Resumo Este estudo avaliou a dinâmica de anticorpos em cães tratados para leishmaniose visceral canina (LVC). Vinte e um cães, naturalmente infectados por Leishmania spp., foram agrupados com base no protocolo de tratamento: G1 (n=4) recebeu alopurinol; G2 (n=10) alopurinol e miltefosina; e G3 (n=7) alopurinol, miltefosina e vacina Leish-Tec®. Os cães foram monitorados mensalmente pelo período de um ano. Para verificar os títulos de anticorpos séricos, foi realizada a reação de imunofluorescência indireta. Observou-se que os cães do G1 e G2 apresentaram escores clínicos e títulos de anticorpos mais baixos, em comparação com os parâmetros avaliados no pré-tratamento; no entanto, recidivas clínicas foram observadas em três animais. No G3, os escores clínicos foram mais baixos do que no pré-tratamento; no entanto, apresentaram títulos de anticorpos relativamente estáveis e não foram observadas recidivas clínicas. Todos os animais, submetidos aos protocolos de tratamento avaliados, apresentaram melhora relativa dos sinais clínicos. Além disso, a resposta imune dos animais deve ser considerada, dados os desafios das cargas parasitárias nas infecções. Portanto, faz-se necessária a complementação dos métodos de acompanhamento clínico e terapêutico de cães com LVC, a fim de estabelecer o risco de transmissibilidade do agente em cães infectados e tratados.

Abstract This study evaluated dynamics of antibodies in dogs treated for canine visceral leishmaniasis (CVL). Twenty-one dogs naturally infected by Leishmania spp. were grouped based on the treatment protocol: G1 (n=4) received allopurinol; G2 (n=10) allopurinol with miltefosine; and G3 (n=7) allopurinol, miltefosine and Leish-Tec® vaccine. The dogs were monitored monthly for a period of one year. To verify serum antibody titers, an indirect immunofluorescence reaction was performed. We found that dogs from G1 and G2 had lower clinical scores and antibody titers, when compared to the parameters evaluated in pre-treatment; however, clinical relapses were observed in three animals. In G3, clinical scores were lower than pre-treatment; however, they presented relatively stable antibody titers and no clinical relapse was observed. All animals submitted to the evaluated treatment protocols showed relative improvement in clinical signs. Furthermore, the immune response of animals must be considered, given the challenges of parasitic loads in infections. Therefore, it is necessary to complement the methods of clinical and therapeutic monitoring of dogs with CVL in order to establish the risk of transmissibility of the agent in infected and treated dogs.

BACKGROUND The nematode Angiostrongylus cantonensis, which is endemic to Southeast Asia and adjacent Pacific Islands, has already been recorded in more than 30 countries, including Brazil and other South American nations. It is one of the principal etiological agents of the zoonosis Eosinophilic Meningitis (EoM), which has a number of different species of terrestrial gastropods that act as its intermediate hosts. OBJECTIVE The present study investigated the occurrence of the larvae of this nematode in specimens of terrestrial molluscs collected in half of the municipalities of the Brazilian State of Rio de Janeiro. METHODS The study is based on the surveillance of this nematode in the Brazilian State of Rio de Janeiro, where terrestrial snails and slugs were collected in more than half of the state’s municipalities (46 in all), and examined for parasitological infections. The nematode larvae retrieved from these specimens were identified based on their morphology and cytochrome oxidase I (COI) mitochondrial DNA sequences. FINDINGS Angiostrongylid larvae were found in 230 (8.8%) of the 2,600 terrestrial molluscs examined, collected from 26 municipalities. Overall, 14 terrestrial gastropod species were identified, including both native and exotic taxa, and six were found to be infected naturally by A. cantonensis. The natural infection rates by Angiostrongylus in the different terrestrial molluscs species were 12.5% in Angustipes erinaceus, 9.7% in Achatina fulica, 6.8% in Bradybaena similaris, 6.3% in Sarasinula linguaeformis, 3.9% in Leptinaria unilamellata, and 4.6% in Subulina octona. A. fulica was the most frequent and extensively distributed species, with infected snails being found in 22 municipalities. MAIN CONCLUSIONS The data from this first comprehensive survey of A. cantonensis in Rio de Janeiro highlights the potential epidemiological risk of human infection in this state. Mapping the spread of infected molluscs will also provide essential information for the evaluation of the risk of human infection, and should help local health authorities to provide a faster and more accurate diagnosis whenever neuroangiostrongyliasis is suspected.

