1
|
Cardona-Arias JA, Vidales-Silva M, Ocampo-Ramírez A, Higuita-Gutiérrez LF, Cataño-Correa JC. Prevalence of HIV, Treponema pallidum and Their Coinfection in Men Who Have Sex with Men, Medellín-Colombia. HIV AIDS (Auckl) 2024; 16:141-151. [PMID: 38650744 PMCID: PMC11034557 DOI: 10.2147/hiv.s452144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 02/27/2024] [Indexed: 04/25/2024] Open
Abstract
Introduction In Colombia, HIV and gestational syphilis are notifiable events; however, they are poorly investigated infections in men who have sex with men (MSM). Objective To determine the prevalence of HIV, Treponema pallidum, and their co-infection in MSM treated at a Health Services Provider Institution (HSPI) specialized in infectious diseases from Medellín. Methods Cross-sectional study with 3454 MSM. Prevalence was determined with its 95% confidence interval; associated factors were identified using Fisher's Exact test, Pearson's Chi-square, and trend Chi-square. Multivariate adjustment was performed using logistic regression. Analyses were performed using SPSS 29.0. Results The prevalence of HIV was 5.7%, T. pallidum 0.7%, and co-infection 0.6%. The prevalence of HIV was higher in MSM aged between 24-40 years (7.5%), with technical or university studies (10.0%), without health insurance affiliation (12.4%), and those who have had a sexual partner with HIV (36.2%). T. pallidum was higher in MSM without health insurance affiliation (3.4%), who had sexual relations with people diagnosed with an STI (5.9%), and a sexual partner with HIV (12.1%). Co-infection was higher in MSM without health insurance affiliation (2.7%), and those who had a partner with HIV (11.2%). Conclusion Compared with the general Colombian population, MSM have a higher risk of HIV, but are similar to T. pallidum. The identification of the main associated factors in each infection demonstrates the need to prioritize subgroups of MSM that show greater vulnerability to these events. This research demonstrates the urgency of implementing health education strategies in MSM who have a sexual partner with HIV or other STIs. Large gaps were also evident in the magnitude of the three events according to the health insurance affiliation regime, which demonstrates problems of social and health injustice, especially with MSM without health insurance affiliation.
Collapse
Affiliation(s)
| | | | | | - Luis Felipe Higuita-Gutiérrez
- Escuela de Microbiología, Universidad de Antioquia, Medellín, Colombia
- Facultad de Medicina, Universidad Cooperativa de Colombia sede Medellín, Medellín, Colombia
| | - Juan Carlos Cataño-Correa
- Facultad de Medicina, Universidad de Antioquia, Fundación Antioqueña de Infectología, Medellín, Colombia
| |
Collapse
|
2
|
Cataño-Correa JC, Montoya-Flórez PA, Cardona-Arias JA. Descripción de la experiencia de un programa de Profilaxis preexposición (PrEP) a VIH en Medellín, Colombia. Infect 2023. [DOI: 10.22354/24223794.1118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023] Open
Abstract
Objetivo: describir la experiencia de un programa de profilaxis preexposición para VIH (PrEP) en Medellín. Métodos: estudio de una cohorte retrospectiva. El programa tuvo tres fases: talleres de motivación frente al VIH y su prevención, inclusión de participantes y evaluación de desenlaces clínicos y determinantes socioeconómicos de la adherencia. Resultados: se incluyeron 50 hombres que tiene sexo con hombres y 2 mujeres trans; 79% (n=41) con nacionalidad colombiana. Al ingreso 10% presentó sífilis latente indeterminada. No se presentaron casos de VIH, 48% completó el seguimiento, se registraron leves efectos secundarios relacionados a la PrEP que no llevaron al abandono del programa. Los factores económicos fueron la causa más frecuente de abandono. Conclusión: la PrEP es efectiva y segura, los determinantes económicos son el principal factor explicativo de la adherencia. Es importante incluir la PrEP para grupos clave en los planes de salud, y ajustar el programa a la realidad socioeconómica de cada población.
