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      Prevención de leptospirosis humana en la comunidad Translated title: Prevention of human leptospirosis in the community

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          Abstract

          La leptospirosis es endémico-epidémica en Cuba; centenares de casos se han informado desde la década de los 80 hasta la actualidad. Se realizó una revisión de las principales acciones de prevención y control de la leptospirosis en la comunidad y su tratamiento. Se efectuó una búsqueda bibliográfica en las bases de datos MEDLINE, EBSCO y SciELO; se tuvo en cuenta además, la Guía de la Organización Mundial de la Salud para el diagnóstico, vigilancia y control de la leptospirosis humana vigente desde el 2003 y el Programa Nacional de Prevención y Control de la Leptospirosis Humana vigente desde 1997. Se analizan acciones preventivas como: eliminar reservorio de la enfermedad (incluye desratización, saneamiento canino, vacunación animal, detección y tratamiento de animales domésticos portadores y enfermos); evitar la contaminación de medios infectantes (abarca vertimiento sanitario de la excreta animal, drenaje de charcos y terrenos bajos, higienización comunitaria, desinfección del hábitat animal, tratamiento sanitario de piscinas, protección física de fuentes de agua y alimentos); evitar el contagio humano con medios infectantes (implica prohibición sanitaria de ingestión de carnes y leches de animal enfermo o portador, desinfección de frutas y verduras, uso de medios físicos de protección, prohibición sanitaria de inmersión en fluviales contaminadas); quimioprofilaxis y vacunación. Se establecen las principales acciones desarrolladas, tanto por el Ministerio de Salud Pública de Cuba como por la Organización Mundial de la Salud.

          Translated abstract

          Leptospirosis is endemic-epidemic in Cuba. Hundreds of cases have been reported from the 80s to the present. A review of the main actions for prevention and control of leptospirosis in the community and its treatment was performed. A literature search was conducted in MEDLINE, EBSCO and SciELO databases. The World Health Organization Guide for the diagnosis, monitoring and control of human leptospirosis in force since 2003 and the National Program for Prevention and Control of Human Leptospirosis in force since 1997 were taken into account also. Preventive actions are analyzed such as: removing reservoir of this disease (including rodent control, canine sanitation, animal vaccination, screening and treatment of carriers and sick pets); avoiding contamination of infective media (covering health dumping of animal excreta, drainage ponds and lowlands, community sanitation, disinfection of animal habitat, pool-health treatment, physical protection of water sources and food); preventing human infection with infective means (involving ingesting health prohibition of meat and milk from sick animals or carrier, disinfection of fruits and vegetables, using physical means of protection, health ban immersion in contaminated river); chemoprophylaxis and vaccination. The main actions are set by both the Ministry of Public Health of Cuba as the World Health Organization.

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          Most cited references43

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          Urban Leptospirosis in Africa: A Cross-Sectional Survey of Leptospira Infection in Rodents in the Kibera Urban Settlement, Nairobi, Kenya

          Leptospirosis is a widespread but under-reported cause of morbidity and mortality. Global re-emergence of leptospirosis has been associated with the growth of informal urban settlements in which rodents are thought to be important reservoir hosts. Understanding the multi-host epidemiology of leptospirosis is essential to control and prevent disease. A cross-sectional survey of rodents in the Kibera settlement in Nairobi, Kenya was conducted in September–October 2008 to demonstrate the presence of pathogenic leptospires. A real-time quantitative polymerase chain reaction showed that 41 (18.3%) of 224 rodents carried pathogenic leptospires in their kidneys, and sequence data identified Leptospira interrogans and L. kirschneri in this population. Rodents of the genus Mus (37 of 185) were significantly more likely to be positive than those of the genus Rattus (4 of 39; odds ratio = 15.03). Questionnaire data showed frequent contact between humans and rodents in Kibera. This study emphasizes the need to quantify the public health impacts of this neglected disease at this and other urban sites in Africa.
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            Comportamiento de la vigilancia epidemiológica de la leptospirosis humana en Colombia, 2007-2011

