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      Situación epidemiológica de la leptospirosis humana en Centroamérica, Suramérica y el Caribe Translated title: Situação epidemiológica da leptospirosis humana em América Central, América do Sul e do Caribe Translated title: Epidemiology of human leptospirosis in Central America, South America and the Caribbean

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          Abstract

          Para identificar y describir el estado epidemiológico de la leptospirosis humana o enfermedad de Weil, se realizó búsquedas de publicaciones científicas y reportes en entes reguladores de salud, durante el periodo 2006-2013. La extracción de información fue independiente y se realizó una lista de chequeo para evaluar la calidad metodológica de los artículos hallados. El país con mayor prevalencia fue Trinidad & Tobago (22 casos por 100.000 habitantes) y la mayor proporción de casos fue en Guyana (60%). En Colombia, el departamento con mayor proporción de casos fue Antioquia (85,7%) y el de mayor seroprevalencia, Córdoba (67,9%). Para diagnóstico, la técnica más utilizada es la aglutinación microscópica y el posible factor de riesgo es por contacto con animales. La información analizada presentó diversos aspectos epidemiológicos, dificultando su unificación. Para algunos países, es evidente el interés y la concientización académica y gubernamental en el área de salud pública.

          Translated abstract

          Para identificar e descrever o estado epidemiológico da leptospirosis humana o doença de Weil, realizou-se pesquisas de publicações científicas e relatórios de entes reguladoras de saúde, durante o período 2006-2013. A extração da informação foi independente e realizou-se uma lista de verificação para avaliar a qualidade metodológica dos artigos encontrados. O país com maior prevalência foi Trinidad & Tobago (22 casos por 100.000 habitantes) e a maior proporção de casos foi em Guyana (60%). Em Colômbia, o departamento com maior proporção de casos foi Antioquia (85,7%) e o de maior soroprevalência, Córdoba (67,9%). Para o diagnóstico, a técnica mais utilizada é a aglutinação microscópica e o possível fator de risco é pelo contacto com animais. A informação analisada apresentou diversos aspetos epidemiológicos, dificultando a sua unificação. Para alguns países, é evidente o interesse e a consciência académica e governamental na área de saúde pública.

          Translated abstract

          To identify and describe the epidemiological status of human leptospirosis or Weil's disease, we searched scientific publications and reports issued by health control authorities from 2006 to 2013. Information extraction was done independently and the methodological quality of the articles was evaluated using a checklist created for that purpose. The country with the highest incidence of human leptospirosis was Trinidad & Tobago (22 cases per 100,000 people) and the highest percentage of cases occurred in Guyana (60%). In Colombia, the department with the highest percentage of cases was Antioquia (85.7%) and the highest incidence was in Cordoba (67.9%). Contact with animals is possibly the highest risk factor; its diagnosis is commonly accomplished using a microscopic agglutination test. The analyzed data presented various epidemiological aspects, making it difficult to merge the information. Only in some countries is the academic and governmental interest and awareness evident in the area of public health.

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          Most cited references120

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          Leptospira and leptospirosis.

          Leptospirosis is the most wide spread zoonosis worldwide; it is present in all continents except Antarctica and evidence for the carriage of Leptospira has been found in virtually all mammalian species examined. Humans most commonly become infected through occupational, recreational, or domestic contact with the urine of carrier animals, either directly or via contaminated water or soil. Leptospires are thin, helical bacteria classified into at least 12 pathogenic and 4 saprophytic species, with more than 250 pathogenic serovars. Immunity following infection is generally, but not exclusively, mediated by antibody against leptospiral LPS and restricted to antigenically related serovars. Vaccines currently available consist of killed whole cell bacterins which are used widely in animals, but less so in humans. Current work with recombinant protein antigens shows promise for the development of vaccines based on defined protective antigens. The cellular and molecular basis for virulence remains poorly understood, but comparative genomics of pathogenic and saprophytic species suggests that Leptospira expresses unique virulence determinants. However, the recent development of defined mutagenesis systems for Leptospira heralds the potential for gaining a much improved understanding of pathogenesis in leptospirosis. Copyright 2009 Elsevier B.V. All rights reserved.
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            Leptospirosis: a zoonotic disease of global importance

            In the past decade, leptospirosis has emerged as a globally important infectious disease. It occurs in urban environments of industrialised and developing countries, as well as in rural regions worldwide. Mortality remains significant, related both to delays in diagnosis due to lack of infrastructure and adequate clinical suspicion, and to other poorly understood reasons that may include inherent pathogenicity of some leptospiral strains or genetically determined host immunopathological responses. Pulmonary haemorrhage is recognised increasingly as a major, often lethal, manifestation of leptospirosis, the pathogenesis of which remains unclear. The completion of the genome sequence of Leptospira interrogans serovar lai, and other continuing leptospiral genome sequencing projects, promise to guide future work on the disease. Mainstays of treatment are still tetracyclines and beta-lactam/cephalosporins. No vaccine is available. Prevention is largely dependent on sanitation measures that may be difficult to implement, especially in developing countries.
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              Leptospira: the dawn of the molecular genetics era for an emerging zoonotic pathogen.

              Leptospirosis is a zoonotic disease that has emerged as an important cause of morbidity and mortality among impoverished populations. One hundred years after the discovery of the causative spirochaetal agent, little is understood about Leptospira spp. pathogenesis, which in turn has hampered the development of new intervention strategies to address this neglected disease. However, the recent availability of complete genome sequences for Leptospira spp. and the discovery of genetic tools for their transformation have led to important insights into the biology of these pathogens and their pathogenesis. We discuss the life cycle of the bacterium, the recent advances in our understanding and the implications for the future prevention of leptospirosis.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                unsc
                Universitas Scientiarum
                Univ. Sci.
                Facultad de Ciencias de la Pontificia Universidad Javeriana de Bogotá. (Bogotá, Distrito Capital, Colombia )
                0122-7483
                December 2014
                : 19
                : 3
                : 247-264
                Affiliations
                [01] Bogotá orgnamePontificia Universidad Javeriana orgdiv1Facultad de Ciencias orgdiv2Departamento de Microbiología Colombia
                [02] Bogotá, D.C orgnamePontificia Universidad Javeriana orgdiv1Facultad de Ciencias orgdiv2Departamento de Microbiología Colombia
                Article
                S0122-74832014000300007
                10.11144/Javeriana.SC19-3.selh
                52ef7872-42a2-45c0-9285-bfe458cc20b8

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 24 April 2014
                : 28 March 2014
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 77, Pages: 18
                Product

                SciELO Colombia

                Categories
                Ciencia multidisciplinar

                Leptospirosis,humana,prevalência,fator de risco,diagnóstico,Colômbia,Leptospirosis humana,prevalencia,factor de riesgo,Colombia,Human leptospirosis,prevalence,risk factor,diagnosis,Leptospira spp

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