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PubMed2000

Studies in Neotropical paleobotany. XIV. A palynoflora from the Middle Eocene Saramaguacan Formation of Cuba.

An assemblage of 46 fossil pollen and spore types is described from a core drilled through the middle Eocene Saramaguacán Formation, Camagüey Province, eastern Cuba. Many of the specimens represent unidentified or extinct taxa but several can be identified to family (Palmae, Bombacaceae, Gramineae, Moraceae, Myrtaceae) and some to genus (Pteris, Crudia, Lymingtonia?). The paleoclimate was warm-temperate to subtropical which is consistent with other floras in the region of comparable age and with the global paleotemperature curve. Older plate tectonic models show a variety of locations for proto-Cuba during Late Cretaceous and later times, including along the norther coast of South America. More recent models depict western and central Cuba as two separate parts until the Eocene, and eastern Cuba (joined to northern Hispaniola) docking to central Cuba also in the Eocene. All fragments are part of the North American Plate and none were directly connected with northern South America in late Mesozoic or Cenozoic time. The Saramaguacán flora supports this model because the assemblage is distinctly North American in affinities, with only one type (Retimonocolpites type 1) found elsewhere only in South America.

Journal Article↗

PubMed1986

Epstein-Barr viral serology in nasopharyngeal carcinoma patients in the USSR and Cuba, and its value for differential diagnosis of the disease.

Serological responses to Epstein-Barr virus (EBV)-associated antigens were studied in nasopharyngeal carcinoma (NPC) patients in 2 countries non-endemic for the disease: the USSR (77 cases) and Cuba (55 cases). Two age- and sex-matched control groups were available, one consisting of patients with other head-and-neck tumours (OHNT) (171 from the USSR and 56 from Cuba), and the other of normal individuals (blood donors) (83 from the USSR and 80 from Cuba). Unlike the control groups, NPC patients from both countries had high levels of IgG and IgA antibodies, similar to those seen in patients from endemic areas. The only difference between NPC patients in the USSR and those in Cuba was lower (2-2.5 fold) anti-VCA IgG and IgA antibody titres. Using one-factor and multi-factor statistical methods the diagnostic value of different titres of EBV-specific IgG and IgA antibodies and their combinations for NPC patients (in the USSR) was evaluated. It was found that with simple mathematical analysis of EBV-specific antibody titres a differential diagnosis of NPC could be made to a significance level of 90%. The data obtained demonstrated the importance and reliability of EBV serology in the diagnosis of NPC in areas of low incidence of the disease.

Adolescent↗

PubMedDate not supplied

The pharmaceutical industry in Cuba.

Cuba has developed a relatively sophisticated pharmaceutical sector, originally to provide medicinal products for her own population and, more recently, to earn hard currency through exports. Cuba has achieved both of these goals despite the US trade embargo, which isolates Cuba from commercial relations with US firms. Cuba is opening its economy to firms from other countries through the use of joint ventures and other forms of cooperation. US firms are unable to avail themselves of these opportunities, and the opportunities are thus being lost. In the case of pharmaceuticals, the Cubans recognize that they need assistance, particularly in the areas of marketing and packaging. Allowing the participation of US firms in the Cuban pharmaceutical industry could enhance the possibility of improving worldwide health care.

Biotechnology↗

PubMed2005

Comparing environmental issues in Cuba before and after the Special Period: balancing sustainable development and survival.

