Abstract This article evaluates the influence of implementing the Multisectoral Strategy Barrio Seguro (EMBS) on the inhabitants of the Manzanares neighbourhood in the district of Huacho in Peru. Since 2017, this public policy of the Ministry of Interior seeks to intervene in the security conditions and safe coexistence of certain territories that report high crime rates. This quantitative research surveyed 353 people to establish that, in 49.2% of cases, the EMBS has had inadequate influence. Although not a significant impact, the policy meets certain expectations that suggests that robust institutions, greater trust in the authorities, and organic participation of civil society could enhance its effects. The study recommends assessing the EMBS experience in other neighbourhoods and cities. It also proposes the application of qualitative studies that provide tools for building the idea of citizen security.

Resumen Este artículo evalúa la influencia de la aplicación Estrategia Multisectorial Barrio Seguro (EMBS) sobre los habitantes del barrio Manzanares en el distrito de Huacho en Perú. Esta es una política pública del Ministerio del Interior que, desde 2017, busca intervenir las condiciones de seguridad y convivencia pacífica de ciertos territorios que reportan altas tasas de criminalidad. Esta investigación de enfoque cuantitativo encuestó a 353 personas para establecer que en el 49,2 % de los casos la EMBS ha tenido una influencia regular. Si bien no es una influencia significativa, la política colma ciertas expectativas y su efecto podría potenciarse con una institucionalidad más fuerte, mayor confianza hacia las autoridades y participación orgánica de la sociedad civil. El estudio recomienda que la experiencia de la EMBS pueda evaluarse en otros barrios y ciudades. Se propone, además, que se apliquen estudios cualitativos que den cuenta de una aproximación a la construcción de la idea de la seguridad ciudadana.

Resumen Este texto busca presentar una visión general de la autopista BR-319 (de Manaos a Porto Velho, Brasil) a partir de un análisis geopolítico del transporte y de los frentes pioneros, con el fin de destacar el papel del Estado en la Amazonia y en el proceso de integración territorial brasileño. También se consideran las actividades de transporte de mercancías y pasajeros organizadas a lo largo de este eje, destacando la existencia de frentes pioneros con diferentes temporalidades. Se realizó una investigación bibliográfica e histórica, que incluyó la consulta de periódicos publicados entre 1960 y 2000 y un trabajo de campo entre 2014 y 2022. Tras la realización del trabajo de campo, fue posible identificar la organización de las actividades de transporte y el desarrollo de frentes pioneros en la porción sur de la carretera en el distrito de Realidade, en el municipio de Humaitá-AM.

Abstract This paper aims to provide an overview of the BR-319 highway (connecting Manaus and Porto Velho, Brazil) through a geopolitical analysis of transportation and pioneer fronts. The objective is to highlight the State’s role in the Amazon and the process of Brazilian territorial integration. It also points out considerations on cargo and passenger transport activities organized along this corridor and highlights the existence of pioneer fronts with various temporalities. Bibliographic and historical surveys were conducted, involving the examination of newspapers from the decades 1960 to 2000. Additionally, fieldwork was undertaken between 2014 and 2022. Following the completion of the fieldwork, the study identified the organization of transport activities and the development of pioneer fronts in the southern segment of the highway in the district of Realidade, within the municipality of Humaitá-AM.

Resumo Este texto busca apresentar um panorama da rodovia BR-319 (Manaus a Porto Velho, Brasil) a partir de uma análise geopolítica dos transportes e das frentes pioneiras para fins de evidenciar o papel do Estado na Amazônia e no processo de integração territorial brasileiro. Alem disso, são apresentadas considerações sobre as atividades de transporte de cargas e passageiros organizadas ao longo desse eixo, ressaltando a existência de frentes pioneiras com diversas temporalidades. Foram realizados levantamentos bibliográficos e históricos com consulta em jornais das décadas de 1960-2000 e realização de trabalho de campo entre os anos de 2014 até 2022. Após a realização dos trabalhos de campo foi possível identificar a organização das atividades de transporte e o desenvolvimento das frentes pioneiras na porção Sul da rodovia no distrito de Realidade, no município de Humaitá-AM.

