ABSTRACT Background: Malaria is a major global public health issue with varying epidemiologies across countries. In Colombia, it is a priority endemic-epidemic event included in the national public health policy. However, evidence demonstrating nationwide variations in the disease behavior is limited. This study aimed to analyze changes in the levels and distribution of endemic-epidemic malaria transmission in the eco-epidemiological regions of Colombia from 1978 to 1999 and 2000 to 2021. Methods: We conducted a comprehensive time-series study using official secondary data on malaria-associated morbidity and mortality in Colombia from 1978 to 2021. Temporal-spatial and population variables were analyzed, and the absolute and relative frequency measures of general and regional morbidity and mortality were estimated. Results: We observed an 18% reduction in malaria endemic cases between the two study periods. The frequency and severity of the epidemic transmission of malaria varied less and were comparable across both periods. A shift was observed in the frequency of parasitic infections, with a tendency to match and increase infections by Plasmodium falciparum. The risk of malaria transmission varied significantly among the eco-epidemiological regions during both study periods. This study demonstrated a sustained decrease of 78% in malarial mortality. Conclusions: Although the endemic components of malaria decreased slightly between the two study periods, the epidemic pattern persisted. There were significant variations in the risk of transmission across the different eco-epidemiological regions. These findings underscore the importance of targeted public health interventions in reducing malarial morbidity and mortality rates in Colombia. Background countries endemicepidemic policy However limited ecoepidemiological eco epidemiological 197 199 200 2021 Methods timeseries time series malariaassociated associated Temporalspatial Temporal spatial analyzed estimated Results 18 periods falciparum 78 Conclusions persisted 19 20 202 1 7 2

RESUMEN Se presenta un caso de enfermedad de Chagas en fase aguda en un paciente masculino de 40 años, procedente de la Vereda Buenos Aires, Municipio de Miraflores, Departamento del Guaviare. El paciente acudió a urgencias con fiebre, cefalea, astenia, adinamia y disuria. Se realizó un frotis de sangre y un análisis de orina, con resultados positivos para infección urinaria sintomática, pero negativos para malaria. Cinco días más tarde se confirmó el diagnóstico de enfermedad de Chagas en fase aguda tras recibir un resultado positivo para Trypanosoma cruzi. El paciente recibió tratamiento con nifurtimox y benznidazol, y se llevó a cabo una investigación de contactos y zonas de riesgo, búsqueda activa comunitaria e institucional, entomológica y de reservorios, y una vigilancia de laboratorio para detectar posibles casos de infección en la comunidad. Se identificaron cinco casos con síntomas similares, pero las pruebas parasitológicas fueron negativas. Se aplicaron medidas de educación sanitaria para prevenir la propagación de la enfermedad.

ABSTRACT We present a case of acute phase Chagas disease in a 40-year-old male patient from Vereda Buenos Aires, Municipality of Miraflores, Department of Guaviare. The patient attended the emergency department with fever, headache, asthenia, adynamia and dysuria. The blood smear and urinalysis were positive for symptomatic urinary tract infection, but negative for malaria. Five days later the diagnosis of acute phase Chagas disease was confirmed after a positive result for Trypanosoma cruzi. The patient was treated with nifurtimox and benznidazole, his contacts and risk areas were investigated, an active entomological community and institutional search was carried out, as well as in the reservoirs, finally, laboratory surveillance for possible cases of infection in the community was conducted. Five cases with similar symptoms were identified, but parasitological tests were negative. Health education measures were implemented to prevent the spread of the disease.