RESUMO: O Rio Grande do Sul possui uma grande diversidade de espécies de répteis distribuídos por todo o Estado. Devido às ações antrópicas, como a fragmentação de habitats, estes animais vêm sendo observados com frequência no meio urbano e periurbano. Isso facilita a disseminação de patógenos entre animais e seres humanos, sendo um risco a saúde única, visto que muitas doenças são consideradas zoonoses. A leptospirose está entre as zoonoses mais comuns do mundo e é causada pelas espécies patogênicas da bactéria do gênero Leptospira. Ainda não se sabe o papel dos répteis no ciclo da doença, porém, estudos sorológicos demonstraram positividade para anticorpos contra Leptospira spp. em cágados e serpentes, o que pode indicar que estes animais atuam na manutenção do patógeno no ambiente. O objetivo deste estudo foi observar a presença de anticorpos anti-Leptospira em répteis oriundos de resgate e levados ao Núcleo de Reabilitação da Fauna Silvestre e Centro de Triagem de Animais Silvestres da Universidade Federal de Pelotas (NURFS-CETAS/UFPEL). As amostras foram coletadas de 55 animais (39 Trachemys dorbigni; 3 Philodryas patagoniensis; 3 Caiman latirostris; 3 Salvator merianae; 2 Acanthochelys spixii; 2 Phrynops hilarii; 2 Hydromedusa tectifera; 1 Philodryas aestiva), durante o período de agosto de 2022 a dezembro de 2023, e testadas para 12 sorovares de referência. Dois animais demonstraram positividade, um deles para o sorovar patogênico Pyrogenes e outro para o sorovar patogênico Canicola. Este resultado demonstra a importância de outras espécies, além dos mamíferos, como potenciais reservatórios e responsáveis pela manutenção da leptospirose no ambiente. RESUMO Estado antrópicas habitats periurbano humanos única doença porém spp serpentes ambiente antiLeptospira anti NURFSCETAS/UFPEL. NURFSCETASUFPEL NURFS CETAS/UFPEL . CETAS UFPEL (NURFS-CETAS/UFPEL) 5 39 (3 dorbigni patagoniensis latirostris merianae spixii hilarii tectifera aestiva, aestiva , aestiva) 202 2023 referência Canicola mamíferos NURFSCETAS NURFSCETAS/UFPEL CETASUFPEL (NURFS-CETAS/UFPEL ( 20

ABSTRACT: The state of Rio Grande do Sul has a great diversity of reptile species distributed throughout its territory. Due to human actions, such as habitat fragmentation, these animals have been frequently observed in urban and peri-urban environments. This facilitates the spread of pathogens between animals and humans, posing a unique health risk, as many diseases are considered zoonoses. Leptospirosis is among the most common zoonoses in the world and is caused by pathogenic species of bacteria of the genus Leptospira. The role of reptiles in the cycle of this disease is yet unknown. However, serological studies have demonstrated positivity for antibodies against Leptospira spp. in tortoises and snakes, which may indicate that these animals act in maintaining the pathogen in the environment. This observed the presence of anti-Leptospira antibodies in rescued reptiles taken to the Center for Rehabilitation of Wild Fauna and Screening Center for Wild Animals at the Universidade Federal de Pelotas (NURFS-CETAS/UFPEL). Samples were collected from 55 animals (39 Trachemys dorbigni; 3 Philodryas patagoniensis; 3 Caiman latirostris; 3 Salvator merianae; 2 Acanthochelys spixii; 2 Phrynops hilarii; 2 Hydromedusa tectifera; 1 Philodryas aestiva) from August 2022 to December 2023 and tested for 12 reference serovars. Two animals demonstrated positivity, one for the pathogenic serovar Pyrogenes and the other for the pathogenic serovar Canicola. This result reflected the importance of different species besides mammals as potential reservoirs and responsible for maintaining leptospirosis in the environment. ABSTRACT territory actions fragmentation periurban peri environments humans risk unknown However spp snakes environment antiLeptospira anti NURFSCETAS/UFPEL. NURFSCETASUFPEL NURFS CETAS/UFPEL . CETAS UFPEL (NURFS-CETAS/UFPEL) 5 39 (3 dorbigni patagoniensis latirostris merianae spixii hilarii tectifera aestiva 202 serovars Canicola NURFSCETAS NURFSCETAS/UFPEL CETASUFPEL (NURFS-CETAS/UFPEL ( 20

RESUMO Objetivo. Descrever a experiência brasileira na resposta a emergências de saúde pública em 2023, bem como a estrutura organizacional e as características epidemiológicas. Métodos. Foram analisadas três emergências (estudos de casos) ocorridas durante o ano do estudo de acordo com as ações empreendidas durante a resposta e os impactos na população. As emergências de saúde pública foram resumidas e analisadas por meio de pesquisas em documentos e sites oficiais do Ministério da Saúde e de autoridades sanitárias municipais. Resultados. Caso 1 – Emergência devido à falta de assistência: considerada pelo governo brasileiro uma emergência de saúde pública de importância nacional, exigiu a mobilização de um Centro de Operações de Emergência em Saúde Pública (COE) para a resposta devido à complexidade das ações. Caso 2 – Emergência devido a zoonoses (arbovírus e influenza aviária): a estrutura de resposta do COE foi usada para desenvolver atividades para interromper o surgimento de arbovírus e evitar uma emergência de influenza aviária no país. Caso 3 – Emergências devido a desastres: exigiram estruturas de resposta municipais e uso do COE para coordenar ações com o apoio do governo federal. Conclusões. A experiência brasileira destaca a importância dos seguintes fatores: coordenação intra e intersetorial na gestão das ações de resposta; monitoramento e comunicação constantes para aprimorar as medidas de resposta; apoio nacional aos esforços municipais de resposta; e adaptação da estrutura do COE aos diferentes contextos e complexidades das emergências enfrentadas.