Resumo A partir de duas pesquisas realizadas em comunidades indígenas de Puno, Peru, a uma altitude superior a 3910 metros, entre 2015 e 2017, busca-se compreender as possíveis contribuições do conhecimento tradicional para a elaboração e gestão de políticas públicas relacionadas à biodiversidade e à adaptação às mudanças climáticas. As pesquisas realizadas mostram conhecimentos milenares que fornecem diretrizes estratégicas, as quais devem ser reconhecidas no âmbito das convenções nacionais e políticas públicas específicas de biodiversidade, mudanças climáticas e adaptação. A sistematização de práticas comunitárias em Puno revela conhecimentos tradicionais sobre diferentes problemas, a partir dos quais se derivam práticas milenares de adaptação ligadas a saberes e uma biocultura alimentar sustentável e saudável. As contribuições são essenciais para fornecer conteúdo de gestão de políticas públicas em nível nacional, regional e local. No entanto, as controvérsias em torno do conhecimento científico e do conhecimento tradicional persistem, gerando ceticismo em relação à possibilidade de avançar nos acordos de biodiversidade e, especialmente, nos objetivos de desenvolvimento sustentável projetados para 2030.

Abstract The investigation aimed to identify the contribution of traditional knowledge in the construction and management of public policies for biodiversity conservation and adaptation to climate change. It was based on two studies conducted between 2015 and 2017 in two indigenous rural communities situated above 3,910 meters above sea level in the northern Puno region of Peru. The results have been synthesized to generate a proposal for strategic guidelines for high mountain agriculture with a focus on adaptation to climate change. The identified categories of traditional knowledge encompass: a) soil, b) water, c) plant health, d) measures against hailstorms, e) measures against frost, f) organization and ritual, and g) varieties and mixtures tolerant to climatic extremes. A workspace is the community itself. In the absence of public policies that take into consideration the promotion of traditional knowledge, the community establishes guidelines and actions rooted on traditional knowledge of biodiversity conservation and adaptation to climate change in plans of life aligned with the local worldview, with the aim of escalating to the district level.

Resumen A partir de dos investigaciones en comunidades originarias de Puno, Perú, a más de 3910 m.s.n.m., entre 2015 y 2017, se busca conocer los aportes potenciales del conocimiento tradicional en la construcción y gestión de las políticas públicas sobre biodiversidad y adaptación al cambio climático. Las investigaciones realizadas dan muestras de conocimientos milenarios que dan lineamientos estratégicos, los cuales deben ser reconocidos en el marco de las convenciones nacionales y políticas públicas específicas de biodiversidad, cambio climático y adaptación. La sistematización de prácticas comunitarias en Puno, dan cuenta de conocimientos tradicionales sobre diferentes problemas, a partir de estos, se derivan prácticas milenarias de adaptación ligadas a saberes y una biocultura alimentaria sostenible y saludable. Los aportes son fundamentales para dar contenidos de gestión de las políticas públicas a nivel nacional, regional y local; no obstante, las controversias sobre el conocimiento científico y el conocimiento tradicional persiste, llenando de escepticismo la posibilidad de avanzar en los convenios de biodiversidad y, en particular, en los objetivos de desarrollo sostenible proyectados al 2030.

Abstract The main objective of this article is to study the representations, ideas and visions generated by the governmental and judicial elite of the Federal District regarding problems such as crimes against property, as well as the treatment and punishment of thieves, between 1823 and 1840. Its hypothesis is twofold: on the one hand, these representations of property crimes and their actors revolved around the consolidation of an ideal of property, which, although it did not emerge with the advent of the republic, configured the category of citizenship. Secondly, although the enlightened rhetoric regarding the punishment of such offenders had legal and juridical continuity, the exceptionality of some criminal laws left open the space for the administration of punishments contrary to the proportionality between crimes and punishments. The present proposal, therefore, seeks to study the class prejudices surrounding property rights and their violation, explained through the need to configure a new, moderately stable social and political order, which had the periodical press as its main organ of expression.