Abstract Recently, interest in studying pigments from lichens has been aroused due to their bioactive properties and health benefits. The Geolashon (Teloschistes flavicans) is a thousand-year-old lichen from the Peruvian Andes characterized by its yellow filaments, traditionally used by the Peruvian inhabitants as a natural pigment for making handicrafts and medicinal purposes. In this sense, this article aims to compile all the studies on Geolashon as a source of natural yellow pigments, starting from its importance and applications by the Andean population to research on obtaining, characterizing, and properties of its extracts. Although studies on this lichen are limited, it was observed that the obtained from lichen are rich in 3-[1’-(2”,3”-dihydroxy-phenyl)-propyl]-7-hydroxy- chroman-4-one, vicanicin, parietin, other compounds and has antidiabetic, antibacterial, antileukemic, antimicrobial, anticancer and termiticide activity that would be interesting for use in the pharmaceutical, cosmetic, food and agricultural industries, generating added value in the final product. Aspects such as processing, functional properties, and toxicology of the bioactive components of Geolashon must be studied for its correct use.

RESUMEN La malaria en Colombia tiene un comportamiento heterogéneo y variable, entre las regiones. Para establecer su comportamiento epidemiológico en la región del Caribe colombiano entre 1960 y 2019 se realizó un estudio observacional, descriptivo y retrospectivo a partir de registros del Ministerio de Salud y otras fuentes secundarias. Se definieron variables epidemiológicas y se elaboraron medidas de frecuencia y tendencia central. Se registraron 155 096 casos. Las décadas con mayor número de casos fueron 1990-1999 (20,5%) y 1980-1989 (18,9%). El promedio de casos por década fue de 25 849,3. Los índices parasitarios más elevados se registraron en 1970 (3,3 por 1000 habitantes) y 1981 (3,9 por 1000 habitantes). La especie Plasmodium vivax fue la más frecuente y la mayoría de la carga por grupos de edad se registró en menores de 29 años, entre 2010-2019. La malaria presentó un patrón endemo-epidémico de baja y muy baja intensidad de transmisión, con una tendencia al descenso.

ABSTRACT Malaria has a heterogeneous and variable behavior among Colombian regions. In order to establish its epidemiological behavior in the Colombian Caribbean region between 1960 and 2019, we carried out an observational, descriptive and retrospective study based on records from the Ministry of Health and other secondary sources. We defined epidemiological variables and used measures of frequency and central tendency. A total of 155,096 cases were registered. The decades with the highest number of cases were 1990-1999 (20.5%) and 1980-1989 (18.9%). The average number of cases per decade was 25,849.3. The highest parasite rates were recorded in 1970 (3.3 per 1000 population) and 1981 (3.9 per 1000 population). Plasmodium vivax was the most frequent species and most of the burden by age group was found in people under 29 years of age, between 2010-2019. Malaria showed an endemic-epidemic pattern of low and very low transmission intensity, with a decreasing trend.

Resumen Introducción. A mediados de la década de 1950, el país adoptó e implementó la Campaña de Erradicación de la Malaria (CEM), sin que hasta ahora se haya hecho su evaluación. Objetivo. Evaluar los resultados alcanzados en las fases de ataque y consolidación de la campaña de erradicación de la malaria en Colombia, entre 1959 y 1979. Materiales y métodos. Se hizo un estudio descriptivo y retrospectivo de los resultados “malariométricos” y operacionales de la CEM en Colombia entre 1959 y 1979 a partir de los datos recopilados de los archivos del Ministerio de Salud Pública. Se utilizaron los criterios establecidos por la Organización Mundial de la Salud (OMS) relacionados con las fases de un programa de erradicación de malaria. Se almacenó, tabuló y analizó la información, y se elaboraron y aplicaron indicadores malariométricos. Resultados. En el periodo de erradicación a corto plazo (1959-1969), durante el primer año de la fase de ataque (1959), se alcanzó una reducción de la transmisión del 94 % (4.172) y, en el último año (1962), una disminución del 88 % (8.426) en la carga acumulada de casos comparada con el promedio anual de la década del 50 (71.031); estos bajos niveles de transmisión se mantuvieron hasta finales de 1969. En el periodo de intensificación del control para la erradicación (1970-1979), se produjo un incremento de la endemia y resurgió la transmisión epidémica. Debido a problemas financieros que afectaron la regularidad de la operación para mantener los resultados, y no habiéndose logrado la interrupción de la transmisión, se observó un resurgimiento de casos en las fases de ataque y consolidación. Conclusiones. La campaña no logró la meta de interrupción de la transmisión de la malaria en el territorio nacional, pero sí se consiguió un acentuado control en áreas de mediana y baja intensidad.

