Objective: To study the NAT2 gene polymorphisms 481T, 590A and 857A in the Chimila, Wiwa and Wayuu indigenous groups of the Colombian Caribbean to determine the frequencies of the allelesNAT2*4, NAT2*5, NAT2*6, and NAT2*7 and to determine the types of acetylators present in these populations. Methods: A total of 202 subjects were studied: 47 Chimila, 55 Wiwa, and 100 Wayuu. The polymorphisms were idenjpgied using a real-time PCR method for allelic discrimination designed using Taqman of Applied Biosystems. Results: The following alleles were found at the highest frequency in the following groups: the NAT2*4 allele (wild type) in the Wayuu group (55.3%), the NAT2*5 allele in the Wiwa group (34.5%), and the NAT2*7 allele in the Chimila group (24.2%). A higher frequency of the rapid acetylator status was found in the Wayuu group (31.3%) and Chimila group (29.5%) compared with the Wiwa group (12.7%). The intermediate acetylator status distribution was very similar in all three groups, and the frequency of the slow acetylator status was higher in the Wiwa group (32.7%) compared with the Chimila and Wayuu groups (20.5% and 21.2%, respectively). Conclusion: The results demonstrated the allelic distribution and pharmacogenetic differences of the three groups studied and revealed the most frequent acetylator status and phenotype. Because of the high prevalence of slow acetylators, a greater incidence of tuberculosis (TB) drug-induced hepatotoxicity is predicted in these populations, with a higher frequency in the Wiwa group.
La miasis humana es el parasitismo de órganos y tejidos producido por especies de larvas del orden Díptera. El diagnóstico se realiza con base en hallazgos clínicos y se confirma con estudios entomológicos. Se presenta el caso de una niña de siete años de edad que fue llevada por su padre al servicio de urgencias por presentar fiebre asociada a una lesión abscedada en el cuero cabelludo, con salida espontánea de larvas. Como hallazgo en el examen físico se reportó pediculosis grave. La paciente fue hospitalizada y tratada con clindamicina, gentamicina e ivermectina, y mostró mejoría de sus condiciones clínicas. Se dio alta médica al cuarto día de estancia hospitalaria. Se recolectaron larvas en estadio dos de Cochliomyia hominivorax (Diptera: Calliphoridae) directamente del área lesionada, observándose la asociación miasis-pediculosis; por lo tanto, se alerta a los trabajadores del área de la salud del riesgo potencial que representa la pediculosis para el desarrollo de la miasis.Palabras clave: miasis, infección por Cochliomyia hominivorax, ivermectina, Colombia. Cutaneous myiasis by Cochliomyia hominivorax (Coquerel) (Díptera Calliphoridae) in Hospital Universidad del Norte, Soledad, AtlánticoHuman myiasis is the parasitism of human tissues by fly larvae. Diagnoses are based on clinical pattern of tissue damage and presence of insect stages. Herein, a case myiasis is described in a seven-year-old female child. She presented with fever associated with abscessed scalp lesions containing exposed larvae. Severe pediculosis was also observed. The patient was hospitalized and treated with clindamycin, gentamicin (for bacterial secondary infections) and ivermectin (treatment for lice) after which the patient showed clinical improvement and was discharged four days later. Since human myiasis can be caused by a number of different species, larvae were collected from the patient and identified as those of Cochliomyia hominivorax (Diptera: Calliphoridae). Because other cases of coinfestation of flies and lice are on record, health workers are to be alerted about the possible pediculosis-myasis risk..
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