RESUMEN Objetivo. Describir la experiencia de la respuesta a emergencias de salud pública en Brasil en el 2023, su estructura organizativa y sus características epidemiológicas. Métodos. Se analizaron tres emergencias (estudios de casos) ocurridas durante el año de estudio en lo que respecta a las medidas aplicadas durante la respuesta y su impacto en la población. Las emergencias de salud pública se resumieron y analizaron mediante la investigación de los documentos y sitios web oficiales del Ministerio de Salud y de las autoridades de salud locales. Resultados. En el caso 1, una emergencia por falta de asistencia que el gobierno brasileño consideró una emergencia de salud pública de importancia nacional, fue necesario un centro de operaciones de emergencia (COE) para la respuesta debido a la complejidad de las medidas. En el caso 2, una emergencia debida a varias zoonosis (infecciones por arbovirus y gripe aviar), se utilizó la estructura de respuesta del COE para llevar a cabo actividades destinadas a detener el surgimiento de los arbovirus y prevenir una emergencia de gripe aviar en el país. Por último, en el caso 3, las emergencias debidas a catástrofes requirieron estructuras de respuesta locales y utilizaron el COE para coordinar las medidas aplicadas, con el apoyo del gobierno federal. Conclusiones. La experiencia brasileña destaca la importancia de la coordinación intra e intersectorial en la gestión de las medidas de respuesta, el seguimiento y la comunicación constantes para mejorar esas medidas, el apoyo nacional a las actividades locales de respuesta y la adaptación de la estructura del COE a los diferentes contextos y complejidades de las emergencias afrontadas.

ABSTRACT Objective. To describe the Brazilian experience of responding to public health emergencies in 2023, the organizational structure, and epidemiological characteristics. Methods. Three emergencies (case studies) that occurred during the study year were analyzed according to the actions implemented during the response and the impacts on the population. The public health emergencies were summarized and analyzed through research on official documents and websites of the Ministry of Health and local health authorities. Results. Case 1 – Emergency due to lack of assistance, considered by the Brazilian government to be a public health emergency of national importance, required an Emergency Operations Center (EOC) for the response due to the complexity of the actions. Case 2 – Emergency due to zoonoses (arboviruses and avian influenza) used the EOC response structure to develop activities aimed at stopping the emergence of arboviruses and preventing an avian influenza emergency in the country. Finally, case 3 – Emergencies due to disasters required local response structures and used the EOC to coordinate their actions with the federal government’s support. Conclusions. The Brazilian experience highlights the importance of intrasectoral and intersectoral coordination in managing response actions, constant monitoring and communication to improve response measures, national support for local response efforts, and adaptation of the EOC structure to the different contexts and complexities of the emergencies faced.

A esporotricose transmitida por gatos é atualmente hiperendêmica na Região Metropolitana do Rio de Janeiro, Brasil. Apesar do contexto zoonótico, a vigilância é fragmentada, sendo as dimensões humana e animal avaliadas separadamente. Este estudo descreve e compara os padrões espaciais e temporais dos casos de esporotricose em humanos e animais (cães e gatos) notificados ao Sistema de Informação de Agravos de Notificação na Região Metropolitana do Rio de Janeiro, no período de 2013 a 2020. Foi realizado um estudo ecológico, baseado na evolução espacial e temporal da esporotricose na área, comparando-se as séries temporais para casos humanos e animais por mês. Também comparamos as incidências humanas cumulativas e a proporção de casos de animais por habitante por bairros ou subdistritos e exploramos a correlação espacial com Moran global e local. Durante o período, foram notificados 9.552 casos suspeitos de esporotricose humana e 12.532 de animais. Análises exploratórias espaciais e temporais apontaram ações que favoreceram a notificação nesse período, como o estabelecimento da notificação obrigatória e campanhas relacionadas à assistência veterinária pública. Verificou-se também a existência de aglomerados na zona oeste da capital e cidades fronteiriças e a expansão da esporotricose para outras áreas desfavorecidas da capital e da periferia da região metropolitana. Ademais, observamos padrões divergentes entre a distribuição da esporotricose humana e animal no tempo e no espaço. Nossos achados mostram uma expansão espacial da esporotricose para humanos e animais; no entanto, eles também destacam as limitações da vigilância atual, indicando subestimação da magnitude do problema.