Resumen El presente artículo tiene como objetivo principal el estudio de las representaciones, las ideas y las visiones generadas por la élite gubernativa y judicial del Distrito Federal en torno a problemas como los delitos contra la propiedad, así como también el tratamiento y la punición a los ladrones, entre 1823 y 1840. Su hipótesis es doble: por una parte, dichas representaciones de los delitos contra la propiedad y sus actores giraron en torno a la consolidación de un ideal de propiedad, que si bien no surgió con el advenimiento de la república, configuró de un modo prístino la categoría de ciudadanía. En segundo término, aunque la retórica ilustrada con respecto al castigo de tales delincuentes tuvo continuidad legal y jurídica, la excepcionalidad de algunas leyes penales dejó abierto el espacio para la administración de castigos contrarios a la proporcionalidad entre delitos y penas. La presente propuesta, en consecuencia, busca estudiar los prejuicios de clase en torno a los derechos de propiedad y su vulneración, explicados a través de la necesidad de configurar un nuevo orden social y político medianamente estable, y que tuvo como principal órgano de expresión a la prensa periódica.

Abstract The “public policy for the full guarantee of the rights of LGBT people”and on gender identities and sexual orientations in the Capital District has been implemented for almost 12 years. After its formalization, it has been implemented during the four district administrations that have governed. During this period, it has materialized through programs that have had the general objective of “guaranteeing the full exercise of the rights of people from the LGBT sectors as part of the production, social management and collective well-being of the city” (Concejo de Bogotá, 2009, p. 2); through four strategic processes: i) institutional strengthening at the district and local levels; ii) co-responsibility in the exercise of rights; iii) communication and education for cultural change; and iv) the production and application of knowledge (Acuerdo 371, 2009). This document analyzes the factors that led to its adoption in Bogotá, presents some of its main achievements, and offers recommendations for its strengthening. For the analysis, the application of the multiple currents approach is used as the main theoretical model. This approach focuses on understanding the political dynamics and processes that, at different levels and occurring independently and in parallel, have managed to come together at a specific moment (window of opportunity) to position politics as a viable institutional alternative based on the action of some political entrepreneurs (Zahariadis, 2010). In order to take stock of joint actions and to take into account how cultural and collective imaginaries about the community have affected their impact, the analysis is complemented by the framework of promoting coalitions (Sabatier y Weible, 2010) and the social construction framework and policy design (Ingram et al. 2010).

Resumen La “política pública para la garantía plena de los derechos de las personas LGBT” y sobre identidades de género y orientaciones sexuales en el Distrito Capital lleva casi 12 años en implementación. Después de su formalización, ha sido implementada durante las cuatro administraciones distritales que han gobernado desde entonces. Durante este periodo, se ha materializado a través de programas que han tenido por objetivo general “garantizar el ejercicio pleno de derechos de las personas de los sectores LGBT como parte de la producción, gestión social y bienestar colectivo de la ciudad”(Concejo de Bogotá, 2009, p. 2); esto, por medio del desarrollo de cuatro procesos estratégicos: i) el fortalecimiento institucional en los niveles distritales y locales; ii) la corresponsabilidad en el ejercicio de derechos; iii) la comunicación y educación para el cambio cultural; y iv) la producción y aplicación de conocimientos y saberes (Acuerdo 371, 2009). Este documento analiza los factores que llevaron a su adopción en Bogotá, presenta algunos de sus principales logros y ofrece recomendaciones para su fortalecimiento. Para el análisis se recurre a la aplicación del enfoque de las corrientes múltiples como modelo teórico principal; este enfoque se concentra en entender las dinámicas y procesos políticos que, en distintos niveles y ocurriendo de manera independiente y paralela, han logrado confluir en un momento específico (ventana de oportunidad) para posicionar a la política como una alternativa institucional viable a partir de la acción de unos emprendedores de política (Zahariadis, 2010). Con el fin de hacer un balance sobre las acciones conjuntas y para tener en cuenta cómo los imaginarios culturales y colectivos sobre la comunidad han afectado su incidencia, el análisis se complementa con el marco de las coaliciones promotoras (Sabatier y Weible, 2010) y el marco de la construcción social y diseño de políticas (Ingram et al., 2010).