Following the Earth Summit in 1992, Cuba designed and implemented a variety of programs, administrative structures, and public awareness activities to promote sound environmental management and sustainable development. This came shortly after the fall of the Soviet Union and the strengthening of the US blockade in 1990, which resulted in a 35% drop in Cuban GDP. This period, referred to as the Special Period, witnessed a decrease in many environmentally damaging activities both by choice and by necessity, but also resulted in many decisions to resuscitate the Cuban economy. The purpose of this work was to compare and rank the environmental risks Cuba faced before and during the Special Period (1990-2000) using two Comparative environmental risk assessments (CERAs). To do so, an ecosystem integrity risk assessment matrix was constructed with 42 risk end points. The matrix assessed the risk posed by 17 problem areas including air pollution, water contamination, solid waste sites, pesticides and ecosystem degradation. The risks were calculated using five criteria: area affected, vulnerability of affected population, severity of impact, irreversibility of effect and uncertainty. To construct this matrix, both literature reviews and expert interviews in Cuba were conducted in 2000. The results showed a general decrease in risk scores during the Special Period. Before the Special Period, high risks were posed by: terrestrial degradation and industrial wastewater and sludge, followed by freshwater degradation, surface water stressors, and pesticides. After the Special Period, industrial wastewater and sludge and pesticides were no longer high-risk areas, but municipal wastewater and marine coastal degradation ranked higher than previously. Also, the risk endpoints most stressed after 1990 were affected by activities controlled by the government, such as mining and tourism, and lack of infrastructure. Therefore, the claims that public environmental education is the main pathway to sustainable development in Cuba seem uninformed and other management practices should be evaluated.

Cuba↗

PubMed2005

Origin and evolution of viruses causing classical swine fever in Cuba.

We have analyzed the origin and evolution of viruses from the classical swine fever (CSF) epidemic that affects Cuba since 2001 by nucleotide sequencing of regions within the E2 glycoprotein and the NS5B (polymerase) genes. The sequence of 190 nucleotides from E2 gene was determined for 10 CSF viruses isolated at different locations of the island, and used for phylogenetic analyses, including sequences from viruses of the 1993--1997 epizootic, previously determined, as well as those from representatives of the different CSFV genotypes. The phylogenetic tree obtained indicates that viruses circulating at present belong to the subgroup 1.2 and are closely related to those isolated during the 1993--1997 epizootic, including the strain Margarita used for vaccine potency tests in Cuba. However, the pattern of evolution revealed by these analyses was different than that observed previously, in which western isolates were almost identical to Margarita strain, while eastern isolates showed a higher level of genetic diversification. In this case, all the viruses analyzed grouped in an independent, define cluster that is closely related, albeit distinguishable, from that of Margarita-related viruses that previously circulated in the western part of Cuba. In addition, the 2001--2003 viruses showed a branched pattern with a level of sequence diversification similar to that observed in the eastern 1993--1997 viruses. Interestingly, a significant fraction (about 54%) of the mutations found in the E2 sequence led to amino acid replacements. This high rate of non-synonymous mutations was not found in the previous Cuban epizootic and has not been reported for other CSF outbreaks. In spite of these amino acid replacements, no antigenic changes were observed in the reactivity of different isolates with CSFV-specific MAbs and polyclonal sera. The phylogenetic tree derived from 409 nucleotides of NS5B gene of seven isolates and Margarita strain, was consistent with that obtained from E2 sequences. In this region, encoding a non-structural protein, a low level of fixation of non-synonymous mutations was observed. The results obtained suggests that epidemiological factors affecting CSFV spread during the current epizootic in Cuba can favour the fixation of non-synonymous mutation in the E2 gene, which could be associated with a lower severity in the clinical signs developed by most of the affected animals.

Amino Acid Sequence↗

PubMed1999

Molecular epidemiology of classical swine fever in Cuba.

The origin and evolution of the classical swine fever (CSF) epizootic that occurred in Cuba from 1993 to 1997 has been investigated by the analysis of E2 gene sequences from 15 representative viral isolates as well as the vaccine and the challenge strains used in this country. In the phylogenetic tree derived from these sequences, the Cuban isolates were located in a defined cluster within the previously reported genomic subgroup 1.2. This cluster was related, although distinguishable, from the live vaccine used in Cuba since 1965. Two further groups were identified. One of them included the early viruses isolated in the western part of Cuba until 1996 and the strain Margarita, used for vaccine potency tests since 1965. These results are consistent with the strain Margarita being the origin of the western outbreaks. The viruses isolated from 1996 in eastern Cuba defined a related, but independent group. The level of sequence variation observed in this group does not exclude an independent origin for the eastern isolates.

