Abstract Introduction: The use of technological resources to support processes in health systems has generated robust, interoperable, and dynamic platforms. In the case of institutions working with neglected tropical diseases, there is a need for specific customizations of these diseases. Objectives: To establish a medical record platform specialized in neglected tropical diseases which could facilitate the analysis of treatment evolution in patients, as well as generate more accurate data about various clinical aspects. Materials and methods: A set of requirements to develop state of the art forms, concepts, and functionalities to include neglected tropical diseases were compiled. An OpenMRS distribution (version 2.3) was used as reference to build the platform, following the recommended guidelines and shared-community modules. Results: All the customized information was developed in a platform called NTD Health, which is web-based and can be upgraded and improved by users without technological barriers. Conclusions: The electronic medical record system can become a useful tool for other institutions to improve their health practices as well as the quality of life for neglected tropical disease patients, simplifying the customization of healthcare systems able to interoperate with other platforms.

Resumen Introducción. El uso de recursos tecnológicos destinados a apoyar procesos en los sistemas de salud ha generado plataformas sólidas, interoperables y dinámicas. En el caso de las instituciones que trabajan con enfermedades tropicales desatendidas, existe la necesidad de personalizaciones específicas en las herramientas de uso médico. Objetivos. Establecer una plataforma para historias clínicas especializada en enfermedades tropicales desatendidas, con el fin de facilitar el análisis de la evolución del tratamiento de los pacientes, además de generar datos más precisos sobre diversos aspectos clínicos. Materiales y métodos. Se compiló un conjunto de requisitos para implementar formularios, conceptos y funcionalidades que permitan incluir enfermedades tropicales desatendidas. Se utilizó una distribución de OpenMRS (versión 2.3) como referencia para construir la plataforma, siguiendo las pautas recomendadas y módulos compartidos por la comunidad. Resultados. Toda la información personalizada se implementó en una plataforma llamada NTD Health, la cual se encuentra almacenada en la web y los usuarios pueden actualizarla y mejorarla sin barreras tecnológicas. Conclusiones. El sistema de historias clínicas electrónicas puede convertirse en una herramienta útil para que otras instituciones mejoren sus prácticas en salud, así como la calidad de vida de los pacientes con enfermedades tropicales desatendidas, simplificando la personalización de los sistemas de salud capaces de interoperar con otras plataformas.

Resumen Ante la necesidad de desarrollar nuevos medicamentos para el tratamiento de la leishmaniasis cutánea que sean efectivos, seguros, de mayor aceptación entre los pacientes, fáciles de administrar en los entornos rurales y más económicos, en el presente estudio se evaluó in vitro e in vivo el potencial terapéutico y el perfil de citotoxicidad de un extracto etanólico y un extracto glicólico de las ramas de Caesalpinia spinosa (Molina) Kuntze y sus respectivas formulaciones: loción y emulsión. Asimismo, se validó la utilidad de las dos formulaciones como tratamiento tópico en diez pacientes con leishmaniasis cutánea no complicada. Ambos extractos fueron activos contra Leishmania braziliensis en concentraciones de menos de 22 μg/mL, tuvieron baja toxicidad en las células U-937 y HL60 cuando se administraron en forma pura y en las células Hep G2 y Detroit 551 cuando se administraron en concentraciones de menos de 20 %. Ni los extractos ni las formulaciones fueron irritantes o corrosivos y no causaron ningún otro tipo de toxicidad dérmica. La exposición de fibroblastos al extracto glicólico y a las formulaciones favoreció su migración y la reparación de la monocapa luego de 16 horas de contacto, permitiendo cierres de la brecha entre 33,9 y 70,9 %. Tanto los extractos como las formulaciones favorecieron la curación completa de los hámsteres con leishmaniasis cutánea en porcentajes mayores al 80 %. La loción y la emulsión se absorben y penetran en la piel después de su aplicación y, aunque se alcanzan a detectar en plasma hasta las 24 h (la loción) o las 6 h (la emulsión) de la aplicación, la mayor parte queda retenida en la piel. Por último, el tratamiento de los diez pacientes con la loción y la emulsión logró la curación completa de las lesiones con la reparación de la piel dañada y sin efectos adversos. En conclusión, los resultados demostraron las propiedades leishmanicidas y cicatrizantes de C. spinosa, lo que le permitiría ser una alternativa segura para el tratamiento local de la leishmaniasis cutánea. Es necesario validar estos resultados en ensayos clínicos controlados y determinar la eficacia y la seguridad del tratamiento con los productos fitoterapéuticos de C. spinosa.