Abstract The objective of this article is to analyze the transformations in the legal-social discourses around incest, emanating from liberal reformism and the legal transition during the second half of the 19th century, in Michoacán. We start from the fact that the enactment of the Civil Marriage Act (1859) upended the legal systems by reducing the fields in which incest was committed. From that moment on, the lawsuits began to move away from the spiritual terrain, to have only legal repercussions of a criminal nature. Through the methodology of discourse analysis and having as main sources judicial records, legislation and literature of the time, the changes that occurred in the sixties in the justice delivery system, the reduction of incest files and the generation of new discursive nodes are enunciated, all of which outlines modifications in the representations of said crime.

Resumen El objetivo del artículo es analizar las transformaciones en los discursos jurídico-sociales en torno al incesto, emanados del reformismo liberal y la transición jurídica durante la segunda mitad del siglo XIX, en Michoacán. Partimos del hecho de que la promulgación de la Ley de Matrimonio Civil (1859) trastocó los ordenamientos legales al reducir los campos en que se cometía incesto. A partir de ese momento, las demandas judiciales comenzaron a alejarse del terreno espiritual, para tener únicamente repercusiones legales de orden penal. Mediante la metodología del análisis del discurso y teniendo como fuentes principales expedientes judiciales, legislación y literatura de la época, se enuncian los cambios ocurridos en los años sesenta en el sistema de impartición de justicia, la reducción de expedientes de incesto y la generación de nuevos nodos discursivos, lo cual bosqueja modificaciones en las representaciones de dicho delito.

INTRODUCTION: Holistic healthcare service delivery requires rehabilitation personnel to consider all the components of health that influence the client's quality of life. However, there is limited literature on approaches to implementing rehabilitation services within South African public healthcare. This study explored rehabilitation personnel's (such as occupational therapists, speech therapists, physiotherapists) use of occupation-based practice impairment-based practice and the barriers and facilitators associated with their practice choice. METHODS: A qualitative research design was conducted through semi-structured interviews (13 participants), a focus group (4 participants) and community mapping. Purposive sampling was utilised to select participants in the iLembe district, KwaZulu-Natal, South Africa. Data were analysed using deductive thematic analysis. FINDINGS: Three themes emerged from the study; Attitudes towards impairment-based practice, Reflections on OBP, and The way forward. The need to focus on all the components of health rather than just the disease and the benefits of using the occupation-based practice approach were highlighted. Additionally, different factors required to implement holistic rehabilitation services and the barriers to OBP were identified. CONCLUSION: Although the study identified OBP benefits, various barriers associated with its implementation were identified. Rehabilitation personnel, community stakeholders, and clients must work together to improve OBP implementation in public healthcare by combating the barriers identified in the study. IMPLICATIONS FOR PRACTICE: This study has implications for rehabilitation service implementation in the iLembe district public healthcare sector. OBP was perceived to have more quality of life and health outcomes, which leads to implications for practice. There is a need to transition from the medical model with approaches only focusing on body structures and functions into approaches that consider all the components of health, such as the OBP. Even though there are barriers towards OBP implementation, rehabilitation personnel can still promote its implementation through inter-professional practice, continuous professional development and health promotion. Furthermore, there are implications for undergraduate programmes to equip undergraduates with the skills to implement OBP within under-resourced facilities.