La esporotricosis transmitida por gatos es actualmente hiperendémica en la Región Metropolitana de Río de Janeiro, Brasil. A pesar del contexto zoonótico, la vigilancia está fragmentada, y las dimensiones humana y animal se evalúan por separado. Este estudio describe y compara los patrones espaciales y temporales de los casos de esporotricosis en humanos y animales (perros y gatos) notificados al Sistema de Información de Enfermedades de Notificación Obligatoria en la Región Metropolitana de Río de Janeiro, en el período de 2013 a 2020. Se realizó un estudio ecológico, basado en la evolución espacial y temporal de la esporotricosis en la región, comparando las series temporales de casos humanos y animales por mes. También se compararon las incidencias humanas acumuladas y la proporción de casos de animales por habitante por barrios o subdistritos, y se exploró la correlación espacial con Moran global y local. Durante el período, se reportaron 9.552 casos sospechosos de esporotricosis humana y 12.532 casos en animales. Los análisis exploratorios espaciales y temporales indicaron acciones que favorecieron la notificación en este período, como la notificación obligatoria y las campañas relacionadas con la atención veterinaria pública. También hubo agrupaciones en la zona oeste de la capital y las ciudades fronterizas, y la expansión de la esporotricosis hacia otras zonas desfavorecidas de la capital y la periferia de la región metropolitana. Además, se observaron patrones divergentes entre la distribución de la esporotricosis humana y animal en el tiempo y el espacio. Los hallazgos muestran una expansión espacial de la esporotricosis a humanos y animales; sin embargo, también resaltan las limitaciones de la vigilancia continua, lo que indica una subestimación de la magnitud del problema.

Cat-transmitted sporotrichosis is currently hyperendemic in the Rio de Janeiro Metropolitan Area, Brazil. Despite the zoonotic context, surveillance is fragmented, with human and animal contagion being assessed separately. This study aimed to describe and compare spatial and temporal patterns of sporotrichosis cases in humans and animals (cats and dogs) reported to the Brazilian Information System for Notificable Diseases in the Rio de Janeiro metropolitan area, from 2013 to 2020. We conducted an ecological study based on the spatial and temporal evolution of sporotrichosis in the area. We compared the time series of human and animal cases per month. We also compared the cumulative human incidences and the ratio of animal cases per inhabitant by neighborhood or subdistrict and explored spatial correlation with global and local Moran’s I. During the period, 9,552 human and 12,532 animal sporotrichosis suspected cases were reported. Via spatial and temporal exploratory analyses, we verified actions that favored notification during this period, such as establishing mandatory notification and campaigns related to public veterinary care. We also verified the existence of clusters in the west zone of the capital and border cities, and the expansion of sporotrichosis to other disadvantaged areas in the capital and the outskirts of the metropolitan area. Moreover, we observed divergent patterns between human and animal sporotrichosis distribution in time and space. Our findings show a spatial expansion of sporotrichosis in humans and animals; however, they also highlight the limitations of ongoing surveillance, indicating we probably are underestimating magnitude of the problem.

Abstract Background: Due to new seafood consumption habits, anisakiasis has been reported in more countries worldwide. However, little is known if fish consumers really know about this zoonosis. Aim: The main goal of this study was to know the degree of knowledge about anisakiasis by fish consumers, as well as to know if some socio-demographic characteristics are related to this level of knowledge in the Maule Region, Chile. Methods: A survey conducted in the Maule region was applied to 578 people. The results indicated that the level of knowledge of fish consumers about anisakiasis had a score of 46,05 on a scale of 1 to 100, which was classified as low. Furthermore, there was no difference in knowledge between men or women (p-value = 0.420), as well as when people live on the coast or in the interior areas of the Maule region (p-value = 0.807). However, there is a higher knowledge among young people and those with a higher educational level (p-values of 0.005 and < 0.001, respectively). Conclusion: In view of these results, and in accordance with the "One Health" approach, we believe that it is necessary to educate the population about the dangers of consuming raw fish and shellfish.

Resumen Introducción: Debido a los nuevos hábitos de consumo de productos marinos, la anisakiasis ha sido descrita en más países del mundo. Sin embargo, poco se sabe si los consumidores de pescados realmente conocen esta zoonosis. Objetivos: El principal objetivo del presente estudio fue saber el grado de conocimiento sobre anisakiasis en consumidores, además de conocer si algunos factores sociodemográficos se relacionan con este nivel de conocimiento en la Región del Maule, Chile. Métodos: Se realizó una encuesta a 578 habitantes de la región. Resultados. Los resultados indicaron que el nivel de conocimiento de los consumidores de pescado sobre la anisakiasis tuvo un puntaje de 46,05 en una escala del 1 al 100, lo cual se clasificó como medio. Además, no hubo diferencias de conocimiento entre hombres o mujeres (valor p = 0,420), así como cuando las personas viven en la costa o en el interior de la región (valor p = 0,807). Sin embargo, existe un mayor conocimiento en personas jóvenes y con mayor nivel educacional (valores p de 0,005 y < 0,001; respectivamente). Conclusión: A la vista de estos resultados, y de acuerdo con el enfoque "Una salud", creemos que es necesario educar a la población sobre los peligros del consumo de pescado y mariscos crudos.