Collapse
|
3
|
Cataño-Correa JC, Cardona-Arias JA, Porras-Mancilla JP, Tabares-García M. Comparison of Survival and Clinical Profile of Adults with COVID-19 Hospitalized in Two Clinics in Medellín, Colombia. Curr Clin Micro Rpt 2022; 9:11-19. [PMID: 35433195 PMCID: PMC8993667 DOI: 10.1007/s40588-022-00179-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/26/2022] [Indexed: 12/15/2022]
Abstract
Purpose of Review This study compares the survival and clinical profile of hospitalized adults with COVID-19 in two clinics in the city of Medellín, Colombia, with a prospective study with 198 patients in clinic A and 201 in clinic B. Comparisons were made with chi-square and Mann–Whitney U, factors associated with survival were identified with a Cox regression. Recent Findings The proportion of deaths was 7.1% in clinic A with a mean survival of 51.9 days (95% CI = 45–59); in clinic B 13.9% of patients died with mean survival of 37.8 days (95% CI = 32–43). The most prevalent comorbidities were hypertension (41.6%), diabetes (23.8%), obesity (15.0%), hypothyroidism (13.0%), dyslipidemia (11.0%), and chronic lung disease (10.8%) with similar proportions in both clinics. There were also differences by the clinic in the most prevalent complications: bacterial pneumonia (18.8%), acute renal failure (14.3%), and encephalopathy (9.5%). There were no differences in the days of hospitalization, mechanical ventilation (clinic A 23.7% and clinic B 29.4%) and admission to the ICU (25.3% in A and 32.3% in B). Summary We evidence the heterogeneity of the survival and the clinical profile of the patients who are cared for by two institutions of the same city. These findings demonstrate the need to conduct unique studies for each institution, which poses a significant challenge for hospital epidemiology programs due to the impossibility of extrapolating evidence from other healthcare institutions and the need to implement personalized medicine programs given the clinical diversity of patients hospitalized for COVID-19.
Collapse
|
4
|
Salazar BE, Pérez-Cala T, Gomez-Villegas SI, Cardona-Zapata L, Pazos-Bastidas S, Cardona-Estepa A, Vélez-Gómez DE, Justinico-Castro JA, Bernal-Cobo A, Dávila-Giraldo HA, Benítez-Guerra JC, Valencia-Cárdenas JT, Ospina EDJ, Castaño-Llano R, Bravo MM, Cataño-Correa JC, Zabaleta J, Trespalacios-Rangel AA, Cock-Botero AM, Roldán-Pérez MI, Martínez A. The OLGA-OLGIM staging and the interobserver agreement for gastritis and preneoplastic lesion screening: a cross-sectional study. Virchows Arch 2022; 480:759-769. [PMID: 35089403 DOI: 10.1007/s00428-022-03286-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 01/04/2022] [Accepted: 01/21/2022] [Indexed: 12/20/2022]
Abstract
Stomach cancer (SC) incidence and mortality are relevant public health issues worldwide. In Colombia, screening for preneoplastic lesions (PNL) and the presence of H. pylori is not routinely performed. Therefore, the aim of this study was to evaluate OLGA-OLGIM staging and the interobserver agreement in gastritis and preneoplastic lesions in patients with gastroduodenal symptoms from Colombia. A cross-sectional study was conducted in 272 patients with gastroduodenal symptoms. Gastric biopsies were taken following the Updated Sydney System with the OLGA-OLGIM classification, and the results were evaluated by two pathologists. Chronic gastritis and PNL were reported in 76% and 24% of the patients, respectively. Furthermore, 25% of the patients with PNL displayed gastric atrophy (GA) and 75% intestinal metaplasia (IM). Agreement in the histopathological reading for IM was good, whereas for OLGA was variable, and for the H. pylori quantity was poor. OLGA-OLGIM stages 0-II were the most frequent (96%), while stage III (4%) and SC (4%) were the least frequent. Age and coffee consumption were associated with a higher prevalence of PNL. This work determined that 4% of the population is at high risk of developing SC and would benefit from follow-up studies. Reinforcement of training programs to improve the agreement in histopathology readings is required.
Collapse
Affiliation(s)
- Beatriz E Salazar
- Bacteria & Cancer Group, Department of Microbiology, School of Medicine, University of Antioquia, Medellín, Colombia.