RESUMEN El riesgo de amputaciones en pacientes con diabetes es 10 a 20 veces más frecuente en comparación con no diabéticos. El equipo biotecnológico desarrollado por ROKIT Healthcare, Inc., de procedencia surcoreana: Dr. INVIVO, es un equipo de biotecnología que ofrece una terapia eficaz para el tratamiento del pie diabético, con una plataforma de regeneración de órganos hiperpersonalizados que mediante la inteligencia artificial, escanea la lesión para así, fabricar un parche que contiene células madres autólogas, matriz extracelular y materiales específicos de tejido, para posteriormente aplicarla a la herida, y con esto, lograr la cicatrización y regeneración completa. El propósito del presente reporte apunta a demostrar la efectividad del tratamiento en úlceras en pie diabético y exponer los resultados de 3 casos clínicos con extensas lesiones posteriores a amputaciones de miembros inferiores, atendidos en el Hospital Distrital de Ñemby, Paraguay, utilizando esta tecnología.

ABSTRACT The risk of amputations in patients with diabetes is 10 to 20 times more frequent compared to non-diabetics. The biotechnological team developed by ROKIT Healthcare, Inc., of South Korean origin: Dr. INVIVO, is a biotechnology team that offers an effective therapy for the treatment of diabetic foot, with a hyper-personalized organ regeneration platform that, through artificial intelligence, scan the injury in order to manufacture a patch that contains autologous stem cells, extracellular matrix and specific tissue materials, to later apply it to the wound, and with this, achieve complete healing and regeneration. The purpose of this report aims to demonstrate the effectiveness of treatment in diabetic foot ulcers and present the results of 3 clinical cases with extensive injuries after lower limb amputations, treated at the District Hospital of Ñemby, Paraguay, using this technology.

Maternal healthcare in South Africa faces huge private and public health systems challenges. A key challenge for policy makers is how to address the inappropriate patterns of obstetric care in the private sector and how to mobilise private sector resources to serve the broader population dependent on the public sector, without replicating those patterns of inappropriate care. Developing and implementing new obstetric care models that address these challenges and lend themselves to public private engagements could play a vital role in efforts to improve obstetric care in the country. Drawing on insights from research we carried out on the care and contracting models used by five rural district hospitals in the Western Cape Province to contract private general practitioners to provide caesarean delivery services, this article outlines a potential alternative private sector obstetric care model with the aim of stimulating discussion by all relevant stakeholders on the development of new obstetric models for improving obstetric care in the country.

Given South Africa's historical and contemporary realities of both internal mobility and migration from other countries, this paper argues that engaging with space, place, and migration is pivotal to understanding and strengthening public health-care provision in South Africa. This paper views place as emerging from and relating to space. A mutually reinforcing and reciprocal relationship between people and place over time shapes health-care delivery and health outcomes in South Africa. Therefore, this paper argues that engaging with a place-based approach is required to understand the local context in which diverse groups are situated. There is, however, a lacuna in studies situating South(ern) African public health-care challenges within such a place-based approach. This paper presents findings from a mixed-methods study that was designed to fill this gap. The research team conducted fieldwork in six health-care facilities across two provinces in South Africa - four in Gauteng and two in the Vhembe district of Limpopo province - representing urban, peri-urban, and rural settings. The study included exploratory in-depth interviews with 77 health-care providers (including nursing and administrative staff), a survey conducted with 229 health-care users, and site visits. The findings show how diverse spaces shape and are shaped by different migrant profiles, producing diverse places, which in turn present particular demands to the public-health system. It is crucial to understand the pathways, behaviors, and meanings associated with such mobility if we are to strengthen the provision of healthcare services in South Africa.