Abstract Introduction: In the mid-fifties, Colombia adopted and implemented the Malaria Eradication Campaign (MEC), which has not been evaluated yet in the country. Objective: To evaluate the results achieved during the attack and consolidation phases of the MEC regarding malaria transmission in Colombia between 1959 and 1979. Materials and methods: We conducted a descriptive and retrospective study based on the malariometric and operational results of the MEC in Colombia from 1959 to 1979 compiled from the archives of the Ministry of Public Health. We used the criteria defined by the WHO Expert Committee on Malaria. The information was stored, tabulated, and analyzed based on the malariometric indicators we developed. Results: In the short-term eradication period (1959-1969), a reduction of 94% (4,172) in transmission was achieved during the first year of the attack phase (1959) while in the last year (1962), there was an 88% (8,426) reduction of the accumulated load of cases compared to the annual average of the 1950s (71,031). These low levels of transmission were maintained until the end of 1969. During the intensification period of control of the eradication (1970-1979), there was an increase in malaria endemicity and a resurgence of the epidemic transmission. Due to financial problems affecting the regularity of the operations, Colombia was unable to sustain the results and achieve an interruption of transmission, which resulted in a resurgence of cases during the attack and consolidation phases. Conclusions: The campaign did not achieve the goal of interrupting malaria transmission in the national territory but there was marked control in areas of medium and low intensity.

ABSTRACT Background: Malaria has unstable transmission in Colombia and has variable endemic-epidemic patterns. This study describes the epidemiological characteristics of malaria epidemics registered in Colombia from 1970-2019. Methods: Data from 1979-2019 were collected from the National Public Health Surveillance System. The data was tabulated and pertinent descriptive analyses were carried out. Results: Fifteen malaria outbreaks and approximately five-year-long epidemic cycles were observed in Colombia during the study period. Conclusions: Malaria epidemics in Colombia present a five-yearly transmission pattern, mainly due to the increased vulnerability produced by seasonal population migrations in receptive areas with active transmission.

Abstract: Objective: We describe two adolescent patients with multiple sclerosis, which is a demyelinating disease of the central nervous system. Presentation of the cases: The first case was a 14-year-old female patient with overweight; her condition was characterized by dizziness, headache, paresthesia in the lower limbs, diplopia and bradylalia. On physical examination, compatible data of cerebellar involvement were identified. A magnetic resonance imaging (MRI) of the skull showed areas of demyelination in the posterior fossa. Multiple sclerosis, the relapsing-remitting variety, is diagnosed. After the administration of steroids and beta interferon, there was improvement in symptoms. Second case: 13-year-old female, who presented fall from her own height, bladder incontinence, loss of strength in the left arm and leg. On physical examination, left hemiparesis was detected. MRI: demyelination data in lateral ventricle, cerebellum and spinal cord. The patient improved after starting steroids and interferon. Conclusions: The clinical presentation of multiple sclerosis in pediatric patients is a challenge, since it is a condition with unspecific manifestations. Establishing the diagnosis requires multiple studies. The earlier treatment is started, the more favorable the prognosis.