            Introducción. La leptospirosis es una zoonosis reemergente de distribución mundial causada por una espiroqueta del género Leptospira. Durante los últimos años en Colombia aumentó el número de casos en humanos y animales. Objetivo. Caracterizar epidemiológicamente los casos de leptospirosis notificados al Sistema Nacional de Vigilancia en Salud Pública de Colombia y hacer una aproximación para conocer los serogrupos que circulan en el país. Materiales y métodos. Se diseñó un estudio observacional de corte retrospectivo, con registros del proceso de vigilancia de los casos reportados por el software Sivigila y muestras enviadas al Grupo de Microbiología de la Red Nacional de Laboratorios, durante el periodo 2007 a 2011. Se registraron variables de tipo sociodemográficas y se analizaron 17 serogrupos de Leptospira . En el análisis se utilizaron medidas de frecuencia, tendencia central y dispersión. Resultados. Se procesaron 11.786 registros, confirmándose 4.621 casos de leptospirosis. Las entidades territoriales con mayor registro fueron Valle del Cauca, Antioquia, Risaralda, Atlántico y Barranquilla; y las de incidencia más alta fueron Guaviare, Risaralda, San Andrés, Santa Marta y Barranquilla. El mayor número de casos reportados perteneció al área urbana, con mayor frecuencia de hombres (77 %), estudiantes (19,4 %) y amas de casas (13,6 %), con una mediana por edad de 29 años (rango intercuartílico: 45-19). Se evidenció la circulación de 17 serogrupos en el país; los más frecuentes fueron Australis (24,89 %), Hebdomadis (9,33 %) y Sejroe (8,0 %). Conclusión. En Colombia se ha mejorado la notificación y clasificación final de los casos, lo que ha permitido identificar al serogrupo Australis como el de mayor circulación.
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              Studying Risk Factors Associated with Human Leptospirosis

              Background: Leptospirosis is one of the most under diagnosed and underreported disease in both developed and developing countries including India. It is established that environmental conditions and occupational habit of the individuals put them at risk of acquiring disease, which varies from community to community. Various seroprevalence studies across the world have documented emerging situation of this neglected tropical disease, but limited have probed to identify the risk factors, especially in India. Objectives: The objective of this study was to identify the environmental and occupational risk factors associated with the disease in Udupi District. Materials and Methods: This population-based case-control study was carried out in Udupi, a District in Southern India from April 2012 until August 2012. Udupi is considered to be endemic for Leptospirosis and reported 116 confirmed cases in the year 2011. Seventy of 116 laboratory confirmed cases and 140 sex matched neighborhood healthy controls participated in the study. A predesigned, semi-structured and validated questionnaire was used for data collection through house to house visit and observations were noted about environmental conditions. Univariate analysis followed by multivariate analysis (back ward conditional logistic regression) was performed by using STATA version 9.2 (StataCorp, College Station, TX, USA) to identify potential risk factors. Results: Occupational factors such as outdoor activities (matched odds ratio [OR] of 3.95, 95% confidence interval [CI]: 1.19-13.0), presence of cut or wound at body parts during work (matched OR: 4.88, CI: 1.83-13.02) and environmental factors such as contact with rodents through using the food materials ate by rat (matched OR: 4.29, CI: 1.45-12.73) and contact with soil or water contaminated with urine of rat (matched OR: 4.58, CI: 1.43-14.67) were the risk factors identified to be associated with disease. Conclusion: Leptospirosis is still considered as neglected disease in the district. Early diagnosis and prompt treatment of cases can save many lives. However, there is a need of integrated rodent control measures with great effort to increase awareness and education among subjects in controlling the disease.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                mil
                Revista Cubana de Medicina Militar
                Rev Cub Med Mil
                ECIMED (Ciudad de la Habana )
                1561-3046
                March 2015
                : 44
                : 1
                : 86-95
                Affiliations
                [1 ] Facultad de Ciencias Médicas Finlay-Albarrán Cuba
                Article
                S0138-65572015000100010
                845aa008-9d19-4c0a-b140-0cb23ca12e27

                http://creativecommons.org/licenses/by/4.0/

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                SciELO Cuba

                Self URI (journal page): http://scielo.sld.cu/scielo.php?script=sci_serial&pid=0138-6557&lng=en
                Categories
                MEDICINE, LEGAL
                MEDICINE, RESEARCH & EXPERIMENTAL

                Social law,Medicine
                leptospirosis,primary prevention,primary health care,national program,practical guide,prevención primaria,atención primaria de salud,programa nacional,guía práctica

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