Assessing the reporting of Dengue,Chikungunya and Zika to the National Surveillance System in Colombia from 2014–2017: A Capture-recapture analysis accounting for misclassification of arboviral diagnostics

BackgroundChikungunya, dengue, and Zika are three different arboviruses which have similar symptoms and are a major public health issue in Colombia. Despite the mandatory reporting of these arboviruses to the National Surveillance System in Colombia (SIVIGILA), it has been reported that the system captures less than 10% of diagnosed cases in some cities.Methodology/Principal findingsTo assess the scope and degree of arboviruses reporting in Colombia between 2014–2017, we conducted an observational study of surveillance data using the capture-recapture approach in three Colombian cities. Using healthcare facility registries (capture data) and surveillance-notified cases (recapture data), we estimated the degree of reporting by clinical diagnosis. We fit robust Poisson regressions to identify predictors of reporting and estimated the predicted probability of reporting by disease and year. To account for the potential misclassification of the clinical diagnosis, we used the simulation extrapolation for misclassification (MC-SIMEX) method. A total of 266,549 registries were examined. Overall arboviruses’ reporting ranged from 5.3% to 14.7% and varied in magnitude according to age and year of diagnosis. Dengue was the most notified disease (21–70%) followed by Zika (6–45%). The highest reporting rate was seen in 2016, an epidemic year. The MC-SIMEX corrected rates indicated underestimation of the reporting due to the potential misclassification bias.ConclusionsThese findings reflect challenges on arboviruses’ reporting, and therefore, potential challenges on the estimation of arboviral burden in Colombia and other endemic settings with similar surveillance systems.     

Brote de Salmonella enterica subsp. enterica serovar Give asociado con enfermedad transmitida por alimentos en Vichada,Colombia, 2015

IntroducciónSalmonella enterica subsp. enterica serovar Give se encuentra en mamíferos rumiantes, cerdos, aves y ambientes acuáticos, pero rara vez en humanos. En Colombia este serotipo ocupó el decimoprimer lugar en frecuencia en la vigilancia por laboratorio de la enfermedad diarreica aguda entre el 2000 y el 2013.ObjetivoCaracterizar el fenotipo y el genotipo de S. Give en aislamientos relacionados con un brote de enfermedad transmitida por alimentos en el departamento de Vichada en la quinta semana epidemiológica del 2015.Materiales y métodosSe buscó Salmonella spp. en 37 muestras de materia fecal con el método de estudio del Instituto Nacional de Salud. La muestra de sardinas enlatadas fue procesada según la norma ISO6579:2002 Cor.1:2004. Se determinó el serotipo en los aislamientos confirmados mediante serología o PCR en tiempo real, y se hicieron pruebas de sensibilidad a antimicrobianos y electroforesis en gel de campo pulsado con las enzimas Xbal y BlnI.ResultadosTodos los aislamientos de origen humano (11) y el aislamiento del alimento (1), se identificaron como S. Give y este último presentó resistencia a la tetraciclina. El análisis por PFGE-XbaI agrupó bajo el patrón COIN15JEXX01.0005 diez aislamientos de origen humano y a los restantes bajo el COIN15JEXX01.0006, con un 96,3% de similitud. Los resultados de todos los aislamientos se confirmaron con la enzima BlnI; cuatro de ellos (tres humanos y el del alimento) se agruparon bajo el patrón COIN15JEXA26.002, con un porcentaje de similitud del 95,65%.ConclusiónEl estudio confirmó que las sardinas enlatadas se relacionaron con la transmisión de S. Give en el brote, que es el tercero ocasionado por este serotipo en Colombia.Palabras clave: Salmonella, brotes de enfermedades, enfermedades transmitidas por los alimentos, vigilancia epidemiológica, Colombia     

First record of Oxytorinae (Hymenoptera: Ichneumonidae) from South America,with description of a new species of <Emphasis Type="Italic">Oxytorus</Emphasis> Förster, 1869

The monotypic subfamily Oxytorinae is recorded for the first time from South America. Oxytorus peruvianus sp. n. from a Peruvian premontane rain forest is described and illustrated. Information on the habitat and phenology of the new species is reported.     

Adaptation and performance of a mobile application for early detection of cutaneous leishmaniasis

BackgroundDetection and management of neglected tropical diseases such as cutaneous leishmaniasis present unmet challenges stemming from their prevalence in remote, rural, resource constrained areas having limited access to health services. These challenges are frequently compounded by armed conflict or illicit extractive industries. The use of mobile health technologies has shown promise in such settings, yet data on outcomes in the field remain scarce.MethodsWe adapted a validated prediction rule for the presumptive diagnosis of CL to create a mobile application for use by community health volunteers. We used human-centered design practices and agile development for app iteration. We tested the application in three rural areas where cutaneous leishmaniasis is endemic and an urban setting where patients seek medical attention in the municipality of Tumaco, Colombia. The application was assessed for usability, sensitivity and inter-rater reliability (kappa) when used by community health volunteers (CHV), health workers and a general practitioner, study physician.ResultsThe application was readily used and understood. Among 122 screened cases with cutaneous ulcers, sensitivity to detect parasitologically proven CL was >95%. The proportion of participants with parasitologically confirmed CL was high (88%), precluding evaluation of specificity, and driving a high level of crude agreement between the app and parasitological diagnosis. The chance-adjusted agreement (kappa) varied across the components of the risk score. Time to diagnosis was reduced significantly, from 8 to 4 weeks on average when CHV conducted active case detection using the application, compared to passive case detection by health facility-based personnel.ConclusionsTranslating a validated prediction rule to a mHealth technology has shown the potential to improve the capacity of community health workers and healthcare personnel to provide opportune care, and access to health services for underserved populations. These findings support the use of mHealth tools for NTD research and healthcare.     

