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M C Contreras

Publications and source records attributed to M C Contreras.

At least 19 recordsLinked to original sources

Evaluation of a Triatoma infestans elimination program by the decrease of Trypanosoma cruzi infection frequency in children younger than 10 years, Chile, 1991-1998.

Chagas disease is widespread in Chile, distributed in rural and periurban areas in the 7 most northern regions of the country. The principal vector of Trypanosoma cruzi is Triatoma infestans. The interruption of the domestic cycle of transmission of T. cruzi has been attempted by health education, human housing improving, and elimination of the vector by means of systematic insecticide spraying of human dwellings. Spraying with insecticides has been supported by Chile's health authorities and has been carried out for the last 12 years. A total of 13,280 children (aged up to 10 years) were randomly selected from 47 counties in the area of Chile endemic for Chagas disease, and blood samples were collected to determine the levels of antibodies to T. cruzi by indirect hemagglutination and enzyme-linked immunosorbent assay tests. The results of the tests were analyzed to determine the changes that occurred after 12 years of insecticide spraying of dwellings to eliminate T. infestans infestation. A total of 142 (1.1%) samples of children showed antibodies to T. cruzi. This rate is significantly lower than the data generated in similar studies conducted in 1982-1985. The following reduction in prevalence rates were observed in each of the 7 endemic regions of the country: region I, 5.5-0.3%; region II, 6.6-0.3%; region III, 9.8-1.0%; region IV, 7.2-2.0%; region V, 5.2-1.9%, Metropolitan region, 1.4-0.6%; and region VI, 1.4-0.4%. Serovigilance of T. cruzi antibodies level represents a novel approach that may allow the evaluation of the impact of the vector elimination program. The results identify regions that need to strengthen the efforts to reduce the insect infestation of dwellings.

Animals↗

[Parasitic and viral marker detection in pregnant adolescents and their newborn infants at risk].

We have investigated the prevalence of antibodies against Toxoplasma gondii, Trypanosoma cruzzi, Hepatitis B virus, cytomegalovirus, rubella virus, and human immunodeficiency virus in 139 adolescent pregnant women and in their high risk newborn children. The methods employed were the Sabin and Feldman reaction, complement fixation reaction, ELISA, and xenodiagnostic 30.9% of the pregnant group were seropositive for T. gondii, both mothers and newborns were IgM-negative. Two mothers (1.4%) presented anti T. cruzii antibodies, and one newborn child had circulating parasites. Related to the virological studies, 93.5% of the population were anti CMV antibodies positive and all their newborns were IgM (-) 90.6% of the adolescents were rubella positive and one was seropositive to VIH. We conclude that the prevalence found in this group of adolescent pregnant women are not significantly different to the one reported for the general pregnant women population.

Adolescent↗

Congenital Chagas disease of second generation in Santiago, Chile. Report of two cases.

Congenital Chagas disease (CChD) has been reported in different countries, mostly in Latin America. In 1987 a fatal case of CChD of second generation (CChDSG) was published. Within a period of six months--1989-1990--two cases of CChDSG were diagnosed and studied in the city of Santiago. Two premature newborns, sons of two sisters, with moderate liver and spleen enlargement, were found to have positive serology for Chagas disease and xenodiagnoses. The mothers, urban residents all their lives, without antecedents of triatomine bugs contact or blood transfusions, showed positive serology and xenodiagnoses. Their mother (grandmother of the infants), lived 20 years in a Northern rural Chagas disease endemic locality, in a triatomine infested house. Afterwards, she moved to Santiago, where she married and has resided up to now. Serology and xenodiagnoses were also positive. All the Trypanosoma cruzi infected individuals were successfully treated with nifurtimox.

Chagas Disease↗

[Epidemiological status of Chagas disease in the endemic area from Region II of Antofagasta].

During 1997 a seroepidemiological study on Chagas' disease was carried out in 18 localities of three provinces (Tocopilla, El Loa and Antofagasta) of Region II (20 degrees 56'-26 degrees South Lat.; 70 degrees 38'-67 degrees West Long.), in order to assess the impact of the control program against Triatoma infestans launched in 1988, based on insecticide spraying of dwellings. By means of ELISA and an indirect hemagglutination test for Chagas' disease blood samples from 1,034 children under 10 years of age were examined, arising a 0.5% (3 cases) positivity. Test resulted positive in 2 (0.9%) children from the locality of San Pedro de Atacama and 1 (0.4%) from Calama city, all in the age group 6-10 year-old. However, none of their dwellings were found infested with T. infestants. These results indicate that the control program has a good possibility to prevent new human infections. It is advisable to continue the seroepidemiological and entomological vigilance and remark the necessity of increasing the effort in the study of transmission through other routes, to adopt or reinforce the pertinent preventive measures.