Resumen: Objetivo: Describir dos pacientes adolescentes con esclerosis múltiple, la cual es una enfermedad desmielinizante del sistema nervioso central. Presentación de los casos: El primer caso se trató de una paciente de 14 años con sobrepeso, con un padecimiento caracterizado por mareo, cefalea, parestesias en miembros inferiores, diplopía y bradilalia. A la exploración, datos compatibles de afectación a nivel cerebeloso. En estudio de imagen de resonancia magnética (IRM) de cráneo se evidencia áreas de desmielinización en fosa posterior. Se diagnostica esclerosis múltiple de variedad remitente recurrente. Con la administración de esteroides e interferón beta hubo mejoría de sintomatología. Segundo caso: femenino de 13 años de edad, quien presenta caída de propia altura, incontinencia de esfínter vesical, pérdida de fuerza en brazo y pierna izquierdas. En la exploración física, hemiparesia izquierda. IRM: datos de desmielinización en ventrículo lateral, cerebelo y médula espinal. La paciente mejoró al iniciar esteroides e interferón. Conclusiones: La presentación clínica de la esclerosis múltiple en pacientes pediátricos es un reto, ya que es un padecimiento que tienen manifestaciones poco específicas. Para establecer el diagnóstico se requiere realizar múltiples estudios. El pronóstico puede ser más favorable entre más temprano se inicie el tratamiento.

ABSTRACT The presence of gastrointestinal parasites in gastrointestinal tract of 100 Colombian sliders (Trachemys callirostris) admitted to the Wildlife Care and Assessment Center (CAV), Córdoba, Colombia, during 2009 and 2010, as a result of confiscations from illegal trafficking of wild animals. The gastrointestinal tracts were separated, washed and its contents were removed to identify and quantify the parasites. A total of 1064 individuals of the taxa Nematophila argentinum (44%), Serpinema sp (44%) and Spiroxys sp (12%) were isolated. The observed prevalences were 70% for N. argentinum (Trematode), and 63 and 49% for Serpinema sp and Spiroxys sp (Nematode), respectively. The mean intensity was 6.7 for N. argentinum, 7.3 for Serpinema sp, and 3.2 for Spiroxys sp. N. argentinum was mainly found in the large intestine (40%); however, this is the first report of this parasite in the mouth, oesophagus and cloaca. Individuals of Serpinema sp were found mixed within the content of the digestive tract, especially in the small intestine (63%), whereas Spiroxys sp were located mainly in the stomach (64%). The lesions found were focused and without compromising the lives of turtles.

RESUMEN Se determinó la presencia de parásitos gastrointestinales en el tracto gastrointestinal de 100 hicoteas de la especie Trachemys callirostris ingresadas al Centro de Atención y Valoración de Fauna Silvestre (CAV), Córdoba, Colombia, durante los años 2009 y 2010, como producto de decomisos del tráfico ilegal de animales silvestres. Los tractos gastrointestinales fueron separados, seccionados y lavados y el contenido fie removido para identificar y cuantificar los parásitos. Se aislaron 1064 individuos de la especie Nematophila argentinum (44%) y de los géneros Serpinema (44%) y Spiroxys (12%). Las prevalencias encontradas fueron de 70% para N. argentinum (Trematoda) y de 63 y 39% para Serpinema sp y Spiroxys sp (Nematoda), respectivamente. La intensidad media fue de 6.7 para N. argentinum, 7.3 para Serpinema sp y de 3.2 para Spiroxys sp. N. argentinum se encontró mayormente en intestino grueso (40%); sin embargo, este es el primer reporte de este parásito en boca, esófago y cloaca. Los individuos del género Serpinema sp, se encontraron inmersos en el contenido del tracto digestivo, con mayor proporción en intestino delgado (63%), mientras que Spiroxys sp se localizaron principalmente en estómago (64%). Las lesiones encontradas fueron localizadas y probablemente no comprometían significativamente la vida de los individuos.

Abstract INTRODUCTION: Colombia has an endemo-epidemic for malaria, with a downward trend in mortality over the last few decades. This study describes the malaria mortality rates from 2009-2018. METHODS We obtained data from the Colombian Mortality Information System and calculated the case fatality and crude and age-adjusted mortality rates. RESULTS: During the study, 148 malaria-related deaths were registered. The average annual mortality rate was 0.032 deaths/100,000. Two peaks were observed in 2010 and 2016. Choco contributed to the highest number of deaths (27.7%). CONCLUSIONS: The unstable downward trend of malaria mortality rates calls for greater emphasis on surveillance and interventions.