Abstract Introduction: The urban ecosystems of Costa Rica are home to several anuran species that coexist with still poorly studied parasites. Objective: To report the presence of zoonotic and non-zoonotic gastrointestinal parasites in Hyalinobatrachium fleischmanni, Espadarana prosoblepon, Smilisca sordida, in urban river habtat in San José, Costa Rica. Methods: We analyzed 30 fecal samples, from specimens kept in the laboratory for ten months, with three diagnostic techniques. Results: We detected for the first time in Costa Rica the presence of Giardia duodenalis and Cryptosporidium parvum in H. fleischmanni, E. prosoblepon and S. sordida (with antigen detection tests); in addition, nematodes (Strongylidae and Rhabdias spp.), intestinal ciliates and cestode eggs with other diagnostic techniques. Conclusion: These urban frogs carried at least six types of parasites, some of them, first reports.

Resumen Introducción: Los ecosistemas urbanos de Costa Rica albergan varias especies de anuros que coexisten con parásitos aún poco estudiados. Objetivo: Informar sobre la presencia de parásitos gastrointestinales zoonóticos y no zoonóticos en Hyalinobatrachium fleischmanni, Espadarana prosoblepon y Smilisca sordida, en hábitats fluviales urbanos en San José, Costa Rica. Métodos: Analizamos 30 muestras de heces de ejemplares mantenidos en el laboratorio durante diez meses, utilizando tres técnicas de diagnóstico. Resultados: Detectamos por primera vez en Costa Rica la presencia de Giardia duodenalis y Cryptosporidium parvum en H. fleischmanni, E. prosoblepon y S. sordida (mediante pruebas de detección de antígeno); además, encontramos nematodos (Strongylidae y Rhabdias spp.), ciliados intestinales y huevos de céstodos con otras técnicas de diagnóstico. Conclusión: Estas ranas urbanas tenían al menos seis tipos de parásitos, algunos de ellos primeros registros.

Introduction: Hydatidosis, or cystic echinococcosis, is a parasitic zoonosis caused by the Echinococcus granulosus worm in the larval stage and is currently classified as the main endemic zoonosis in Chile. The most commonly affected organ is the liver (59-75% of the cases), with primary pelvic echinococcosis being extremely rare (< 1%). However, in endemic countries, it must be considered in the differential diagnoses of cystic lesions of the pelvis. Case Report: We present a clinical case of primary pelvic echinococcosis with extension to the left gluteal region. Complementary studies find no evidence of hydatidosis in the liver, lungs or other locations. Considering its rare incidence, its suspicion, diagnosis, and management will be discussed.

Resumen Introducción La hidatidosis o equinococosis quística, es una zoonosis parasitaria causada por la forma larvaria del cestodo Echinococcus granulosus y actualmente se clasifica como la principal zoonosis endémica en Chile. El órgano comúnmente afectado es el hígado (59-75% de los casos), siendo la hidatidosis pélvica primaria extremadamente infrecuente (< 1%), sin embargo en países endémicos debe ser considerada en los diagnósticos diferenciales de lesiones quísticas de la pelvis. Caso Clínico: Se presenta un caso clínico de hidatidosis pélvica primaria con extensión a la región glútea izquierda, los estudios complementarios no evidencian hidatidosis hepática, pulmonar u otra ubicación. Se discutirá sobre la sospecha, diagnóstico y manejo de ésta, en consideración a su infrecuente incidencia.

RESUMEN La fasciolosis constituye una zoonosis de significativa relevancia en salud pública, inducida por parásitos del género Fasciola, específicamente Fasciola hepatica, que es un helminto de la clase Trematoda, la cual exhibe una morfología lanceolada y se implica en el ciclo zoonótico mediante la contaminación de cuerpos de agua y vegetación acuática, incluidos los berros, mediante las metacercarias, su forma infectiva. Su ciclo biológico comprende una fase de migración desde el intestino del hospedador hacia el hígado, donde maduran y se establecen en los conductos biliares, en los que producen alteraciones patológicas como lesiones hepáticas directas, obstrucción de los conductos biliares y respuesta inflamatoria sistémica. Clínicamente, estos eventos se manifiestan mediante síntomas predominantemente hepáticos y gastrointestinales secundarios a la afectación hepática, que pueden escalar a complicaciones graves como cirrosis y abscesos hepáticos en ausencia de un diagnóstico temprano y un tratamiento adecuado. Se presenta el caso de una paciente de 54 años que ingresó por emergencia manifestando un cuadro caracterizado por cefalea, vómitos, tos, palpitaciones y disnea de esfuerzo. La evaluación diagnóstica inicial, orientada por la presentación de coledocolitiasis en ecografía, derivó en una colangiopancreatografía retrógrada endoscópica que reveló la presencia de una única papila; ello, junto con la sintomatología descrita, permitió establecer el diagnóstico de fasciolosis hepática ocasionada por Fasciola hepatica, la cual fue posteriormente extraída. Este hallazgo subraya la importancia de la inclusión de esta parasitosis como diagnóstico diferencial de patologías hepáticas y gastrointestinales, particularmente en contextos epidemiológicos compatibles o antecedentes de exposición a fuentes de agua dulce contaminadas.