Amino Acid Sequence↗

PubMed1997

Emergency medicine in Cuba: report from a country in isolation.

Cuba is one of the poorest countries of the world. For the past 34 years the United States has maintained an economic embargo against Cuba. Because of this, Cuba has not been able to share in advances in American medical technology, pharmaceuticals, or research. The country has also been abandoned by the former Soviet Union. Recent political developments have assured continuation of the embargo. This report describes the current state of prehospital and emergency medical care in Cuba, how the embargo has affected emergency services, and possibilities for the future.

Cuba↗

PubMedDate not supplied

Comprehensive care and the sanatoria: Cuba's response to HIV/AIDS.

The authors present an overview of Cuba's response to HIV/AIDS including: (a) the development of comprehensive health care in Cuba; (b) the epidemiology of AIDS in Cuba; (c) the sanatoria approach to treatment and recent changes; (d) the idea of comprehensive HIV/AIDS care as a basic human right; (e) the effects of the special period on the HIV/AIDS program and containment of the epidemic; and (f) a critique of Cuba's HIV/AIDS program.

Acquired Immunodeficiency Syndrome↗

PubMed2006

A molecular epidemiological study of rabies in Cuba.

To investigate the emergence and current situation of terrestrial rabies in Cuba, a collection of rabies virus specimens was employed for genetic characterization. These data supported the monophyletic nature of all terrestrial rabies viruses presently circulating in Cuba but additionally delineated several distinct variants exhibiting limited spatial distribution which may reflect the history of rabies spread on the island. The strain of rabies currently circulating in Cuba, which emerged on the island in the early 20th century, has very close evolutionary ties to the Mexican dog type and is a member of the cosmopolitan lineage widely distributed during the colonial period. The Cuban rabies viruses, which circulate predominantly within the mongoose population, are phylogenetically distant from viruses circulating in mongooses in other parts of the world. These studies illustrate, at a global level, the adaptation of multiple strains of rabies to mongoose species which should be regarded as important wildlife hosts for rabies re-emergence. Given the recent emergence of human cases due to bat contact in Cuba, this study also included a single insectivorous bat specimen which was found to most closely resemble the rabies viruses known to circulate in Mexican vampire bats.

Animals↗

PubMed2003

Body composition by hydrometry (deuterium oxide dilution) and bioelectrical impedance in subjects aged >60 y from rural regions of Cuba, Chile and Mexico.

BACKGROUND: In Latin American and Caribbean countries such as Chile, Mexico and Cuba, the population over 60 y has increased steadily. In this age group, there is scarce information about body composition, particularly for those living in rural areas. OBJECTIVE: The purpose of this study was to determine body composition in free-living and healthy elderly subjects >60 y from rural areas of Chile, Cuba and Mexico using deuterium oxide dilution and bioelectrical impedance (BIA) and to develop and cross-validate a predictive equation for this group of subjects by BIA for future use as a field technique. SUBJECTS: The study included 133 healthy subjects (73 males and 60 females) >60 y from rural regions of Cuba, Chile and Mexico. MEASUREMENTS: Total body water, body weight, height and other anthropometric and BIA variables (resistance and reactance) were measured. METHODS: Total body water was determined by deuterium oxide dilution, and fat-free mass (FFM)/fat mass were derived from this measurement. The total sample was used in a split-sample internal cross-validation. BIA and other anthropometric variables were integrated to multiple regression model to design the best predictive equation, which was validated in the other sample. ANOVA, multiple regression and Bland and Altman's procedure were used to analyze the data. RESULTS: Body weight, percentage of fat and fat-free mass were lower in the Cuban men and women compared with Chilean and Mexican men and women. The best predictive equation of the FFM was: FFM kg=(-7.71+(H(2)/R x 0.49)+(country or ethnicity x 1.12)+(body weight x 0.27)+(sex x 3.49)+(Xc x 0.13)), where H(2) is height(2) (cm); R is resistance (Omega); country: Chile=1, Mexico=2 and Cuba=3; sex: women=0 and men=1; body weight (kg) and Xc is reactance (Omega). R(2) was 0.944 and the root mean square error (RMSE) was 2.08 kg. The mean+/-s.d. of FFM prediction was 44.2+/-9.2 vs 44.6+/-10.1. The results of cross-validation showed no significant difference with the line of identity, showing that the predicted equation was accurate. The intercept (=-0.32) was not significantly different from zero (P=0.89) and the slope (=1.02) not significantly different from 1.0 (P>0.9). The R(2) was 0.86, RMSE=3.86 kg of FFM and the pure error was 3.83. CONCLUSION: The new BIA equation is accurate, precise and showed good agreement. The use of this equation could improve the estimates of body composition for the elderly population for these regions, as well as enhancing the opportunity to conduct studies in the elderly population from Latin America.