Abstract: Objective: To know the characteristics of medical education and identify its strengths and weaknesses. Materials and methods: A transversal and quantitative study of the characteristics of medical education in 29 medical schools in Mexico was carried out, between April and September 2017. Questionnaire with Likert scale was applied to explore context, regulation, structure, process, results and impact of medical education. Bivariate analysis was performed with a Chi square test and the significance level was equal to or less than 0.05. Results: The political context obtained 64%, economical context 10% and mechanisms of regulation 31%. The educational structure was 61% and the social impact was 93%. Conclusions: Public policies, regulatory mechanisms and public investment must be strengthened to improve the quality of medical education.

Resumen: Objetivo: Conocer las características de la educación médica e identificar sus fortalezas y debilidades. Material y métodos: Se realizó un estudio transversal y cuantitativo para conocer las características de la educación médica en 29 escuelas de medicina en México, entre abril y septiembre de 2017. Se utilizó un cuestionario con escala tipo Likert para explorar el contexto, la regulación, la estructura, el proceso, los resultados y el impacto de la educación médica. Se realizó un análisis bivariado con ji cuadrada y una significancia estadística depigual o menor a 0.05. Resultados: El contexto político obtuvo 64%, el contexto económico 10%, los mecanismos de regulación 31%, la estructura educativa 61% y el impacto social 93%. Conclusiones: Se requiere fortalecer las políticas públicas, la regulación y la inversión pública, para mejorar la calidad de la educación médica.

Abstract: Objective: To know the characteristics of medical education and identify its strengths and weaknesses. Materials and methods: A transversal and quantitative study of the characteristics of medical education in 29 medical schools in Mexico was carried out, between April and September 2017. Questionnaire with Likert scale was applied to explore context, regulation, structure, process, results and impact of medical education. Bivariate analysis was performed with a Chi square test and the significance level was equal to or less than 0.05. Results: The political context obtained 64%, economical context 10% and mechanisms of regulation 31%. The educational structure was 61% and the social impact was 93%. Conclusions: Public policies, regulatory mechanisms and public investment must be strengthened to improve the quality of medical education.

Resumen: Objetivo: Conocer las características de la educación médica e identificar sus fortalezas y debilidades. Material y métodos: Se realizó un estudio transversal y cuantitativo para conocer las características de la educación médica en 29 escuelas de medicina en México, entre abril y septiembre de 2017. Se utilizó un cuestionario con escala tipo Likert para explorar el contexto, la regulación, la estructura, el proceso, los resultados y el impacto de la educación médica. Se realizó un análisis bivariado con ji cuadrada y una significancia estadística depigual o menor a 0.05. Resultados: El contexto político obtuvo 64%, el contexto económico 10%, los mecanismos de regulación 31%, la estructura educativa 61% y el impacto social 93%. Conclusiones: Se requiere fortalecer las políticas públicas, la regulación y la inversión pública, para mejorar la calidad de la educación médica.

Abstract For over two decades, there has been an increasing interest in finding natural antioxidants, because they can protect the human body from free radicals and retard the progress of many chronic diseases. Phenolic compounds were identified and quantified in potato cooking water from freeze–dried slices with peel and from whole potato stored for 20 days. Extracts were obtained with an aqueous solution composed of 50% methanol and 0.5% acetic acid. Fifteen secondary metabolites were monitored using the Ultra Performance Liquid Chromatography system coupled to mass spectrometry (UPLC-MS / MS). A calibration curve (from 0.1 ng to 100 μg) was generated and the data was analyzed using the software “MassHunter Workstation” VB 06.00, the results were expressed as mg/100 g of sliced potato or raw potato. Principal Components Analysis (PCA) was performed using XLSTAT 2015 Software. The potato cooking water contains phytonutrients with potential antioxidant activity to prevent non-transmissible degenerative diseases. The metabolite content in the cooking water of the Huagalina native potato is directly related to the freshness of the product before cooking. Potato cooking water could be considered a neutraceutical food. However, further research is required to identify any other substances that can be harmful to health depending on the amount consumed.