Resumen: En los proyectos de Vivienda Social en La Florida, Núcleo San Diego y Townhouses Lo Recabarren la pregunta respecto a la colectividad se articula en torno al diseño de los elementos y dinámicas espaciales de los accesos, tanto a los conjuntos como entre sus unidades. Circulaciones de dimensiones generosas, materialidades que facilitan los cruces visuales, la posición de las unidades individuales en relación a los espacios colectivos; en todas estas obras, y en su diversidad de condiciones, es en el ámbito del acceso y circulaciones donde las decisiones de diseño extienden con fluidez el espacio de juego y de recreación desde el interior de la vivienda hasta el corazón del espacio común, ofreciendo más formas de convivencia.

Abstract: In the Social Housing Project in La Florida, San Diego Complex, and Townhouses Lo Recabarren, the question of collectivity is addressed in the design of the elements and spatial dynamics of accesses, both to the complex and between units. Generous circulation spaces, materialities that encourage visual interaction, the strategic placement of individual units vis-à-vis communal areas; in all these works, and in their diverse conditions, it is within the realm of access and circulation spaces where design decisions seamlessly extend the space of leisure and recreation from the confines of the dwelling unit to the heart of the common space, fostering more forms of living together.

RESUMEN Durante los últimos tiempos, el análisis de costos y la manera en que se relaciona con la rentabilidad ha ido cobrando mayor importancia, siendo un poco más delicada la problemática cuando se trata de empresas dentro del sector servicios. Para el presente estudio, se tuvo como objetivo determinar la relación entre la gestión estratégica de costos y la rentabilidad en empresas de transporte de carga por carretera ubicadas en el distrito de Ate (Lima - Perú) durante el 2022. El estudio se ciñó al enfoque cuantitativo, alcance correlacional y se utilizó el diseño no experimental transeccional correlacional-causal; los participantes fueron 40 responsables de este tipo de empresas (dos encargados por cada una de las 20 compañías consideradas), a los cuales se les aplicó un cuestionario de 23 ítems, y en cuya redacción se empleó la escala de Likert. Luego del procesamiento y análisis de la información, se evidenció la existencia de una asociación fuerte y significativa (p <0.05) entre las dos variables del estudio, debido a que se halló un coeficiente de correlación de Spearman de 0.843. En consecuencia, se afirma que la gestión estratégica de costos se relaciona directa, fuerte y significativamente con la rentabilidad en empresas de transporte de carga por carretera del distrito de Ate; eso permite aseverar que, a una mejor gestión estratégica de costos, mayor rentabilidad.

ABSTRACT In recent times, cost analysis and the way in which it relates to profitability has become more important, with the problem being a little more delicate when it comes to companies within the service sector. For the present study, the objective was to determine the relationship between strategic cost management and profitability in road freight transport companies located in the district of Ate (Lima - Peru) during 2022. The study adhered to the quantitative approach, correlational scope and used the non-experimental correlational-causal cross-sectional design; the participants were 40 managers of this type of companies (two managers for each of the 20 companies considered), to whom a questionnaire of 23 items was applied, and in whose writing the Likert scale was used. After processing and analyzing the information, the existence of a strong and significant association (p <0.05) between the two study variables was evidenced, due to the fact that a Spearman correlation coefficient of 0.843 was found. Consequently, it is stated that the strategic cost management is directly, strongly and significantly related to the profitability in road freight transport companies in the district of Ate; this allows us to assert that, with better strategic cost management, greater profitability.