In vitro tuberization and plant regeneration from multinodal segment culture of Habenaria bractescens Lindl., an Argentinean wetland orchid

Tuberization in many terrestrial orchids represents the most important physiological process for reproduction and survival. An in vitro controlled and reproducible tuberization and plant regeneration system was designed for Habenaria bractescens. Multinodal segments were incubated on Murashige and Skoog (MS) medium supplemented with different concentrations of N⁶-benzylaminopurine (BAP) and sucrose. After 45 days, the explants developed root tubers in vitro in 8 of the 12 media assayed. MS medium with 87.6 mM sucrose plus 4.4 μM BAP was one of the most effective for stimulating root tubers. Plants derived from in vitro root tubers were successfully transferred to the greenhouse without any acclimatization. The morphology and anatomy of the regenerated underground organs were examined to find identifying and distinguishing features. The protocol to regenerate root tubers of H. bractescens will be useful to study the basic aspects and control of tuberization and to carry out restoration programs.     

Calcium Induces Mitochondrial Oxidative Stress Because of its Binding to Adenine Nucleotide Translocase

Several studies have demonstrated that the mitochondrial membrane switches from selective to non-selective permeability because of its improved matrix Ca²⁺ accumulation and oxidative stress. This process, known as permeability transition, evokes severe dysfunction in mitochondria through the opening of a non-specific pore, whose chemical nature is still under discussion. There are some proposals regarding the components of the pore structure, e.g., the adenine nucleotide translocase and dimers of the F1 Fo-ATP synthase. Our results reveal that Ca²⁺ induces oxidative stress, which not only increases lipid peroxidation and ROS generation but also brings about both the collapse of the transmembrane potential and the membrane release of cytochrome c. Additionally, it is shown that Ca²⁺ increases the binding of the probe eosin-5-maleimide to adenine nucleotide translocase. Interestingly, these effects are diminished after the addition of ADP. It is suggested that pore opening is caused by the binding of Ca²⁺ to the adenine nucleotide translocase.     

Diagnostic performance of a Recombinant Polymerase Amplification Test—Lateral Flow (RPA-LF) for cutaneous leishmaniasis in an endemic setting of Colombia

BackgroundControl of cutaneous leishmaniasis by public health systems in the Americas relies on case identification and treatment. Point-of-care diagnostics that can be performed by health workers within or near affected communities could effectively bring the health system to the resource-limited sites providing early diagnosis and treatment, reducing morbidity and the burden of disease.Methodology/principal findingsA cross-sectional study was undertaken to evaluate the diagnostic test performance of Isothermal Recombinase Polymerase Amplification (RPA) targeting Leishmania kinetoplast DNA, coupled with a lateral flow (LF) immunochromatographic strip, in a field setting and a laboratory reference center. Minimally invasive swab and FTA filter paper samples were obtained by community health workers and highly trained technicians from ulcerated lesions of > 2 weeks’ evolution from 118 patients’ ≥ 2 years of age in the municipality of Tumaco, Nariño. Extracted DNA was processed by RPA-LF at a reference center or in a primary health facility in the field. Evaluation was based on a composite “gold standard” that included microscopy, culture, biopsy and real-time polymerase chain reaction detection of Leishmania 18S rDNA. Standard of care routine diagnostic tests were explored as comparators.Sensitivity and specificity of RPA-LF in the reference lab scenario were 87% (95%CI 74–94) and 86% (95%CI 74–97), respectively. In the field scenario, the sensitivity was 75% (95%CI 65–84) and specificity 89% (95%CI 78–99). Positive likelihood ratios in both scenarios were higher than 6 while negative likelihood ratios ranged to 0.2–0.3 supporting the usefulness of RPA-LF to rule-in and potentially to rule-out infection.Conclusions/significanceThe low complexity requirements of RPA-LF combined with non-invasive sampling support the feasibility of its utilization by community health workers with the goal of strengthening the diagnostic capacity for cutaneous leishmaniasis in Colombia.Trial registrationClinicalTrials.gov {"type":"clinical-trial","attrs":{"text":"NCT04500873","term_id":"NCT04500873"}}NCT04500873.     

Fostering equity,diversity, and inclusion in large,first‐year classes: Using reflective practice questions to promote universal design for learning in ecology and evolution lessons

Instructors can deliberately design for equity, diversity, and inclusion, including for large first‐year classes, and now instructors have added challenges given COVID‐19. Our paper explores the question: How do we integrate equity, diversity, and inclusion and universal design for learning (UDL) into first‐year, undergraduate ecology and evolution introductory lessons given the COVID‐19 pandemic? Given the large field exploring equity, diversity, and inclusion, we chose to focus on developing reflective practice question rubrics for before, during, and after lessons to encourage UDL for instructors, teaching assistants, and learners. We conducted a focus group within our team and discussed ideas related to online learning, including related pitfalls and solutions. Lastly, we created a figure to illustrate ideas and end with a general discussion. Our reflective practice questions for UDL rubrics, figure, focus group, and discussion aim to increase positive action for equity, diversity, and inclusion in the classroom and beyond.