Adult↗

[Seroepidemiological survey of human toxoplasmosis in Osorno, Region X, Chile, 1998].

A serological survey was carried out in Osorno X Region, Chile (40 degrees 21'-40 degrees 46' South lat, and 73 degrees 26' -72 degrees-46' West long.). An indirect hemagglutination test (IHAT) for toxoplasmosis was performed to 305 persons--160 blood donors and 145 with sexually transmitted disease (STD). The age of the surveyed persons (167 males and 138 females) varied between 10 and 72 years. IHAT titers > 16 were considered as positive. The general prevalence was 20.3%--21.2% in blood donors and 19.3% in persons with some STD--with no differences between males and females. However, significant differences between males and females with STD were found (35.6% and 8.1% respectively). No differences between urban and rural inhabitants were found with a slight higher prevalence in the urban ones. No antibodies against Toxoplasma gondii were detected in six AIDS patients. The importance of performing toxoplasmosis immunodiagnosis and individual prophylaxis to avoid the infection in high risk group are recommended.

Acquired Immunodeficiency Syndrome↗

[Human hydatidosis in Chile. Seroprevalence and estimate of the number of infected people].

Chile is located in the southwestern border of South America. The country is 4,329 km long and 96-342 wide. From north to south it is divided into five marked different biogeographical zones: deserts, steppes, bushes, forests (cattle raising) and austral (sheep raising). Population (June 1999) 15,017,760 (14.6% rural). Human hydatidosis is endemic in Chile. According to Ministry of Health information about 320 cases are registered each year. In order to find out the likely prevalence of human hydatidosis in Chile, a series of serosurveys was carried out in 1988-1997 throughout the total country. By using the indirect hemagglutination reaction and ELISA for hydatidosis (tests with good sensibility and specificity) 60,790 unselected apparently healthy persons: 41,399 from urban areas (16,428 blood donors, 13,894 delivering mothers and 11,077 middle grade schoolchildren) and 19,361 from rural areas--from randomly selected family groupings--were studied. A total individuals 82 (136/100,000) resulted positive: 36 (87/100,000) urban and 46 (241/100,000) rural, being the prevalence higher in rural areas, particularly in the southern austral zone (mean 1068/100,00). These figures agree with those observed in clinical epidemiological studies. In conformity with the present results, in the whole country 17,002 individuals should have hydatidosis: 10,318 urban and 6,784 rural. All these possible infected people, not necessarily should present pathology in the future, as it has been observed in autopsies from unselected individuals, performed at the Medico-Legal Service in Santiago, in whom 71.3% of diagnosed hydatosis with hydatid cysts in many different locations, was an autopsy finding.

Adolescent↗

[Standardization of ELISA IgM and IgA for immunodiagnosis of human trichinosis].

An ELISA test for trichinosis using as antigen a larvae soluble fraction from Trichinella spiralis was carried out for the detection of IgM and IgA specific antibodies in 45 serum samples from patients confirmed or suspected to have trichinosis by strong clinical and epidemiological evidences. All the patients had positive serology detected by precipitin test, bentonite floculation test, indirect hemagglutination test and ELISA IgG test. The cut-off value was determined using two criteria. Criterion A was determined in each plate, using three positive controls and two negative ones; the average of the negative controls and the weakest positive control, multiplied by a 1.2 factor was, considered the cut-off value. Criterion B was determined using the average plus three standard deviations from 64 apparently healthy persons serum samples. In both cases, three serum dilutions (1:10, 1:100 and 1:500) were used. The sensitivity of ELISA IgM was 100.0, 93.3 and 82.2% using serum dilutions of 1:10, 1:100 and 1:500 respectively (criterion A) and 100.0, 97.8 and 95.6% for the same dilutions (criterion B), whereas the values for ELISA IgA were: 100.0, 91.1 and 86.7% (criterion A) and 100.0, 100.0 and 91.1% (criterion B). In order to find out the specificity of ELISA IgM and ELISA IgA, additional 118 serum samples from individuals with other parasitoses, such as cysticercosis (18) hydatidosis (39), fascioliasis (12), toxocariasis (30), Chagas' disease (12) and individuals with non-specific eosinophilia (7), were also tested. ELISA IgM presented a specificity of 92.3, 93.4 and 97.3% (criterion A) and 96.2, 97.8 and 97.8% (criterion B) whereas the results for ELISA IgA were 97.8, 98.9 and 99.4% (criterion A) and 98.4% for the 1:10 and 1:100 dilutions and 100.0% for the 1:500 dilution (criterion B). The positive predictive values of ELISA IgM were 76.3, 77.8 and 88.1% (criterion A) and 86.5, 91.7 and 91.5% (criterion B) whereas the negative ones were 100.0, 98.3 and 95.7% (criterion A) and 100.0, 99.4 and 98.9% (criterion B). The positive predictive values of ELISA IgA were 91.8, 95.3 and 97.5% (criterion A) and 93.8, 93.8 and 100.0% (criterion B) whereas the negatives ones were: 100.0, 97.8 and 96.8% (criterion A) and 100.0, 100.0 and 97.8% (criterion B). The use of ELISA IgM and ELISA IgA in the immunodiagnosis of trichinosis is discussed.

