Las enfermedades metaxénicas en el Perú constituyen uno de los principales problemas de salud, teniendo gran impacto sobre la salud pública nacional; debido a esta problemática se planteó la pregunta de investigación ¿cuál es el rol de la enfermera en la prevención y control del dengue, chikungunya y zika en red de servicios de salud de Chiclayo, Perú 2017?, tuvo como objetivos describir y analizar el rol de la enfermera (o) en la prevención y control en la red de servicios de salud Chiclayo. Teniendo como bases teórico conceptuales al autor Ayuso D. en su libro enfermería familiar y comunitaria, y la norma técnica peruana de prevención y control de enfermedades metaxénicas. Esta Investigación fue de tipo cualitativa con abordaje metodológico estudio de caso. Los sujetos de estudio fueron 10 enfermeras de los centros de salud de la red de servicios de salud Chiclayo escenario II y III según riesgo entomológico. El tamaño de la muestra se determinó con técnica de saturación y redundancia, se utilizó la entrevista semiestructurada para la recolección de datos, siendo analizadas en tres fases: pre análisis, codificación, categorización. Así mismo se tuvo como base los principios éticos y los criterios de rigor científico. Del análisis realizado se obtuvo como resultado cuatro categorías: Educación para la prevención y control de enfermedades como dengue, chikungunya y zika, cuidado de enfermería en la vigilancia epidemiologia y entomológica, limitantes para la prevención y control de enfermedades antes mencionadas y concertación multisectorial en enfermería en enfermedades de vigilancia epidemiológica. / Tesis

Background: Arboviral diseases has reemerged in the last years affecting primarily the coast of Peru. Piura is an endemic region of Dengue, where the recent appearance of Chikungunya (CHIKV) and Zika (ZIKV) has been renewed. Aim: To assess the presence of DENV, CHIKV, and ZIKV in serum samples of patients with acute febrile illness in a locality of Piura, Peru and describe associated clinical features. Methodology: Descriptive cross-sectional study, sampling was done for convenience where it was obtained a total of 496 serum samples from patients with acute febrile illness were collected from 18 primary care centers. All samples were analyzed via real-time RT-PCR to detect DENV, CHIKV, and ZIKV. In addition, positive samples for DENV were also processed for serotypes 1 to 4 classification via RT-PCR. Results: DENV was the most common arbovirus detected in 170/496 (34.3%), followed by ZIKV in 39/496 (7.9%) and CHIKV in 23/496 (4.6%). Among the 170 samples positive for DENV, serotype 2 was the most predominant type present in 97/170 (57.1%) of samples, followed by the serotype 3 in 9/170 (5.3%). Headaches, muscle pain, and joint pain were the most common symptoms associated with fever in patients with DENV and ZIKV. No symptoms predominance was observed in patients with CHIKV. Conclusions: DENV is considered the most frequent arbovirus in Peru and the number of cases has increased dramatically in the last 5 years. However, it is not the only arbovirus that circulates along the northern coast of Peru. It has also been determined the presence of ZIKV and CHIKV in our population, which may suggest the circulation of other arboviruses that have not been detected. / Tesis

Reproduction de : Thèse d'exercice : Médecine. Médecine générale : Paris 12 : 2008. / Titre provenant de l'écran-titre. Bibliogr. f. 61-66.

Aedes albopictus et Aedes aegypti sont des moustiques vecteurs d’arbovirus tels que le virus de la dengue et le virus du chikungunya. En plus des virus transmis, les moustiques hébergent également des bactéries dont certaines affectent la biologie des hôtes. Par exemple, la bactérie Wolbachia infecte naturellement Aedes albopictus. Comme chez la plupart des insectes, cette bactérie est un parasite qui manipule la reproduction du moustique et peut également interagir avec certains pathogènes, modifiant ainsi la transmission du pathogène par le moustique hôte. Hors Wolbachia, peu d’études ont été consacrées à l’étude des populations bactériennes hébergées par les moustiques du genre Aedes et aux interactions entre ces populations bactériennes et les arbovirus transmis. Dans ce contexte, le travail de cette thèse a consisté à caractériser la diversité des communautés bactériennes des moustiques du genre Aedes et à explorer l’interférence possible entre le compartiment bactérien et le virus chikungunya. L’utilisation de techniques telles que les isolements bactériens, l’amplification par PCR, la DGGE et l’hybridation in situ ont permis de détecter et localiser certaines bactéries présentes chez des populations naturelles et de laboratoires d’Aedes. Ces populations appartiennent aux Alpha, Beta et Gammaprotéobactéries ainsi qu’aux Firmicutes. L’étude de la dynamique des communautés bactériennes symbiotiques et de l’infection par le virus chikungunya chez Aedes albopictus par PCR quantitative et puces taxonomiques a révélé l’existence d’interactions entre les différents partenaires de ce système vectoriel / Aedes albopictus and Aedes aegypti transmit a large number of arboviruses, including dengue and chikungunya. In addition to viruses, mosquitoes harbour other symbionts that are able to affect its biology. For instance, the bacterium Wolbachia infects naturally Aedes albopictus. As for many insects, this bacterium is an obligate parasite that manipulates the host reproduction and can also interact with pathogens, modifying the transmission of the pathogens by the mosquitoes. Except Wolbachia, little is known about the bacteria associated with Aedes mosquitoes. First, we detected and localized bacteria in field-caught and laboratory populations of Aedes, using culture and non-culture methods including PCR, DGGE and in situ hybridization. The bacterial populations belonged to Alpha, Beta and Gammaproteobacteria as well as to Firmicutes. Then, the effects of chikungunya infection on Wolbachia and total bacterial community were measured using quantitative PCR and taxonomic microarrays. Results showed interactions between the different partners in this vectorial system