Abstract Given the need to develop new drugs for the treatment of cutaneous leishmaniasis, not only effective and safe, but also more widely accepted by patients, easily administered in rural settings and cheaper, in the present study the in vitro and in vivo therapeutic potential and cytotoxicity profile of an ethanolic and a glycolic extracts obtained from the branches of Caesalpinia spinosa (Molina) Kuntze and their respective formulations (lotion and emulsion) were evaluated. Finally, the usefulness of the two formulations as topical treatment was validated in 10 patients with uncomplicated CL. Both extracts were active against L. braziliensis at concentrations <22 μg / mL, with low toxicity in U-937 and HL60 cells when administered pure and for Hep G2 and Detroit 551 cells when administered at concentrations <20%. Neither the extracts nor the formulations were irritating or did not cause any corrosive or any other sign of dermal toxicity. The exposure of fibroblasts to the glycolic extract and to the formulations favored the migration of fibroblasts and repair of the monolayer after 16 h of contact, allowing the closing of the gap between 33.9% and 70.9%. Both the extracts and the formulations favored the complete cure of the hamsters with cutaneous leishmaniasis in percentages greater than 80%. After being applied to the skin, lotion and emulsion are absorbed, penetrate, and although they can be detected in plasma up to 24 hours (the lotion) or 6 hours (the emulsion) after application, most of the products it is retained in the skin. Lastly, the treatment of 10 patients with the lotion and the emulsion showed the complete healing of the lesions with the repair of the damaged skin and without adverse effects. In conclusion, the results demonstrate leishmanicidal and healing properties for C. spinosa that give it the potential to become a safe alternative for the local treatment of cutaneous leishmaniasis. It is necessary to validate these results in controlled clinical trials and determine the efficacy and safety of treatment with C. spinosa phytotherapeutic products.

Resumen Introducción. Los departamentos de Chocó y Antioquia en Colombia presentan condiciones climáticas y de vegetación que favorecen el establecimiento de especies de vectores del género Lutzomyia y la transmisión de Leishmania spp. a poblaciones humanas que ingresan a ambientes selváticos conservados. Objetivo. Reportar las especies de flebotomíneos presentes en tres reservas naturales de las regiones del Darién y del Pacífico en Colombia. Materiales y métodos. Los flebotomíneos se recolectaron en las reservas naturales El Aguacate (Acandí, Chocó), Nabugá (Bahía Solano, Chocó) y Tulenapa (Carepa, Antioquia). La recolección se hizo con trampas de luz CDC, mediante búsqueda activa en sitios de reposo y con trampas Shannon. La determinación taxonómica de especies se basó en las claves taxonómicas. En algunas especies de interés taxonómico, se evaluó el uso de secuencias parciales de la región 5’ del gen COI. Resultados. Se recolectaron 611 flebotomíneos adultos: 531 en Acandí, 45 en Carepa y 35 en Bahía Solano. Se identificaron 17 especies del género Lutzomyia, tres del género Brumptomyia y una del género Warileya. Las distancias genéticas (K2P) y los soportes de agrupación (>99 %) en el dendrograma de neighbor joining correspondieron a la mayoría de unidades taxonómicas operacionales moleculares (Molecular Operational Taxonomic Units, MOTU) establecidas para el grupo Aragaoi y confirmaron claramente la identidad de Lu. coutinhoi. Conclusión. Se identificaron especies que tienen importancia en la transmisión de la leishmaniasis en Acandí, Bahía Solano y Carepa. Se confirmó la presencia de Lu. coutinhoi en Colombia.

Abstract Introduction: The departments of Chocó and Antioquia in Colombia show climatic and vegetation conditions favoring the establishment of vector species of the genus Lutzomyia and the transmission of Leishmania spp. to human populations entering conserved forest environments. Objective: To report the species of Phlebotomine sandflies present in three natural reserves in the Darien and Pacific regions of Colombia. Materials and methods: Sand flies were collected specifically in the natural reserves El Aguacate (Acandí, Chocó), Nabugá (Bahía Solano, Chocó) and Tulenapa (Carepa, Antioquia). Sand flies were collected with CDC light traps, active search in resting places and Shannon traps. The taxonomic determination of species was based on taxonomic keys. For some species of taxonomic interest, we evaluated the partial sequences of the 5’ region of COI gene. Results: A total of 611 adult sand flies were collected: 531 in Acandí, 45 in Carepa and 35 in Bahía Solano. Seventeen species of the genus Lutzomyia, three of the genus Brumptomyia and one of the genus Warileya were identified. The genetic distances (K2P) and grouping supported (>99%) in the neighbor joining dendrogram were consistent for most established molecular operational taxonomic units (MOTU) of the Aragaoi group and clearly confirmed the identity of Lu. coutinhoi. Conclusion: Species that have importance in the transmission of leishmaniasis in Acandí, Bahía Solano and Carepa were identified. The presence of Lu. coutinhoi was confirmed and consolidated in Colombia.