ABSTRACT Fasciolosis (liver fluke disease) is a zoonosis of significant public health relevance, caused by parasites of the genus Fasciola, specifically of the species Fasciola hepatica, a helminth of the class Trematoda, which exhibits a lanceolate morphology and is involved in the zoonotic cycle through contamination of bodies of water and aquatic vegetation, including watercress, by means of metacercariae, its infective form. Their biological cycle includes a migration phase from the host’s intestine to the liver, where they mature and settle in the bile ducts, causing pathological changes such as direct hepatic lesions, bile duct obstruction and a systemic inflammatory response. Clinically, these events manifest through predominantly hepatic and gastrointestinal symptoms secondary to hepatic involvement, which can escalate to severe complications such as cirrhosis and hepatic abscesses in the absence of early diagnosis and adequate treatment. We present the case of a 54-year-old female patient who was admitted to the emergency room with a condition characterized by headache, vomiting, cough, palpitations and dyspnea on exertion. The initial diagnostic evaluation, guided by the ultrasound presentation of choledocholithiasis, led to an endoscopic retrograde cholangiopancreatography (ERCP) that revealed the presence of a single papilla. This finding, along with the described symptoms, facilitated the diagnosis of hepatic fasciolosis caused by Fasciola hepatica, which was later removed. Likewise, it underscores the importance of including this parasitosis as a differential diagnosis for hepatic and gastrointestinal diseases, particularly in compatible epidemiological contexts or a history of exposure to contaminated freshwater sources.

Resumen El lupus eritematoso sistémico (LES) es una enfermedad autoinmune por respuesta autorreactiva de células B y T con pérdida de la tolerancia inmunitaria frente a autoantígenos. Se manifiesta con astenia, fiebre, mialgias, artralgias, erupción dérmica y daño fatal a órgano. El dengue es una enfermedad zoonótica por el virus de dengue (DENV), transmitida por mosquitos de la especie Aedes aegypti. La sospecha diagnóstica se realiza en presencia de síndrome febril agudo con manifestaciones clínicas y antecedentes demográficos. La confirmación es por la detección del virus mediante PCR-RT o de la proteína estructural NS1. El presente caso clínico se trata de una mujer de 58 años con datos de exacerbación lúpica y con manifestaciones clínicas sugerentes de dengue; al interrogatorio evidenció el antecedente de viaje a zona endémica. La prueba confirmatoria de PCR-RT conduce a adecuación del tratamiento médico. La importancia del caso recae en diferenciar el diagnóstico oportunamente.

Abstract Systemic Lupus Erythematosus (SLE) is an autoimmune disease caused by an autoreactive B and T cell response with loss of immune tolerance to self-antigens. It manifests with asthenia, fever, myalgias, arthralgias, skin rash and fatal organ damage. Dengue is a zoonotic disease caused by the dengue virus (DENV), transmitted by mosquitoes of the Aedes aegypti species. Diagnostic suspicion is made in the presence of acute febrile syndrome with clinical manifestations and demographic history. Confirmation is made through virus detection by RT-PCR, or the structural NS1 protein. The present case report is a 58-year-old woman with data of lupus exacerbation and with clinical manifestations suggestive of Dengue fever, with a history of travel to an endemic area. The confirmatory RT-PCR test leads to appropriate medical treatment. The importance of the case lies in differentiating the diagnosis in a timely manner.

Resumen Introducción. La angiostrongiliasis abdominal y neura -causadas por Angiostrongylus costaricensis y A. cantonensis, respectivamente- son zoonosis que involucran caracoles como huéspedes intermediarios. Colombia ya ha reportado casos en humanos y la ampliación de la distribución de Lissachatina fulica y Cornu aspersum aumenta la preocupación en salud pública debido al riesgo potencial de transmisión en áreas donde los parásitos y sus huéspedes coexisten. Objetivo. Identificar la presencia de Angiostrongylus spp. en caracoles de las especies L. fulica y C. aspersum en Antioquia (Colombia). Materiales y métodos. Se llevó a cabo un estudio transversal prospectivo con una población de 5.855 caracoles de L. fulica o C. aspersum, capturados en diez ciudades del valle de Aburrá; 169 muestras fueron recolectadas en 28 puntos de muestreo. Se disecaron los tejidos pulmonares de los caracoles y se emplearon técnicas moleculares para detectar la presencia de Angiostrongylus spp. Resultados. Angiostrongylus costaricensis fue detectado en 18 muestras agrupadas (30 %; IC95%: 19,2-43,3), tanto en L. fulica como en C. aspersum. Medellín fue el municipio con el mayor número de muestras positivas (33,3 %). El 72,2 % de los lugares positivos reportaron la presencia de roedores. Ninguna de las pruebas fue positiva para A. cantonensis. Conclusión. Estos hallazgos brindan información importante sobre la distribución de Angiostrongylus spp. en Antioquia (Colombia). La identificación de estos nemátodos en L. fulica y C. aspersum resalta el papel potencial de estos caracoles como huéspedes intermediarios en la transmisión de infecciones por Angiostrongylus en el valle de Aburrá, con implicaciones para la salud humana y veterinaria.

