Giardiasis is a parasitic infection that affects around 200 million people worldwide. This parasite presents a remarkable genetic variability observed in 8 genetic clusters named as 'assemblages' (A-H). These assemblages are host restricted and could be zoonotic where A and B infect humans and animals around the globe. The knowledge of the molecular epidemiology of human giardiasis in South-America is scarce and also the usefulness of PCR to detect this pathogen in fecal samples remains controversial. The aim of this study was to conduct a cross-sectional study to compare the molecular targets employed for the molecular diagnosis of Giardia DNA and to discriminate the parasite assemblages circulating in the studied population. We analyzed 181 fecal samples from Children at La Virgen, Cundinamarca, Colombia that were DNA-extracted and analyzed by SSU rDNA, tpi and gdh loci. We observed positivity by microscopy of 13% and by PCR around 76-80% depending on the molecular marker. Additionally, a lack of statistical concordance between microscopy and PCR was detected. Regarding the genetic assemblages, we detected assemblage A (3%), assemblage B (90%) and mixed infections assemblages A+B (7%). Hence, the sub-assemblages were typed as AI, AII, BIII and BIV across the population. This study represents a reliable attempt to understand the molecular epidemiology of giardiasis in Colombia and the use of PCR to detect cryptic infections. The epidemiological implications are herein discussed.
Introducción: la formación de profesionales en salud tiene fundamento pedagógico y epistemológico para dar servicio al paciente y la comunidad. Objetivos: presentar un análisis de las relaciones entre las competencias profesionales por desarrollar y la formación de profesionales en el área de la salud. Exponer el concepto de modelos pedagógicos, los lineamientos de la formación profesional, particularmente en especialidades médicas, mediante la relación docencia-servicio y el aprendizaje basado en problemas. Métodos: investigación documental, búsqueda de literatura científica publicada en español e inglés, en las bases de datos como Medline, Redalyc, SciELO, Google, Universidad Nacional de Colombia, centros de referencia y libros mediante las palabras clave. Resultados: se conceptualiza la formación por competencias de profesionales en las ciencias de la salud, se detallan las competencias de profesionales genéricas o transversales y específicas; los alcances y las limitaciones actuales de la formación y se exponen cuatro experiencias de formación basada en competencias. Conclusiones: la formación de profesionales en ciencias de la salud debe conducir a la graduación de profesionales autónomos y críticos con profesionalismo que en su práctica demuestren competencias profesionales transversales y específicas; éstas se evalúan permanentemente en la relación con cada paciente; para alcanzar lo anterior es indispensable la formación pedagógica de docentes y la concienciación de directivos y entes gubernamentales. Los currículos tienen un componente nuclear y otro flexible que permiten el desarrollo de las potencialidades de cada estudiante por medio del método del aprendizaje basado en problemas con casos clínicos en la relación docencia-servicio y en equipo interdisciplinario
Abstract. Amebiasis is an important cause of diarrheal disease worldwide and has been associated with childhood malnutrition. Traditional microscopy approaches are neither sensitive nor specific for Entamoeba histolytica. Antigen assays are more specific, but many cases are missed unless tested by molecular methods. Although polymerase chain reaction (PCR) is effective, the need for sophisticated, expensive equipment, infrastructure, and trained personnel limits its usefulness, especially in the resource-limited, endemic areas. Here, we report development of a recombinase polymerase amplification (RPA) method to detect E. histolytica specifically. Using visual detection by lateral flow (LF), the test was highly sensitive and specific and could be performed without additional equipment. The availability of this inexpensive, sensitive, and field-applicable diagnostic test could facilitate rapid diagnosis and treatment of amebiasis in endemic regions.
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