Aged↗

PubMed1998

Hypertension in Cuba: evidence of a narrow black-white difference.

The Caribbean nation of Cuba is comprised of over 10 million persons who trace their ancestry primarily to Africa and Spain. To date, little data on blood pressure (BP) or hypertension prevalence from Cuba have appeared in English language journals. Because the current government has pursued an active policy of reducing social differentiation on the basis of ethnic origin, Cuba provides an important population laboratory from which to advance the understanding of black-white differences in BP and hypertension. The authors conducted a population-based random sample among adults (aged > 15 years) in the city of Cienfuegos. Overall response rate was 95%, yielding 1633 participants who provided BP readings, self-reported racial group, demographic information, and treatment status. Overall prevalence of hypertension (SBP > or = 140 mm Hg or DBP > or = 90 mm Hg or currently treated) was 44% (46% among blacks and 43% whites; P = 0.19). Excess BP among black subjects was reduced slightly by excluding those under treatment, but attained statistical significance after adjustment for sex and age (P = 0.01). The black-white difference was small, however, relative to that observed in the United States. Racial differences in treatment status and control were also observed. Although there remains a difference in socioeconomic profile between those of African and of European origin in Cuba, this has decreased over recent decades. In the United States, the greater magnitude of social differentiation parallels a greater relative risk of BP elevation among blacks, suggesting that social, economic and psychological factors may play an important role in the observed racial gap in cardiovascular risk.

Adolescent↗

PubMed2001

Neisseria gonorrhoeae resistant to ciprofloxacin: first report in Cuba.

BACKGROUND AND OBJECTIVES: The Cuban Ministry of Public Health plans to implement the syndromic approach to sexually transmitted diseases in persons with urethral or vaginal syndrome in Cuba using 500 mg ciprofloxacin as therapy. Although the emergence of clinical isolates of Neisseria gonorrhoeae with decreased susceptibility to ciprofloxacin have been sporadically detected in Cuba, there has been no report of isolates that exhibited significant resistance to this drug. This is the first report of the isolation of a N gonorrhoeae strain resistant to ciprofloxacin in Cuba. STUDY DESIGN: Case report. CONCLUSIONS: This case emphasizes the need for awareness regarding the potential emergence of a clinically significant resistance of N gonorrhoeae in Cuba. There is a need for continued antimicrobial susceptibility surveillance of Cuban isolates to ciprofloxacin and other fluoroquinolones.

Adult↗

PubMed2003

High percentages of resistance to tetracycline and penicillin and reduced susceptibility to azithromycin characterize the majority of strain types of Neisseria gonorrhoeae isolates in Cuba, 1995-1998.