INTRODUCTION: Globally, the number of people unaware of their HIV status, and the rate of transmission of the disease, remains high. Scaling up of HIV testing opportunities and settings, particularly in the dental clinical setting, is needed to address this major public health concern. AIM AND OBJECTIVES: This study assessed dental patients' knowledge, attitudes and practices in voluntary counselling and rapid HIV testing (VCT) in the dental workplace in the eThekwini district, KwaZulu-Natal to determine their understanding and support for these services. METHODS: This was a cross-sectional, descriptive study. A total of 250 questionnaires were distributed to dental patients located in private and public dental settings in the eThekwini district. Two hundred and fifty (n=250) completed questionnaires were retrieved, yielding a response rate of 100%. RESULTS: More than half of the participants (n=134; 53.6%) indicated not to have heard of rapid HIV testing or were "unsure" of their knowledge regarding rapid HIV testing. The majority of participants (n=209; 83.6%) reported wanting the option to test for HIV at the dental workplace and 76.8% (n=192) indicated that rapid HIV testing should be routinely conducted by the oral healthcare worker. Participants (n=189; 75.6%) indicated to be less willing to partake in HIV testing should there be a cost implication. Some participants (n=104; 41.6%) indicated that they did not want the oral healthcare worker to perform the test due to perceived incompetency in rapid HIV counselling and testing. More participants from urban (n=214; 85.6%) and rural (n=217; 86.8%) areas of living were keen on the option to test for HIV at the dental workplace, with only 46.8% (n=117) of the informal dwellers sharing the same sentiment. CONCLUSION: Participants reported inadequate knowledge and practice of VCT at the dental workplace. Participants had positive attitudes towards VCT implementation in the dental setting, provided that the cost of conducting of the test was free.

Abstract In Argentina, hemolytic uremic syndrome (HUS) caused by EHEC has the highest incidence in the world. EHEC infection has an endemo-epidemic behavior, causing 20-30% of acute bloody diarrhea syndrome in children under 5 years old. In the period 2016-2020, 272 new cases per year were notified to the National Health Surveillance System. Multiple factors are responsible for HUS incidence in Argentina including person-to-person transmission. In order to detect possible EHEC carriers, we carried out a preliminary study of the frequency of kindergarten teachers with anti-LPS antibodies against the most prevalent EHEC serotypes in Argentina. We analyzed 61 kindergarten teachers from 26 institutions from José C. Paz district, located in the suburban area of Buenos Aires province, Argentina. Fifty-one percent of the plasma samples had antibodies against O157, O145, O121 and O103 LPS: 6.4% of the positive samples had IgM isotype (n=2), 61.3% IgG isotype (n=19) and 32.3% IgM and IgG (n=10). Given that antibodies against LPS antigens are usually short-lived specific IgM detection may indicate a recent infection. In addition, the high percentage of positive samples may indicate a frequent exposure to EHEC strains in the cohort studied, as well as the existence of a large non-symptomatic population of adults carrying pathogenic strains that could contribute to the endemic behavior through person-to-person transmission. The improvement of continuous educational programs in kindergarten institutions could be a mandatory measure to reduce HUS cases not only in Argentina but also globally.

Resumen En Argentina, el síndrome urémico hemolítico causado por Escherichia coli enterohemorrágica (EHEC) tiene la más alta incidencia del mundo. Las infecciones por EHEC tienen un comportamiento endemoepidémico y causan del 20 al 30% de los síndromes de diarrea sanguinolenta en niños menores de 5 años. En el período 2016-2020, se notificaron 272 nuevos casos por año al Sistema de Vigilancia de Salud Nacional. Múltiples factores son responsables de la alta incidencia de SUH en Argentina, incluyendo la transmisión persona-persona. Con el objetivo de detectar posibles portadores asintomáticos de EHEC, realizamos un estudio preliminar de la frecuencia de anticuerpos antilipopolisacáridos contra los serotipos de EHEC más prevalentes en Argentina. El estudio se realizó con muestras de plasma obtenidas de 61 maestras y maestros de jardines de infantes de 26 instituciones del distrito de José C. Paz, localizado en el área suburbana de la provincia de Buenos Aires, Argentina. El 51% de las muestras presentaron anticuerpos contra los serotipos de lipopolisacáridos O157, O145, O121 y O103; el 6,4% de las muestras positivas tuvieron el isotipo IgM (n=2), el 61,3% el isotipo IgG (n=19) y el 32,3% los isotipos IgM e IgG (n=10). Dado que los anticuerpos antilipopolisacáridos presentan usualmente una duración corta, la detección de IgM específica podría indicar una infección reciente. Además, el alto porcentaje de muestras positivas hallado podría indicar una exposición frecuente a las cepas de EHEC en la cohorte estudiada. Asimismo, la gran población de adultos portadores asintomáticos de estas cepas patógenas podría contribuir al comportamiento endémico, a través de la transmisión persona-persona. El perfeccionamiento de programas educacionales continuos en jardines de infantes podría constituir una medida importante para reducir los casos de síndrome urémico hemolítico, no solo en Argentina, sino también en el mundo.