Adult↗

[Diagnostic use of ELISA, IgG, IgM, IgA and ELISA IgG avidity in recent and chronic toxoplasmosis].

Toxoplasmosis, a world-wide zoonotic infection, is generally asymptomatic and benign in immunocompetent individuals, but it can be serious in immunodeficiencies particularly in patients with acquired immunodeficiency syndrome and in children infected in utero. So, it is important to dispose methods which permit discriminate between recent and chronic infections. In order to contribute to improve the diagnosis of toxoplasmosis ELISA IgG, IgM, IgA and ELISA IgG avidity were performed in 15 and 24 sera from patients suspected of having acute and chronic infection respectively, according dye test (DT) titres. ELISA IgG was positive in both groups, ELISA IgM was positive in 78.6 and 58.3% respectively, while ELISA IgA was positive in 85.7 and 33.3% of recent and chronic group respectively. In those sera with low IgG avidity (18.8%) we found specific IgM in 71.5 and 4.2% and IgA in 78.6 and 0.0% of recent and chronic groups respectively. Parallelling, 208 sera samples were classified according to the results of DT, indirect hemagglutination and complement fixation tests in the following groups: acute (97), intermediate (36), chronic (35) and negative (40). The results were: acute (96.9-64.9-55.6 and 65.9%); intermediate (97.2-63.8-44.4 and 47.2%); chronic (45.7-42.8-5.7 and 34.3%) for IgG, IgM, IgA and low IgG avidity respectively. The use of both acute markers, IgA and low IgG avidity in the diagnosis of toxoplasmosis is discussed.

Animals↗

[Comparison of Trypanosoma cruzi infection in less than 10 years old children from the V Región, Chile, 1982-1995].

Evaluation of desinsectation programs carried out in the two Health Services from the V Region, was undertaken by comparing serologic prevalences of T. cruzi infection age groups exposed to the risk of infection in rural areas during the antivectorial campaign activities (1982 vs 1995). Thus, were studied 2,193 blood samples from children under 10 years of age, proceeding from six chagasic endemic provinces in which antitriatomic domiciliary insecticide sprayings had been performed. Indirect hemagglutination and ELISA tests were carried out to each of the blood samples. A total de 42 (1.9%) children resulted positive. As in five counties no positive cases were detected in the last five years it is possible to assume that vector transmission of T. cruzi should have been interrupted in them. When comparing prevalences existing in 1982 with the present ones, it is possible to observe a 63.5% of reduction of transmission in the V Region, been this reduction higher in the Aconcagua Health Service with 79.6% and lower in the Viña del Mar--Quillota Health Service with 55.6%. According to these results, comparison of prevalence of T. cruzi infection in children less than 10-year-old in diverse periods, allows evaluate the vectorial control of Triatoma infestans programs.

Animals↗

[Chagasic infection in blood donors from hospitals in endemic regions of Chile (1982-1987). Epidemiological impact of the problem].