BACKGROUND: In many regions the susceptibility of Neisseria gonorrhoeae isolates to antimicrobial agents is rarely tested. The Gonococcal Antimicrobial Surveillance Program (GASP) in Cuba was established as part of a larger regional GASP program to facilitate the collection and reporting of antimicrobial susceptibility data for N gonorrhoeae isolates. GOAL: The goal was to retrospectively determine the antimicrobial susceptibility and molecular epidemiology of 91 isolates of N gonorrhoeae isolated from 11 centers in Cuba. STUDY DESIGN: Isolates of N gonorrhoeae were collected and presumptively identified from 11 Cuban provincial health centers. They were then forwarded to the National Laboratory of Pathogenic Neisseria Havana for confirmatory identification and were subsequently analyzed at the Center for GASP in Ottawa. Isolates were tested for susceptibility to penicillin, tetracycline, spectinomycin, ceftriaxone, ciprofloxacin, and azithromycin by the agar dilution method. To establish baseline data for molecular epidemiologic profiles, the auxotype (A), serovar (S), plasmid content (P), and TetM type of the isolates were determined. Certain A/S/P classes were further analyzed by pulsed field gel electrophoresis (PFGE). RESULTS: High percentages of the 91 N gonorrhoeae isolates were resistant to penicillin (68%) and tetracycline (83.5%), with 56% being penicillinase-producing (PPNG) and 64% carrying plasmid-mediated tetracycline resistance (TRNG; 50% were PP/TRNG). An additional 14% of the isolates carried chromosomal resistance (CMRNG) to either tetracycline or penicillin or both antibiotics. All isolates were susceptible to spectinomycin, ceftriaxone, and ciprofloxacin. However, nine isolates were resistant to azithromycin (MIC, > or = 1.0 microgram/ml), and 43 other isolates displayed reduced susceptibility to this antibiotic (MIC, 0.25-0.5 microgram/ml). Although a total of 21 different A/S classes were identified, most of the isolates (61) belonged to three A/S classes: NR/IA-6 (35 isolates), NR/IB-1 (15 isolates), and P/IA-6 (11 isolates). Thirty-two of 45 PP/TRNG were A/S class NR/IA-6, and nine of the P/IA-6 isolates were TRNG. By contrast, most of A/S class NR/IB-1 (8) were CMRNG. PFGE analysis following digestion with NheI or SpeI further clustered the isolates into separate groups. CONCLUSIONS: This study demonstrates high percentages of N gonorrhoeae isolates with penicillin and tetracycline resistance in Cuba. As has been noted in other studies in the Caribbean region and Latin America, resistance and reduced susceptibility to azithromycin are developing as emerging problems. Since penicillin and tetracycline continue to be widely used for the treatment of gonococcal infections in Cuba, this study indicates the importance of antimicrobial susceptibility surveillance so that effective antibiotics may be recommended for treatment of gonococcal infections.

Anti-Bacterial Agents↗

PubMed2006

Natural and traditional medicine in Cuba: lessons for U.S. medical education.

The Institute of Medicine's (IOM's) Academy of Science has recommended that medical schools incorporate information on CAM (complementary and alternative medicine) into required medical school curricula so that graduates will be able to competently advise their patients in the use of CAM. The report states a need to study models of systems that integrate CAM and allopathic medicine. The authors present Cuba's health care system as one such model and describe how CAM (or natural and traditional medicine) is integrated into all levels of clinical care and medical education in Cuba. The authors examine the Cuban medical school curriculum in which students, residents, and practicing physicians are oriented in the two paradigms of CAM and allopathic medicine. Only health professionals are permitted to practice CAM in Cuba; therefore, Cuba's medical education curriculum incorporates not only teaching about CAM, but it also teaches basic CAM approaches and clinical skills. Both the theory and practice of CAM are integrated into courses throughout the six-year curriculum. Similarities and differences between the U.S. and Cuban approaches to CAM are examined, including issues of access and cost, and levels of acceptance by the medical profession and by the public at large in both countries. The authors conclude that there is potentially much to learn from the Cuban experience to inform U.S. medical educators and institutions in their endeavors to comply with the IOM recommendations and to incorporate CAM into medical school curricula.

Complementary Therapies↗

PubMed1998

[Eradication of measles in Cuba].