ABSTRACT Introduction. Leishmaniasis is an endemic zoonotic disease widely distributed in Peru. Objectives. Identify transmission scenarios and the population residing in them and identify the characteristics of the affected populations during the period 2010-2022. Methods. Descriptive, cross-sectional, ecological study with district as analysis units. Publicly accessible secondary data sources were used. Results. During the study period, 85,117 cases were reported; 7,374,007 (22.08%) inhabitants live in 543 districts with continuous transmission; 1,146,7420 (34.33%) inhabitants reside in 454 districts with sporadic reports of cases; and 1,455,8983 (43.59%) reside in 893 transmission-free districts. 98.16% of the cases occurred in districts with continuous transmission; 1.84% occurred in districts with sporadic case reports. The mean annual incidence rate was 3.48 cases/10,000 inhabitants. 18 departments report continuous transmission; Madre de Dios (42.45 cases/10,000 inhabitants) and Cusco (15.78 cases/10,000 inhabitants) report the highest rates. The populations with higher absolute risk are men, adolescents, and young people; residents: from jungle districts; from the quintile with the highest monetary poverty; from the quintile with the highest percentage with at least 1 NBI; and from the quintile with the lowest human development index. Conclusion. Leishmaniasis is widely distributed in Peru, with 56.41% of the population living in districts reporting cases. There are population groups with a higher absolute risk, which can be the target of differentiated prevention and control interventions.

RESUMEN Introducción. La leishmaniasis es una enfermedad zoonótica endémica con amplia distribución en Perú. Objetivo. Identificar los escenarios de transmisión de leishmaniasis y la población que reside en estos, e identificar las características de las poblaciones afectadas durante el periodo 2010 a 2022. Métodos. Estudio descriptivo, transversal, ecológico con unidad de análisis el nivel distrital. Se utilizó datos de fuentes secundarias de acceso público. Resultados. En el periodo de estudio se reportaron 85 117 casos, 7 374 007(22,08%) habitantes residían en 543 distritos con transmisión continua, 11 467 420 (34,33%) habitantes que residían en 454 distritos con reporte esporádico de casos y 14 558 983(43,59%) residían en 893 distritos libres de trasmisión. El 98,16% de los casos ocurrieron en distritos con trasmisión continua, el 1,84%, en distritos con reporte esporádico de casos. La incidencia acumulada media anual fue 3,48 casos/10 000 habitantes. 18 departamentos reportaban trasmisión continua, Madre de Dios (42,45 casos/10 000 habitantes) y Cusco (15,78 casos/10 000 habitantes) tuvieron las tasas más altas. Las poblaciones de mayor riesgo son: hombres, adolescentes y jóvenes; residentes de distritos: de selva, del quintil de mayor pobreza monetaria, del quintil con mayor porcentaje con al menos 1 NBI, y del quintil de menor índice de desarrollo humano. Conclusión. La leishmaniasis tiene amplia distribución en Perú, 56,41% de la población habita en distritos que reportan casos. Existen grupos poblacionales con mayor riesgo absoluto, los cuales pueden ser blanco de intervenciones diferenciadas de prevención y control.