RESUMEN I: Para mantener la reducción de la malaria, se promueven iniciativas que aceleren la eliminación. En años recientes con la reducción sostenida de la malaria, Colombia hacia el 2021 propone su eliminación en áreas urbanas por lo cual se requieren investigaciones para este desafío O: Establecer la situación epidemiológica de la transmisión de malaria urbana/peri en Guapi 2011-2015 y describir los desafíos en capacidad vectorial, receptividad, infectividad y vulnerabilidad. M: Se realizó un estudio descriptivo, se obtuvieron datos epidemiológicos, entomológicos, parasitológicos, de servicios de salud y socio económicos mediante entrevistas y fuentes secundarias. Con la información se realizaron análisis uni y bivariados, se aplicaron formatos de eliminación de malaria propuestos por la Organización Mundial de la Salud y se analizaron brechas. R: Se notificaron 1097 casos, 39,5% se registraron en el área urbana/peri, y a su vez, el 68% de éstos se concentraron en tres barrios. En capacidad vectorial se identificó como vector primario a anopheles albimanus, con susceptibilidad a los insecticidas, múltiples criaderos y estrategias de instalación de mosquiteros con altas coberturas; en infectividad se encontró predominio de infecciones por p, falciparum, oportunidad de consulta en las primeras 48 horas del 48,1% y automedicación; en vulnerabilidad los casos no urbanos representaron 60,5 % del total. C: La malaria se caracterizó por ser de baja intensidad, focalizada y con picos. Hay significativa receptividad, en infectividad hay retrasos de oportunidad de consulta y existe alta vulnerabilidad por población migrante.

ABSTRACT I: To maintain the reduction of malaria, initiatives that accelerate the elimination are promoted. In recent years with the sustained reduction of malaria, Colombia by 2021 proposes its elimination in urban areas, which requires research for this challenge O: Establish the epidemiological situation of transmission of urban / peri malaria in Guapi 2011-2015 and describe the challenges in vector capacity, receptivity, infectivity and vulnerability. M: A descriptive study was conducted, epidemiological, entomological, parasitological, health and socioeconomic services were obtained through interviews and secondary sources. With the information, univariate and bivariate analyzes were carried out, malaria elimination formats proposed by the World Health Organization were applied and gaps were analyzed. A: 1097 cases were notified, 39.5% were registered in the urban / peri area, and in turn, 68% of these were concentrated in three neighborhoods. In vectorial capacity anopheles albimanus was identified as the primary vector with susceptibility to insecticides, multiple hatcheries and strategies for installing mosquito nets with high coverage; In infectivity, predominance of p. falciparum, 48.1% consultation opportunity in the first 48 hours and self-medication; in vulnerability, non-urban cases represented 60.5% of the total. C: Malaria was characterized by being of low intensity, focused and with spikes. There is significant receptivity, in infectiousness there are delays in the opportunity of consultation and there is high vulnerability due to migrant population.