Abstract Introduction. Abdominal and neural angiostrongyliasis caused by Angiostrongylus costaricensis and A. cantonensis, respectively, are zoonotic diseases involving snails as intermediate hosts. Colombia has already reported human cases, and the increasing distribution of Lissachatina fulica and Cornu aspersum raises public health concerns due to the potential risk of disease transmission in areas where parasites and hosts coexist. Objective. To identify the presence of Angiostrongylus spp. in snail species L. fulica and C. aspersum in Antioquia, Colombia. Materials and methods. This prospective cross-sectional study had a population of 5,855 L. fulica and C. aspersum snails captured in the ten towns of the Valle de Aburrá (Antioquia, Colombia), 169 samples were collected in 28 sampling points. Lung tissues of the collected snails were dissected and analyzed to detect Angiostrongylus spp. through molecular techniques. Results. Angiostrongylus spp. were identified in both L. fulica and C. aspersum. Angiostrongylus costaricensis was detected in 18 pooled prevalence of 30% (95% CI = 19.2-43.3), and Medellín was the municipality with the highest number of positive samples (33.3%). Seventy-two-point-two percent of the positive places reported the presence of rodents. None of the tests were positive for A. cantonensis. Conclusion. Our findings provide important insights into the epidemiology and distribution of Angiostrongylus spp. in Antioquia, Colombia. The identification of these parasitic nematodes in L. fulica and C. aspersum highlights the potential role of these snails as intermediate hosts in the transmission of Angiostrongylus spp. infections in the Valle de Aburrá, with implications for human and veterinary health.

RESUMEN La anisakidosis, dentro del enfoque «One Heath», se considera una zoonosis debida al consumo crudo o insuficientemente cocido de pescado infestado con larvas anisákidas. El objetivo de este estudio fue analizar la vitalidad de larvas anisákidas y su capacidad de migración en el hospedero. Con una muestra de 180 merluzas recién extraídas, se formaron tres grupos similares, manteniendo los especímenes por 24, 48 y 72 h en almacenamiento bajo refrigeración. La prevalencia de anisákidos en la cavidad celómica fue de 100%. El grado de vitalidad parasitaria para los tres días disminuyó a medida que aumentaron las horas de almacenamiento; sin embargo, no implicó la muerte de las larvas, manteniéndose el riesgo de infección del consumidor.

ABSTRACT Anisakidosis, within the «One Heath» approach, is considered a zoonosis due to the consumption of raw or undercooked fish infested with anisakid larvae. The aim of this study was to analyse the vitality of anisakid larvae and their migration capacity in the host. A total 180 freshly extracted hakes was used. Three similar groups were formed, keeping the specimens for 24, 48 and 72 h in refrigerated storage. The prevalence of anisakids in the coelomic cavity was 100%. The degree of parasitic vitality for the three days decreased as the hours of storage increased; however, it did not imply the death of the larvae, maintaining the risk of infection for the consumer.

Introduction: Hepatic hydatidosis is an endemic zoonosis in Chile; Aysén region have the highest incidence. Management of cystic liver disease is based on the WHO Classification, which determines the surgical indication. Materials and Method: Case series study of patients operated on for hepatic hydatid cyst by laparoscopic partial cystectomy, between 2005 and 2022, at the Coyhaique Regional Hospital, using a standardized surgical technique. Results: 133 patients, with a total of 165 operated cysts. 70% were WHO type 1 and 2 lesions, with an average diameter of 9.5cm. Average operating time 92 minutes. The intraoperative complication rate was 3.7% and conversion to open surgery was 11%. Global morbidity was 35%, highlighting the presence of biliary fistula with 21%. 83% of the complications were Clavien I, II and IIIb. There was no mortality in the series. Conclusion: Laparoscopic partial cystectomy is an adequate and safe technique for the treatment of hepatic hydatid cyst, especially in General Surgery centers.

Resumen Introducción: La Hidatidosis hepática es una zoonosis endémica en Chile, siendo la región de Aysén la de mayor incidencia. El manejo de la enfermedad quística hepática se basa en la Clasificación de la OMS, que determina la indicación quirúrgica. Materiales y Método: Estudio de serie de casos de pacientes operados de quiste hidatídico hepático mediante quistectomía parcial laparoscópica, entre los años 2005 y 2022, en el Hospital Regional Coyhaique, utilizando una técnica quirúrgica estandarizada. Resultados: 133 pacientes, con un total de 165 quistes operados. El 70% eran lesiones OMS tipo 1 y 2, con diámetro promedio de 9,5 cm. Tiempo operatorio promedio 92 minutos. La tasa de complicaciones intraoperatorias fue de 3,7% y de conversión a cirugía abierta 11%. La morbilidad global fue de 35%, destacando la presencia de la fístula biliar con un 21%. El 83% de las complicaciones fueron Clavien I, II y IIIb. No hubo mortalidad en la serie. Conclusión: La quistectomía parcial laparoscópica es una técnica adecuada y segura para el tratamiento del quiste hidatídico hepático, especialmente, en centros de Cirugía General.