| | - Tania Pérez-Cala
- Bacteria & Cancer Group, Department of Microbiology, School of Medicine, University of Antioquia, Medellín, Colombia
| | - Sara Isabel Gomez-Villegas
- Bacteria & Cancer Group, Department of Microbiology, School of Medicine, University of Antioquia, Medellín, Colombia
| | - Laura Cardona-Zapata
- Bacteria & Cancer Group, Department of Microbiology, School of Medicine, University of Antioquia, Medellín, Colombia
| | - Sebastián Pazos-Bastidas
- Bacteria & Cancer Group, Department of Microbiology, School of Medicine, University of Antioquia, Medellín, Colombia
| | - Alejandra Cardona-Estepa
- Bacteria & Cancer Group, Department of Microbiology, School of Medicine, University of Antioquia, Medellín, Colombia
| | - Diego Enrique Vélez-Gómez
- Bacteria & Cancer Group, Department of Microbiology, School of Medicine, University of Antioquia, Medellín, Colombia
| | | | - Andrés Bernal-Cobo
- Department of Pathology, School of Medicine, University of Antioquia, Medellín, Colombia
| | | | - Juan Carlos Benítez-Guerra
- Bacteria & Cancer Group, Department of Microbiology, School of Medicine, University of Antioquia, Medellín, Colombia.,Promedan IPS, Medellín, Colombia
| | | | | | | | | | | | - Jovanny Zabaleta
- Department of Integrative Oncology and Department of Pediatrics, Stanley S. Scott Cancer Center, Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | | | | | - Miguel Ignacio Roldán-Pérez
- Bacteria & Cancer Group, Department of Microbiology, School of Medicine, University of Antioquia, Medellín, Colombia.,Department of Pathology, School of Medicine, University of Antioquia, Medellín, Colombia
| | - Alonso Martínez
- Bacteria & Cancer Group, Department of Microbiology, School of Medicine, University of Antioquia, Medellín, Colombia
| |
Collapse
|
5
|
Cardona Arias J, Higuita-Gutiérrez LF, Cataño-Correa JC. Prevalencia de infección por Treponema pallidum en individuos atendidos en un centro especializado de Medellín, Colombia. Rev Fac Nac Salud Pública 2022. [DOI: 10.17533/udea.rfnsp.e343212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Objetivo: Describir la prevalencia de infección por Treponema pallidum en individuos atendidos en un centro especializado de Medellín, Colombia, 2019.
Metodología: Estudio de corte, con 776 sujetos de población general (aparentemente sanos-asintomáticos y sin factores de riesgo para sífilis), 126 hombres que tienen sexo con hombres (hsh) y 190 jóvenes vulnerables (estrato socioeconómico bajo, desempleados y sin finalizar educación básica), captados intramural y extramuralmente en espacios de concentración de hsh y organizaciones no gubernamentales. Se empleó fuente de información primaria basada en un encuesta y prueba de detección de anticuerpos IgG, IgM e IgA específicos para T. pallidum.
Resultados: La prevalencia de infección por T. pallidum fue 0,53 % en jóvenes vulnerables, 2,19 % en población general y 16,67 % en hsh. La razón de odds de infección en los sujetos con edad entre 51-60 años fue 13,8 (IC 95 % = 3,5-51,5) respecto a la hallada en los jóvenes entre 21-30 años; 12,0 (IC 95 % = 1,8-79,2) en quienes no tienen escolaridad frente a los universitarios; 3,3 (IC 95 % = 1,1-9,9) en las personas sin afiliación en salud, comparadas con las del régimen contributivo, y 8,1 (IC 95 % = 2,8-23,0) en quienes tiene relaciones sexuales con grupos clave versus quienes no refieren estas prácticas.
Conclusión: Se halló una menor prevalencia de infección por T. pallidum en los jóvenes, seguida de los sujetos de población general y fue mayor en hsh. Se identificaron los grupos de mayor riesgo (entre los tres subgrupos estudiados), que incluyen sujetos excluidos de los programas de prevención, con confluencia de factores de riesgo sexual y privación socioeconómica.
Collapse
|
6
|
Cataño-Correa JC, Cardona-Arias JA, Porras Mancilla JP, García MT. Bacterial superinfection in adults with COVID-19 hospitalized in two clinics in Medellín-Colombia, 2020. PLoS One 2021; 16:e0254671. [PMID: 34255801 PMCID: PMC8277025 DOI: 10.1371/journal.pone.0254671] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 06/30/2021] [Indexed: 12/23/2022] Open
Abstract
COVID-19 represents high morbidity and mortality, its complications and lethality have increased due to bacterial superinfections. We aimed to determine the prevalence of bacterial superinfection in adults with COVID-19, hospitalized in two clinics in Medellín-Colombia during 2020, and its distribution according to sociodemographic and clinical conditions. A cross sectional study was made with 399 patients diagnosed with COVID-19 by RT-PCR. We determined the prevalence of bacterial superinfection and its factors associated with crude and adjusted prevalence ratios by a generalized linear model. The prevalence of superinfection was 49.6%, with 16 agents identified, the most frequent were Klebsiella (pneumoniae and oxytoca) and Staphylococcus aureus. In the multivariate adjustment, the variables with the strongest association with bacterial superinfection were lung disease, encephalopathy, mechanical ventilation, hospital stay, and steroid treatment. A high prevalence of bacterial superinfections, a high number of agents, and multiple associated factors were found. Among these stood out comorbidities, complications, days of hospitalization, mechanical ventilation, and steroid treatment. These results are vital to identifying priority clinical groups, improving the care of simultaneous infections with COVID-19 in people with the risk factors exposed in the population studied, and identifying bacteria of public health interest.
Collapse
|