RESUMO I: Para manter a redução da malária, são promovidas iniciativas que aceleram a eliminação. Nos últimos anos, com a redução sustentada da malária, a Colômbia propõe, até 2021, sua eliminação nas áreas urbanas, o que requer pesquisa para esse desafio O: Estabelecer a situação epidemiológica da transmissão da malária urbana / peri-Guapi 2011-2015 e descrever os desafios em capacidade de vetores, receptividade, infecciosidade e vulnerabilidade. M: Estudo descritivo, epidemiológico, entomológico, parasitológico, de saúde e socioeconómico, obtido por meio de entrevistas e fontes secundárias. Com as informações, foram realizadas análises univariadas e bivariadas, os formatos de eliminação de malária propostos pela Organização Mundial da Saúde foram aplicados e as lacunas foram analisadas. R: 1097 casos foram notificados, 39,5% foram registrados na área urbana / peri e, por sua vez, 68% destes foram concentrados em três bairros. Em capacidade vetorial, anopheles albimanus foi identificado como vetor primário, com suscetibilidade a inseticidas, múltiplos incubatórios e estratégias para a instalação de redes mosquiteiras com alta cobertura; Na infectividade, predomínio de p. falciparum, 48,1% de oportunidade de consulta nas primeiras 48 horas e automedicação; em vulnerabilidade, os casos não urbanos representaram 60,5% do total. C: A malária foi caracterizada por ser de baixa intensidade, focada e com picos. Há uma receptividade significativa, na infecciosidade há atrasos na oportunidade de consulta e há alta vulnerabilidade devido à população migrante.

Resumen Introducción. Las enfermedades transmitidas por vectores representan más de 17 % de todas las enfermedades infecciosas y causan anualmente un millón de defunciones a nivel mundial. En Colombia, la malaria, el dengue, la enfermedad de Chagas y las leishmaniasis son condiciones endemoepidémicas persistentes. Objetivo. Determinar el comportamiento epidemiológico de las enfermedades transmitidas por vectores en zonas urbanas y rurales de Colombia entre 1990 y 2016. Materiales y métodos. Se hizo un estudio descriptivo del comportamiento epidemiológico de las principales enfermedades transmitidas por vectores en zonas urbanas y rurales de Colombia entre 1990 y 2016, con la información proveniente de fuentes oficiales secundarias. Resultados. En el periodo estudiado se registraron 5’360.134 casos de enfermedades transmitidas por vectores, de los cuales 54,7 % fueron de malaria y 24,9 % de dengue. Estos casos concentraron el 80 % de la carga acumulada de casos de enfermedades transmitidas por vectores. Las medianas de las tasas de incidencia fueron 1.371 y 188 por 100.00 habitantes para malaria y dengue, respectivamente. Además, los casos de chikungunya fueron 774.831 desde su introducción en el 2014 y, los de Zika, 117.674 desde su aparición en 2015. En las zonas rurales predominaron las enfermedades parasitarias transmitidas por vectores como la malaria, las leishmaniasis y la enfermedad de Chagas. A nivel urbano, predominaron el dengue, el chikungunya y el Zika. Conclusiones. La transmisión en Colombia de estas enfermedades es persistente en las zonas urbanas y en las rurales, y de tipo endemoepidémico en los casos de malaria, dengue, leishmaniasis y enfermedad de Chagas. Dicha transmisión se ha dado de manera focalizada y con patrones variables de intensidad. Asimismo, se mantienen las condiciones que han favorecido la transmisión emergente de nuevas arbovirosis.

Abstract Introduction: Vector-borne diseases account for more than 17% of all infectious diseases and annually they cause one million deaths worldwide. In Colombia, malaria, dengue, Chagas disease, and leishmaniasis are persistent endemo-epidemic events. Objective: To determine the behavior and transmission scenarios of vector-borne diseases in Colombia between 1990 and 2016. Materials and methods: We conducted a descriptive study on the epidemiological behavior of the main vector-borne diseases in Colombia between 1990 and 2016 based on information from official secondary sources. Results: During the study period, there were 5,360,144 cases of vector-borne diseases, 54.7% of which were due to malaria and 24.9% to dengue, accounting for 80% of the cumulative disease burden of vector-borne disease cases. The median incidence rates were 1,371 and 188 per 100,000 inhabitants for malaria and dengue, respectively. In addition, emerging events such as Chikungunya registered 774,831 cases since its introduction in 2014, while 117,674 Zika fever cases were reported since its emergence in 2015. In rural settings, parasitic vector-borne diseases such as malaria, leishmaniasis and Chagas disease predominated, while in urban scenarios dengue, chikungunya and Zika were predominant. Conclusions: Persistent epidemic and endemic transmission of vector-borne diseases in urban and rural settings in Colombia was observed mainly in the case of malaria, dengue, leishmaniasis and Chagas disease. Such transmission was focused and had variable intensity patterns. On the other hand, the conditions that have favored the emergence of new arboviruses persist.