The vaccine against measles came into use in Cuba in 1971. During the seventies, a new early strategy for measles control was established, and it was followed by further efforts in the early eighties. Despite improvements to the control program, disease outbreaks continued to occur. In 1986, after examining the experience acquired through the control initiatives that were already in place, a new measles vaccination strategy was adopted. In time, the new vaccination strategy against measles came to have three main components: first, a single vaccination "catching-up" campaign targeting children 1 to 14 years of age. Second, efforts were made to achieve and maintain high vaccine coverage through mandatory vaccination services for 12-month-old children ("maintenance vaccination"). Finally, periodic "follow-up" campaigns were carried out for children 2 to 6 years of age. Steps were taken, for the purpose of monitoring the progress made so far toward eliminating measles, to strengthen disease surveillance systems, including the screening of suspected cases. The "catching-up" and "follow-up" campaigns both achieved greater than 98% coverage within targeted age groups. The routine vaccination program has also maintained high coverage. The high population immunity against measles that has been attained through these vaccination strategies has resulted in a rapid decrease in the incidence of the disease. From 1989 to 1992, less than 20 laboratory-confirmed cases were reported annually. In Cuba, the last case confirmed through serologic screening was reported in July 1993. Cuba's strategy for measles elimination has interrupted disease transmission and kept the causal virus from circulating on the island. Cuba's experience with measles elimination suggests that if an appropriate vaccination strategy is applied, measles can be globally eradicated.

Adolescent↗

PubMed2001

Genotypic resistance mutations to antiretroviral drugs in HIV-1 B and non-B subtypes from Cuba.

OBJECTIVES: To determine the prevalence of drug resistance and to analyze the subtyping in HIV-1 samples from Cuba. METHODS: From an estimated total number of 1,950 HIV-1-infected persons in Cuba, a sample of 103 patients were studied, 76 of whom had received drug treatment for HIV and 27 who had not. The RNA plasma viral load was measured, and automated sequencing was used to assess resistance mutations to reverse transcriptase inhibitors (RTIs) and to protease inhibitors (PIs). Subtyping in the V3 region was performed using heteroduplex mobility assay (HMA). In order to corroborate the HMA results, sequencing of env (C2-V3-C3) was done with one-third of the samples in each of the subtype groups detected by HMA. RESULTS: Out of the 103 samples, 81 of them (78.6%) were classified as subtype B, 19 (18.5%) as subtype A, and 3 (2.9%) as subtype C. The prevalence of resistance mutations was 26.2% to RTIs, none to PIs alone, and 3.9% to both categories of drugs. The prevalence of resistance to nucleoside RTIs (NRTIs) was 27.6% in treated patients and 7.4% in the untreated patients, and for nonnucleoside RTIs (NNRTIs) it was 5.3% and 0%, respectively. Among treated patients a low frequency (2.6%) of dual resistance to zidovudine (ZDV) plus lamivudine (3TC) and abacavir (ABC) was detected, and multidrug resistance to NRTIs was not found. In relation to PIs together with RTIs, the prevalence of resistance was 5.3% for treated patients and 0% for untreated patients. CONCLUSIONS: Even though Cuba is generally considered an area where subtype B is dominant, we detected a high proportion of non-B subtype viruses. The low prevalence of resistance mutations to RTIs and PIs reflects the delay in introducing these drugs to Cuba. Multidrug resistance to RTIs was not found, so, as of now, the use of these drugs continues to be an option for Cuban patients.

Anti-HIV Agents↗

PubMed2004

Seroprevalence of Kaposi's sarcoma-associated herpesvirus in various populations in Cuba.