Las enfermedades metaxénicas en el Perú constituyen uno de los principales problemas de salud, teniendo gran impacto sobre la salud pública nacional; debido a esta problemática se planteó la pregunta de investigación ¿cuál es el rol de la enfermera en la prevención y control del dengue, chikungunya y zika en red de servicios de salud de Chiclayo, Perú 2017?, tuvo como objetivos describir y analizar el rol de la enfermera (o) en la prevención y control en la red de servicios de salud Chiclayo. Teniendo como bases teórico conceptuales al autor Ayuso D. en su libro enfermería familiar y comunitaria, y la norma técnica peruana de prevención y control de enfermedades metaxénicas. Esta Investigación fue de tipo cualitativa con abordaje metodológico estudio de caso. Los sujetos de estudio fueron 10 enfermeras de los centros de salud de la red de servicios de salud Chiclayo escenario II y III según riesgo entomológico. El tamaño de la muestra se determinó con técnica de saturación y redundancia, se utilizó la entrevista semiestructurada para la recolección de datos, siendo analizadas en tres fases: pre análisis, codificación, categorización. Así mismo se tuvo como base los principios éticos y los criterios de rigor científico. Del análisis realizado se obtuvo como resultado cuatro categorías: Educación para la prevención y control de enfermedades como dengue, chikungunya y zika, cuidado de enfermería en la vigilancia epidemiologia y entomológica, limitantes para la prevención y control de enfermedades antes mencionadas y concertación multisectorial en enfermería en enfermedades de vigilancia epidemiológica.

Arbovirus infections are widespread, and their disease burden has increased in the past decade. In Africa, arbovirus infections and fever with unknown etiology are common. Due to the lack of well-established epidemiologic surveillance systems and accurate differential diagnosis in most African countries, little is known about the prevalence of human arbovirus infections in Africa. The aim of this review is to summarize the available epidemiological data and diagnostic laboratory tools of infections with dengue, yellow fever, Zika, and chikungunya viruses, all transmitted by Aedes mosquitoes. Studies indicate that these arboviral infections are endemic in most of Africa. Surveillance of the incidence and prevalence of the infections would enable medical doctors to improve the diagnostic accuracy in patients with typical symptoms. If possible, arboviral diagnostic tests should be added to the routine healthcare systems. Healthcare providers should be informed about the prevalent arboviral diseases to identify possible cases.