Resumen Introducción. Trypanosoma cruzi se ha dividido en seis unidades taxonómicas discretas (Discreet Typing Units, DTU) denominadas TcI, TcII, TcIII, TcIV, TcV y TcVI. Aún se desconocen los factores determinantes de la dinámica de la transmisión vectorial de los genotipos de T. cruzi en las diferentes regiones geográficas de distribución de la enfermedad de Chagas en Perú. Objetivo. Detectar y tipificar las unidades taxonómicas discretas de T. cruzi en las heces de siete especies de triatominos (Panstrongylus chinai, P. geniculatus, P. herreri, Rhodnius robustus, R. pictipes, Triatoma carrioni y T. infestans), capturados en ocho departamentos de diferentes regiones naturales de Perú. Materiales y métodos. Se examinaron 197 insectos para la detección de tripanosomas. Se extrajo el ADN del contenido intestinal de cada insecto y se amplificó mediante reacción en cadena de la polimerasa (PCR) de los genes kDNA, SL-IR, 24Sa rRNA y 18Sa RNA para detectar las DTU de T. cruzi. Resultados. Se detectaron cinco infecciones con T. rangeli y 113 con T. cruzi. De estas últimas, fue posible identificar 95 de TcI (dos en P. chinai, una en P. geniculatus, 68 en P. herreri, cuatro en R. pictipes, siete en R. robustus, una en T. carrioni, y 12 en T. infestans); cinco de TcII (cuatro en P. herreri, una en T. infestans); cuatro de TcIII (tres en P. herreri, una en R. robustus) y cuatro infecciones de TcIV en P. herreri. Conclusión. Este es el primer trabajo de caracterización a gran escala de T. cruzi en el intestino de vectores de importancia epidemiológica en Perú, orientado a generar información básica que permita entender la dinámica de la transmisión vectorial de T. cruzi en esta región del continente.

Abstract Introduction: Trypanosoma cruzi has been divided by international consensus into six discrete typing units (DTU): TcI, TcII, TcIII, TcIV, TcV y TcVI. The factors determining the dynamics of T. cruzi genotypes vector transmission of Chagas’ disease in the different geographical regions of Perú are still unknown. Objective: To detect and type T. cruzi DTUs from the faeces of seven species of triatomines (Panstrongylus chinai, P. geniculatus, P. herreri, Rhodnius robustus, R. pictipes, Triatoma carrioni and T. infestans) captured in eight departments from different natural regions of Perú. Materials and methods: We examined 197 insects for detecting trypanosomes. DNA was extracted from each insect intestinal contents and PCR amplification of kDNA, SL-IR, 24Sa rRNA and 18Sa RNAwas performed for detecting T. cruzi DTUs. Results: Five T. rangeli and 113 T. cruzi infections were detected; 95 of the latter were identified as TcI (two in P. chinai, one in P. geniculatus, 68 in P. herreri, four in R. pictipes, seven in R. robustus, one in T. carrioni, 12 in T. infestans), five as TcII (four in P. herreri, one in T. infestans), four as TcIII (three in P. herreri, one in R. robustus) and four TcIV infections in P. herreri. Conclusions: This is the first study which has attempted a large-scale characterization of T. cruzi found in the intestine of epidemiologically important vectors in Perú, thus providing basic information that will facilitate a better understanding of the dynamics of T. cruzi vector transmission in Perú.