RESUMEN Las especies Leishmania infantum y L. chagasi se consideran como agentes causales de leishmaniasis visceral, enfermedad relevante por su zoonosis y gravedad en el humano. Los caninos son los principales reservorios, de allí la necesidad de implementar diagnósticos precisos para identificar la especie de Leishmania involucrada. El objetivo del estudio fue realizar un diagnóstico molecular de leishmaniasis (PCR convencional y secuenciación de Sanger) en 29 muestras de tejidos de caninos clínicamente sospechosos de leishmaniasis, previamente diagnosticados por métodos no moleculares. Se pudo identificar la presencia del parásito por PCR en 9/29 muestras (L. infantum, n=4; L. chagasi, n=4; L. braziliensis, n=1), evidenciando un predominio de L. infantum y L. chagasi en caninos con leishmaniasis cutánea y mucocutánea. El PCR permitió esclarecer diagnósticos previamente negativos; sin embargo, se encontraron limitaciones, como la ausencia de ADN de Leishmania spp en algunas muestras y la imposibilidad de obtener muestras adicionales debido a la inaccesibilidad a los pacientes. A pesar de estas limitaciones, el estudio resalta la importancia del diagnóstico molecular para identificar la especie causante de leishmaniasis.

ABSTRACT The species Leishmania infantum and L. chagasi are considered causal agents of visceral leishmaniasis, a relevant disease due to its zoonosis and severity in humans. Canines are the main reservoirs, hence the need to implement precise diagnoses to identify the Leishmania species involved. The aim of the study was to perform a molecular diagnosis of leishmaniasis (conventional PCR and Sanger sequencing) in 29 tissue samples from canines clinically suspected of leishmaniasis, previously diagnosed by non-molecular methods. The presence of the parasite could be identified by PCR in 9/29 samples (L. infantum, n=4; L. chagasi, n=4; L. braziliensis, n=1), evidencing a predominance of L. infantum and L. chagasi in canines with cutaneous and mucocutaneous leishmaniasis. The PCR allowed to clarify previously negative diagnoses; however, limitations were found, such as the absence of Leishmania DNA in some samples and the inability to obtain additional samples due to inaccessibility to patients. Despite these limitations, the study highlights the importance of molecular diagnosis to identify the species causing leishmaniasis.

RESUMEN Introducción. En el Perú, las leyes de presupuesto público definen el nivel y la distribución inicial del presupuesto para la salud. Objetivo. Analizar la evolución del nivel y distribución inicial del presupuesto para la salud en el Perú en el periodo 2019-2024. Métodos. Estudio descriptivo. Se analizó el presupuesto de la función Salud, por categorías presupuestarias, programas presupuestales, niveles de gobierno y departamentos del periodo 2019-2024, según datos del Ministerio de Economía y Finanzas. Resultados. Entre 2019 y 2024, el presupuesto para la función Salud aumentó en 35%; mientras que su participación en el presupuesto del gobierno general aumentó de 10,8% a 12,2%, respectivamente. Asimismo, disminuyó la participación de programas presupuestales y aumentó la participación de gobiernos regionales. Entre 2019 y 2024, los programas presupuestales relacionados a salud mental, cáncer y atención de emergencias y urgencias médicas tuvieron un aumento progresivo e importante en su presupuesto; en contraste, los programas presupuestales relacionados a enfermedades no transmisibles, metaxénicas y zoonosis y tuberculosis-VIH/SIDA tuvieron un presupuesto menor al del 2019. Asimismo, el 50% del presupuesto de la función Salud se concentró en 2 o 3 departamentos, principalmente en Lima. Conclusiones. Hubo un aumento general del presupuesto para salud, aunque su evolución fue irregular. Dicho aumento favoreció a las acciones no vinculadas a resultados, así como a los gobiernos regionales. Algunos programas presupuestales tuvieron una pérdida efectiva de recursos. Pocos departamentos concentraron gran parte del presupuesto.

ABSTRACT Introduction. In Peru, public budget laws define the level and initial distribution of the health budget. Objective. To analyze the evolution of the level and initial distribution of the health budget in Peru in the period 2019-2024. Methods. Descriptive study. The budget of the Health function was analyzed by budget categories, budget programs, levels of government and departments, from 2019 to 2024, according to data from the Ministry of Economy and Finance. Results. Between 2019 and 2024, the budget for the Health function increased by 35%; while its share in the budget of the General Government increased from 10.8% to 12.2%, respectively. Also, the participation of budgetary programs in the budget decreased; while participation of Regional Governments increased. Between 2019 and 2024, budget programs related to mental health, cancer and emergency and emergency medical care saw a progressive and significant increase in their budget; in contrast, budget programs related to non-communicable diseases, metaxians and zoonoses and tuberculosis-HIV/AIDS had a lower budget than in 2019. Also, 50% of the budget of the Health function was concentrated in 2 or 3 departments, mainly in Lima. Conclusions. There was a general increase in the health budget, although its evolution was irregular. This increase favored actions not linked to results, as well as regional governments. Some budget programs actually lost resources. Few departments concentrated much of the budget.