; Gilman, Robert H.; Mukherjee, Monica
DOI: 10.1016/j.ijcha.2022.101060 | Background: Chagas disease is an endemic protozoan disease with high prevalence in Latin America. Of those infected, 20–30% will develop chronic Chagas cardiomyopathy (CCC) however, prediction using existing clinical criteria remains poor. In this study, we investigated the utility of left ventricular (LV) echocardiographic speckle-tracking global longitudinal strain (GLS) for early detection of CCC. Methods and results: 139 asymptomatic T. cruzi seropositive subjects with normal heart size and normal LV ejection fraction (EF) (stage A or B) were enrolled in this prospective observational study and underwent paired echocardiograms at baseline and 1-year follow-up. Progressors were participants classified as stage C or D at follow-up due to development of symptoms of heart failure, cardiomegaly, or decrease in LVEF. LV GLS was calculated as the average peak systolic strain of 16 LV segments. Measurements were compared between participants who progressed and did not progress by two-sample t-test, and the odds of progression assessed by multivariable logistic regression. Of the 139 participants, 69.8% were female, mean age 55.8 ± 12.5 years, with 12 (8.6%) progressing to Stage C or D at follow-up. Progressors tended to be older, male, with wider QRS duration. LV GLS was −19.0% in progressors vs. –22.4% in non-progressors at baseline, with 71% higher odds of progression per +1% of GLS (adjusted OR 1.71, 95% CI 1.20–2.44, p = 0.003). Conclusion: Baseline LV GLS in participants with CCC stage A or B was predictive of progression within 1-year and may guide timing of clinical follow-up and promote early detection or treatment.
Genome Sequences of Chikungunya Virus Isolates from Bolivia.
(2020) França, Caio M B; Loayza, Roxana; Roca, Yelin; Montaño Arias, Ana Maria; Tinajeros, Freddy; Loaiza, Jose R; Takyar, Anshule; Gilman, Robert H; Miller, Matthew J
We generated nine coding-complete chikungunya virus genome sequences from blood samples collected during the early 2015 outbreak in Bolivia. Relative to other publicly available chikungunya sequences, the Bolivian samples represent a monophyletic group, suggesting that a single lineage was widely circulating in the country between February and May 2015.
[Health-worker barriers to syphilis screening in pregnant women in Bolivia's Los Andes network].
(2017) Tinajeros, Freddy; Ares, Lucila Rey; Elías, Vanessa; Reveiz, Ludovic; Sánchez, Franz; Mejía, Martha; Hernández, Rosalinda; Revollo, Rita
OBJECTIVE: Identify health-worker barriers that keep pregnant women who receive prenatal care from being screened for syphilis (Los Andes Health Network, Bolivia). METHODS: Semi-structured interviews were done with 46 health care providers and 249 clinical health records of pregnant women were analyzed in eight public health facilities in the Los Andes network. RESULTS: Health-worker barriers to syphilis screening in pregnant women included lack of time by personnel to raise awareness of the benefit of syphilis screening; some mentioned that syphilis tests should only be done in facilities that attend deliveries and have a laboratory; lack of communication between clinicians and laboratory personnel; and problems with provision of supplies and reagents. The clinical record review found that only 55.4% contained syphilis laboratory results and only 37.4% of perinatal clinical histories had records of laboratory results. The interviews found that providers believe that syphilis screening is done in 100% of pregnant women receiving prenatal care. CONCLUSION: Syphilis screening is not being done according to Bolivia's strategy for the elimination of congenital syphilis, and is not done on more than half of pregnant women in prenatal care with perinatal clinical history records. This is not perceived by health professionals and can become a barrier to syphilis screening in pregnant women.