Chagas' disease, produced by Trypanosoma cruzi and transmitted by hematophagous triatomine bugs, exists in the Western Hemisphere from the south-western United States to central Chile and Argentina. It exists in rural and periurban sections of the northern half of Chile, with a prevalence of 16.9%. Constant rural-urban migrations have contributed to its spreading to urban sections. In order to investigate the impact of these migrations on the population susceptible of being blood donors and the probable increasing of the risk of T. cruzi transmission by blood transfusion, epidemiological surveys were carried out in donors from 22 hospitals located in the northern half of Chile. By means of an indirect hemagglutination test for Chagas' disease 16,841 blood donors were examined, arising a 2.7% of positivity, percentage that permitted to estimate that 126,477 potential blood donors infected with T. cruzi should be in the urban sections studied. These facts strengthen the need that serology for Chagas' disease must be routinely performed in endemic regions of the country, to adopt or reinforce the pertinent preventive measures.

Adolescent↗

[Usefulness of the ELISA-IgG test in sera and filter paper blood eluates in the Chagas disease immunodiagnosis].

An ELISA-IgG test using a soluble extract of Trypanosoma cruzi antigen has been developed. One hundred and seventy eight sera (74 healthy people, 44 chagasic patients with positive xenodiagnosis and 60 with clinical symptoms), and 64 paper filter blood eluates (35 healthy people, 10 chagasic patients and 19 with clinical symptoms) were tested by ELISA-IgG and an indirect hemagglutination test. Both types of methods presented an overall average concordance of 98.3% and 100.0% with sera and filter paper blood eluates respectively. A cut off (average of optical density plus 3 standard deviations) of 0.365 and 0.379 for sera and eluates was found. The use of ELISA-IgG in Chagas' disease clinical diagnosis and seroepidemiological studies is discussed.

Antigens, Protozoan↗

[Overview of the epidemiology of Chagas' disease in Chile].

Chile is a long and narrow country located in the south western coast of South America. Chagas' disease exists in the seven first (18 degrees 30'-34 degrees 36' South lat.) of the total of thirteen administrative regions of the country. In the 1982-1990 period a series of studies considering different epidemiological aspects of this parasitic zoonosis has been carried out with the following results: 5,601 rural of periurban dwellings were surveyed for the presence of Triatoma infestans (the most important and almost exclusive vector of Trypanosoma cruzi in Chile). 37.4% of the dwellings were infested according to the inhabitants and 29.4% were found infested according to the presence of tracks or insects captured. In 659 (17.2%) out of 3,822 T. infestans captured and examined T. cruzi was found in their abdominal contents. The most common sources of T. infestans feeding were mammals (89.0%), including man, and birds (9.5%). An indirect hemagglutination test (IHAT) for Chagas' disease, a very sensitive and specific reaction, was performed to 5,050 domestic mammals, resulting positive 7.9% of cats, 7.0% of dogs, 7.0% of goats, 4.9% of sheep and 4.1% of rabbits. 2,579 (16.9%) out of 15,418 persons were positive for the IAHT for Chagas' disease. The rates of infection were rather similar in males (17.5%) and females (16.2%) with an increase in infection rates in accordance with increase of age of individuals. The overall frequency of ECG abnormalities in positive IHAT persons was 18.7% against 8.8% in those with negative IHAT, whereas ECG abnormalities considered as suggestive of a chagasic etiology were 6.8% and 2.2% respectively. The esophageal motility in 311 persons with a positive IHAT and in 150 with a negative IHAT was found altered in 42.8% and 18.7% respectively. In the corresponding urban sectors of the 7 regions mentioned 2.7% of blood donors, 2.3% of delivering mothers, 2.6% of newborns and 0.6% of school children had positive IHAT. 646 chagasic women and 709 non-chagasic women in their reproductive span of life, and the products of the pregnancies that they had in a 6-year period were followed-up. No significant differences were found neither in the number nor in the evolution of pregnancies in both groups of mothers. Xenodiagnosis of children from chagasic mothers resulted positive in 6.3-8.9%, showing the transmission of T. cruzi by the placental route. Recently, 3 cases of congenital Chagas' disease of second generation have been demonstrated.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗

[Yielding of xenodiagnosis, according to the number of boxes used in 1,181 persons with chronic chagasic infection diagnosed with indirect hemagglutination reaction].