OBJECTIVE: Little is known about the prevalence and distribution of Kaposi's sarcoma-associated herpesvirus (KSHV) infection in the Caribbean. The aim of this study was to determine rates of KSHV seropositivity in various populations in Cuba. METHODS: During the years 1998 to 2002 we screened serum samples from 410 subjects in Cuba. Serologic screening for KSHV antibodies was a two-step process using (1) indirect immunofluorescence assay (IFA) specifically reactive to the KSHV latency-associated nuclear antigen (LANA) encoded by open reading frame 73 (ORF73), and (2) confirmatory immunoblot using recombinant KSHV ORF65.2, a lytically expressed, 20-kilodalton protein as the target antigen. Five different populations were studied: (1) 45 AIDS patients with Kaposi's sarcoma (AIDS-KS), (2) 154 HIV-1-infected patients without clinical evidence of KS, (3) 171 HIV-negative blood donors, (4) 27 consecutive kidney transplant recipients, who were HIV-negative, and (5) 13 contacts (sexual contacts or relatives) of the AIDS-KS-affected patients. RESULTS: Among the 45 AIDS-KS subjects, 35 of them (77.8%) were KSHV-seropositive. Thirty-two of the 154 HIV-positive patients without KS (20.8% of them) were KSHV-seropositive, and 6 of the 13 contacts of KS-affected patients (46.2% of them) were infected with KSHV. In contrast to other researchers, we did not find in the populations that we studied in Cuba that KSHV seropositivity was associated with male homosexual or bisexual activity. We found high KSHV seropositivity rates among women reporting sexual contact with bisexual men and among men who had acquired an HIV infection in Africa. There were low rates of KSHV infection among the blood donors (1.2%) and the renal transplant recipients (0.0%). The low rates of KSHV infection that we found among the non-HIV-infected populations in Cuba are similar to patterns found in populations in Europe and in the United States. CONCLUSIONS: Together with similar results from Brazil, Jamaica, and the United States of America, our results suggest that KSHV infection is uncommon in some populations in the Western Hemisphere and that KSHV is largely confined to patients with AIDS-associated KS.

Adolescent↗

PubMed2004

[Latex agglutination system for the rapid diagnosis of leptospirosis in Cuba].

OBJECTIVES: To assess the sensitivity, specificity, reproducibility, and stability of five latex agglutination systems for detecting antibodies against leptospira in human and animal sera, by using the Leptospira serotypes that are most widely prevalent in Cuba. METHODS: We performed an analytic and descriptive study with 706 human sera (65 tested positive for antibodies against leptospira with microagglutination (MAT) and hemagglutination (HA) techniques; 156 sera that tested negative with MAT and HA); 485 sera from 424 patients who had clinical or epidemiologic signs of leptospirosis; and 29 animal sera (16 from equines, 6 from bovines, 5 from porcines, 1 from a canine, and 1 from an ovine). All of the samples were tested with five latex conjugates made from whole cells of Leptospira interrogans, specifically the four serogroups that circulated most widely in Cuba from 2002 to 2004. The cells obtained from cultured cell lines yielded four specific conjugates (latex-canicola, latex-icterohemorrhagiae, latexpomona, and latex-sejroe), as well as one latex conjugate made from a combination of all four serogroups in equal quantities (latex-pool). In addition, samples were tested with the commercial latex agglutination Lepto Tek Tri Dot (bioMeriuex, France) kit. The stability and reproducibility of the latex conjugates were assessed through monthly controls over a period of 6 months with positive and negative sera. RESULTS: Of the systems that were assessed, the best combination of sensitivity and specificity was obtained with the latex-Pool conjugate (93,8% and 90,4%, respectively). The best combination of positive and negative predictive values was seen with the latex-Sejroe conjugate (90,9% and 95,8%), respectively), followed by the latex-Pool conjugate (94.2% and 96.6%, respectively). The positive and negative predictive values of the Lepto Tek Dri Dot commercial system were 78.5% and 88.4%, respectively. Among the 137 patient samples that tested positive for one of the serotypes when MAT was used, latex conjugates succeeded in correctly identifying 107 (78.1%), whereas the latex-Pool conjugate detected 116 (84.7%) positive sera. When animal sera were tested, the latex-Pool conjugate detected the greatest number of positive serum samples and showed the greatest concordance with MAT (93.1%). The conjugates studied showed good stability and reproducibility. CONCLUSIONS: Latex conjugates made from whole cells of the most widely circulating leptospira in Cuba showed a degree of concordance with MAT that was similar to or better than that seen with the Lepto Tek Dri Dot commercial system, both in human and animal sera. We recommend more widespread use of the latex-Pool conjugate in Cuba in the initial screening for antibodies against leptospira.

Animals↗