Le virus Chikungunya (CHIKV), arbovirus en pleine ré-émergence, a envahi rapidement de nombreuses zones géographiques du monde. La propagation mondiale de ce virus constitue une menace pour la santé humaine car il n'y a pas de vaccin ou d'agents antiviraux appropriés pour contrôler l'infection virale. La transmission du virus s’effectue lors de la piqure d’un moustique infecté du genre Aedes, qui injecte sa salive contenant le virus dans la peau de l’hôte humain. Afin de contrôler la dissémination du virus, il est primordial de développer des recherches sur l’identification de molécules antivirales et de comprendre les mécanismes moléculaires impliqués dans les interactions hôte-virus et/ou vecteur-virus-hôte. En utilisant différentes stratégies moléculaires et cellulaires, nous avons étudié le potentiel antiviral de l'Imipramine, une molécule déjà commercialisée et qui a la capacité de perturber le transport du cholestérol intracellulaire. Nous avons démontré que cette molécule est capable d'inhiber la réplication du CHIKV dans les fibroblastes cutanés humains. Nous avons mis en évidence que l'Imipramine affectait à la fois les étapes de fusion et de réplication pendant le cycle de réplication du virus. En outre, la molécule a également fortement inhibé la réplication de plusieurs Flavivirus comme le virus Zika (ZIKV), le virus du Nil occidental et le virus de la Dengue. Nous avons également déterminé le profil protéomique global des fibroblastes humains infectés par le CHIKV ou le ZIKV. Cela nous a permis de mettre en évidence les modulations significatives de plusieurs protéines stimulées par l'interféron et de protéines impliquées dans à la défense anti-virale dans les cellules infectées. Plus important encore, nos résultats montrent pour la première fois le rôle de la protéine SAMHD1 dans l'infection des fibroblastes cutanés par les arbovirus. Enfin, compte tenu des fortes interactions entre l’hôte, le vecteur et le CHIKV, l'effet de la salive du moustique Ae. Aegypti sur l'infection virale a été étudié. À notre connaissance, cette étude est la première à montrer l’importance de la salive d’Ae. aegypti sur la facilitation de l’infection du CHIKV, dans des fibroblastes cutanés, à travers la régulation des gènes impliqués dans la réponse interféron de type I. / Chikungunya virus (CHIKV) is a re-emerging mosquito-borne alphavirus that has been spread worldwide. The dissemination of this virus is a threat to human health since there is no approved vaccine or appropriate antiviral agents to control viral infection. The global expansion of the virus is preceded by biting of infected Aedes mosquitos, which injects saliva containing the virus into the skin of the human host. Searching for effective antiviral compounds and understanding of the molecular mechanisms involved in host-virus or vector-virus-host interactions are crucial for controlling viral spread.Using different molecular and cellular strategies, we demonstrated that the FDA approved drug, imipramine, which has the capability to disturb intracellular cholesterol transport inhibits CHIKV replication in human skin fibroblasts. Imipramine was found to affect both the fusion and replication steps of the viral life cycle. Moreover, it also strongly inhibited the replication of several Flaviviridae family members, including Zika, West Nile and Dengue virus. We have also determined the global proteomic profile of Chikungunya and Zika virus infected human skin fibroblasts, and found that several interferon-stimulated proteins and antiviral response proteins are significantly up-regulated in the infected cells. More importantly, our results also provided for the first time a role of SAMHD1 in arbovirus infection of human skin fibroblasts. Finally, we demonstrated that Aedes aegypti saliva enhances CHIKV replication in human skin fibroblasts. To our knowledge, this is the first report showing the importance of Aedes aegypti saliva on promoting CHIKV infection via down regulation of the genes involving type I IFN secretion in the infected human cutaneous cells.