A study for evaluation of the yielding of xenodiagnosis (XD) in 1,181 persons with a previous positive indirect hemagglutination test (IHAT) for Trypanosoma cruzi infection was carried out. The infection of these people was detected during epidemiological surveys performed in rural-periurban and urban sections of the endemo-enzootic area of Chagas' disease in Chile, which involves the first seven, out of the thirteen political-administrative regions of the country. The sex distribution was 75.0% females and 25.0% males, varying the ages between 2 and 80 years. According to individual and geographical possibilities each person was submitted to 1-8 XD, which consisted in cylindrical wooden boxes containing seven third instar nymphs, laboratory reared, of Triatoma infestans. The boxes, covered with a piece of tulle fixed with a rubber band were applied on the skin of the posterior side of the arm of the subject to be examined, held with a linen bracelet during 25-30 min. After the insects were fed the boxes were maintained in the laboratory at 27 degrees C and 85% relative environmental humidity. Posteriorly, all the nymphs of each box were examined at 30, 60 and 90 days after the application. A drop of abdominal content of each of them, homogenized with a drop of saline, was examined at the microscope looking for T. cruzi. XD resulted positive in 503 (42.6%) people. The positiveness of XD showed a trend of increasing according to the number of boxes used, from 11.4% with one to 51.6% with six. Under a practical point of view, the simultaneous application of four XD boxes seems to be advisable.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

[Chagas disease in the Chilean altiplane. Epidemiological, parasitological, and clinical aspects].

Chagas' disease is endemo-enzootic in periurban and rural sections of the first seven (18 degrees 30'-34 degrees 36' South lat.), out of the thirteen political-administrative regions of Chile. Permanent inhabited localities situated at different altitudes over the sea level (OSL) are classified in: coastal settlement (0-1,499 m OSL), intermediate settlement (1,500-3,000 m OSL) and altiplano settlement (> 3,000 m OSL). A total of 1,558 dwellings and their occupants from regions I and II were surveyed in 1982-1984 for different epidemiological Trypanosoma cruzi infection parameters. Hence, 261 dwellings, 189 domestic mammals and 517 people (ages 5- > or = 60 years) from the Altiplano settlement were studied. The results obtained were: 4(1.5%) and 2(0.8%) of dwellings infested with Triatoma infestans, according to occupants information and by observation of direct evidences respectively; 8(4.2%) animals (1 dog, 4 goats and 3 sheep) with a positive hemagglutination test (IHAT) for Chagas' disease; 21 people (4.1%) with a positive IHAT; 4(19.0%) and 3(14.3%), out of the 21 IHAT positive individuals with all types of electrocardiogram (EKG) abnormalities and EKG abnormalities suggestive of a chagasic etiology respectively, whereas 65(13.1%) and 15(3.0%), out of the 496 IHAT negative ones presented the same kinds of EKG abnormalities.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

[Household chagasic endemia detected as a consequence of a case of congenital infection].

During a study on prevalence of parasitic and viral serological markers in pregnant adolescents, a 17-year-old primipara from Polpaico, village near Santiago, gave birth to a normal male newborn in a Santiago hospital. As both of them presented positive an indirect hemagglutination test (IHAT) for Chagas' disease and the corresponding xenodiagnosis (XD), the infection in the infant was considered to be acquired through the placental route. According to recent epidemiological surveys Polpaico is an endemo-enzootic chagasic rural settlement, where 14.7% of dwellings were infested with Triatoma infestans, while triatominae, persons and domestic mammals were found infected with Trypanosoma cruzi. One month later the adolescent mother, her son and other 11 consanguineous members of the family were visited in their homes in order to submit each of them to a physical examination and to IHAT for Chagas' disease, and XD to those whose IHAT resulted positive. Thus, in 7 (53.8%) the IHAT was positive and in 4 (57.1%) out of these 7 presented positive the XD, results that as a whole yielded a household chagasic endemics.

Adolescent↗

[Seroepidemiological study of human hydatidosis and trichinosis, with the indirect hemagglutination reaction, in San Juan de la Costa County. Osorno, X Region, Chile. 1990-1991].

San Juan de la Costa County (40 degrees 45' South lat., 73 degrees 19' West long.) is located in the Osorno province, South of Chile. Its population is 8,486 inhabitants. The basic economic activities are agriculture, cattle raising, timber production and manufacture of wood and coal. According to official reports, the incidence of human hydatidosis and trichinosis in this locality in 1989 were 24 and 59 per 100,000 respectively. In order to contribute to a better knowledge of the epidemiology of human hydatidosis and trichinosis in San Juan de la Costa County, an indirect hemagglutination test (IHAT) for these parasitoses was performed to 511 randomized people. Nine (1.8%) individuals resulted positive for hydatidosis and twenty four (4.7%) were positive for trichinosis. Some considerations on the corresponding prophylactic measures are proposed.

Adolescent↗