Submitted by admin tede (tede@pucgoias.edu.br) on 2017-04-27T14:37:47Z No. of bitstreams: 1 ROSEMARY DE CARVALHO ROCHA KOGA.pdf: 1840064 bytes, checksum: 5be7272271d61789b6dc93e32af0b7a3 (MD5) / Made available in DSpace on 2017-04-27T14:37:47Z (GMT). No. of bitstreams: 1 ROSEMARY DE CARVALHO ROCHA KOGA.pdf: 1840064 bytes, checksum: 5be7272271d61789b6dc93e32af0b7a3 (MD5) Previous issue date: 2017-03-15 / Introduction: Chikungunya fever (FCHIK) is a disease of abrupt onset, transmitted by arthropod mosquitoes intermediate hosts of the Chikungunya virus (CHIKV). The illness has a significant impact on the quality of life of the affected person. Since a disease causes intense and prolonged symptoms of polyarthralgia and myalgia, it requires health care, during a recovery, more than other arboviruses. The objective of this study was to study clinicians and clinicians suggestive of FCHIK, residing in the States of Amapá and Goiás, aiming to correlate the results of laboratory tests with the presented symptomatology. Materials and methods: The study was carried out at the Center for Immunological Studies and Research of the Pontifical Catholic University of Goiás, Goiânia, and in Emergency Care Units in the cities of Macapá, Oiapoque and Santana-AP. The study population consisted of 80 individuals with suspected FCHIK and for investigators of inflammatory markers, the control group consisted of 20 blood samples from healthy donors from Goiana Central de Serologia e Imunohematologia. Viral RNA extraction was performed, followed by RNA detection by Real-Time Polymerase Chain Reaction. In addition to ELISA for detection of IgM and IgG against Chikungunya virus. Participants symptoms were correlated with serology and Creactive protein (CRP), which was evaluated in healthy subjects and in people with FCHIK. Results: No data presented for detection of viral RNA by RT-qPCR for CHIKV, but three samples were positive in this technique for zika virus and one for dengue subtype 1 (DENV1). In an enzyme-linked immunosorbent assay, 26 samples were positive for IgG and 3 for IgM. Regarding the stage of the disease, 10 were in the acute phase, 04 in the subacute phase and 12 in the chronic phase. Correlated the results of the serology with a symptomatology it was observed that the acute phase, all have fever, 90% headache, 70% arthralgia and 60% edema. (100%), myalgia and edema (75%). (100%), arthralgia (92%) and myalgia (75%). When comparing participants with negative serology, n = 54, the most prevalent symptoms were rash, headache, fever, and arthralgia. The CRP levels in individuals infected with more than four symptoms were higher when compared with healthy individuals. Conclusion: The study focused on people with a clinical picture characteristic of FCHIK. The most common symptom in the three phases presented for arthralgia, followed by edema and myalgia, a fever was frequent only in the acute phase. All participants were negative in the evaluation of viral RNA by RT-qPCR for CHIKV, for the virus has a short duration in the body, and this methodology is limited to the time of symptom onset and sample collection, DENV and ZIKV. IG G. Those with negative serology for CHIKV, despite taking into account the joints, symptoms common to other arboviruses. CRP levels have been shown to be high relative to healthy subjects. / Introdução: A Febre Chikungunya (FCHIK) é uma doença de início abrupto, transmitida por mosquitos artrópodes hospedeiros intermediários do vírus Chikungunya (CHIKV). A enfermidade representa um significativo impacto na qualidade de vida da pessoa afetada. Uma vez que a doença causa sintomas intensos e prolongados de poliartralgia e mialgia, requerendo atenção de saúde, durante a recuperação, mais do que outras arboviroses. Objetivou-se estudar aspectos clínicos e sorológicos de indivíduos apresentando quadro clínico sugestivo de FCHIK, residentes nos Estados de Amapá e Goiás, visando correlacionar os resultados de testes laboratoriais com a sintomatologia apresentada. Materiais e métodos: O estudo foi realizado no Núcleo de Estudos e Pesquisa Imunológica da Pontifícia Universidade Católica de Goiás, em Goiânia, e em Unidades de Pronto Atendimento de Saúde das cidades de Macapá, Oiapoque e Santana-AP. A população de estudo foi constituída de 80 indivíduos com suspeita de FCHIK e para comparar os marcadores inflamatórios, o grupo controle foi constituído de 20 amostras de sangue de doadores saudáveis da Central Goiana de Sorologia e Imunohematologia. Foi realizada a extração do RNA viral, seguido de detecção do RNA por meio de Reação em Cadeia de Polimerase em Tempo Real. Além de ELISA para detecção de IgM e IgG específicos para o CHIKV. Os sintomas dos participantes foram correlacionados com o resultado da sorologia e da proteína C reativa (PCR), que foi avaliada em indivíduos saudáveis e em pessoas com FCHIK. Resultados: Nenhuma amostra apresentou limiar de detecção do RNA viral por RT-qPCR para CHIKV, porém três amostras foram positivas nessa técnica para vírus zika (ZIKV) e uma para dengue subtipo 1 (DENV1). Em ensaio imunoenzimático, 26 amostras foram positivas para IgG e 3 dessas para IgM. Em relação ao estágio da doença, 10 encontravam-se em fase aguda, 04 em fase subaguda e 12 em fase crônica. Correlacionados os resultados da sorologia com a sintomatologia observou-se que os de fase aguda, todos tiveram febre, 90% cefaleia, 70% artralgia e 60% edema. Enquanto que, os de fase subaguda tiveram: artralgia e cefaleia (100%), mialgia e edema (75%). Os de fase crônica tiveram edema (100%), artralgia (92%) e mialgia (75%). Quando comparados os participantes com sorologia negativa, n=54, os sintomas mais apresentados foram exantema, cefaleia, febre e artralgia. Os níveis de PCR nos indivíduos infectados e que apresentavam mais de quatro sintomas foram maiores quando comparados com indivíduos saudáveis. Conclusão: O estudo focou em pessoas com quadro clínico característico para FCHIK. O sintoma mais comum nas três fases apresentadas foi a artralgia, seguido de edema e mialgia, a febre foi frequente somente na fase aguda. Todos os participantes foram negativos na avaliação do RNA viral por RT-qPCR para CHIKV, pois o vírus tem uma curta duração no organismo, e esta metodologia é limitada ao tempo de início dos sintomas e coleta de amostra, ainda assim foi encontrado RNA viral do DENV e ZIKV. Alguns participantes foram positivos para sorologia IgG. Aqueles com sorologia negativa para CHIKV, apesar de terem dor nas articulações, tinham sintomas comuns a outras arboviroses. Os níveis de PCR demonstraram-se elevados em relação aos indivíduos saudáveis.