The presence of Anopheles (Nyssorhynchus) dunhami Causey in Colombia (Department of Amazonas) is confirmed for the first time through direct comparison of mtDNA cytochrome c oxidase I (COI) barcodes and nuclear rDNA second internal transcribed spacer (ITS2) sequences with topotypic specimens of An. dunhami from Tefé, Brazil. An. dunhami was identified through retrospective correlation of DNA sequences following misidentification as Anopheles nuneztovari s.l. using available morphological keys for Colombian mosquitoes. That An. dunhami occurs in Colombia and also possibly throughout the Amazon Basin, is of importance to vector control programs, as this non-vector species is morphologically similar to known malaria vectors including An. nuneztovari, Anopheles oswaldoi and Anopheles trinkae. Species identification of An. dunhami and differentiation from these closely related species are highly robust using either DNA ITS2 sequences or COI DNA barcode. DNA methods are advocated for future differentiation of these often sympatric taxa in South America.

This is the first record of the presence of the medically important genus Lutzomyia França in the Department of Guainía, Colombia. Sand flies were collected biting humans in the surroundings of the urban area of the Municipality of Inírida. Three Lutzomyia species were taxonomically identified as L. davisi (Root), L. olmeca bicolor Fairchild & Theodor, and L. antunesi (Coutinho). Additionally, Brumptomyia mesai Sherlock is cited for the first time in the Caribbean Coast of Colombia based on specimens collected with a modified CDC light trap in the Reserva Forestal Protectora Serranía de Coraza y Montes de María, Department of Sucre.

Se registra por primera vez para el Departamento de Guainía, Colombia, la presencia del género Lutzomyia França de reconocida importancia médica. Los flebotomíneos se recolectaron mientras intentaban picar al humano en los alrededores del casco urbano del municipio de Inírida. Se identificaron taxonómicamente tres especies de Lutzomyia, incluidas L. davisi (Root), L. olmeca bicolor Fairchild & Theodor, y L. antunesi (Coutinho). Adicionalmente, Brumptomyia mesai Sherlock es citada por primera vez en el litoral Caribe Colombiano a partir de ejemplares colectados con una trampa de luz CDC modificada en la Reserva Forestal Protectora Serranía de Coraza y Montes de María, Departamento de Sucre.

En este trabajo se describe la síntesis de hidrazonas derivadas de cromano, tiocromano, alquil y aril hidrazonas, su actividad leishmanicida y su efecto sobre proteasas de cisteína de L. (V) panamensis. Se sintetizan feniltiocromanos y bencil y naftil derivados; solamente las fenilhidrazonas muestran alguna actividad sobre amastigotes de Leishmnia (V) panamensis. No se observa ningún efecto sobre una proteasa de cisteína del parásito lo que sugiere un mecanismo de acción diferente a la inhibición de esta enzima.

In this paper, the synthesis of hydrazones derived from cromano, thiocroman, alkyl and aril hydrazones is described, as well as their leishmanicidal activity and their effect on cysteine proteases from L. (V) panamensis. A series of novel phenylthiochromane and benzyl and naphtyl derivatives are synthesized and evaluated for their cytotoxic and antileishmanial activities. Their effect on parasite cysteine protease is also evaluated. Only phenylthiochromane derivatives display some activity against Leishmania (V) panamensis but all compounds are inactive against parasitic cystein protease. These results may suggest a different mechanism of action for these compounds.

The increase of malaria transmission in the Pacific Coast of Colombia during the occurrence of El Niño warm event has been found not to be linked to increases in the density of the vector Anopheles albimanus, but to other temperature-sensitive variables such as longevity, duration of the gonotrophic cycle or the sporogonic period of Plasmodium. The present study estimated the effects of temperature on duration of the gonotrophic cycle and on maturation of the ovaries of An. albimanus. Blood fed adult mosquitoes were exposed to temperatures of 24, 27, and 30°C, held individually in oviposition cages and assessed at 12 h intervals. At 24, 27, and 30°C the mean development time of the oocytes was 91.2 h (95% C.I.: 86.5-96), 66.2 h (61.5-70.8), and 73.1 h (64-82.3), respectively. The mean duration of the gonotrophic cycle for these three temperatures was 88.4 h (81.88-94.9), 75 h (71.4-78.7), and 69.1 h (64.6-73.6) respectively. These findings indicate that both parameters in An. albimanus are reduced when temperatures rose from 24 to 30°C, in a nonlinear manner. According to these results the increase in malaria transmission during El Niño in Colombia could be associated with a shortening of the gonotrophic cycle in malaria vectors, which could enhance the frequency of man-vector contact, affecting the incidence of the disease.

During the execution of an epidemiological study to assess the risk of Leishmania infection, an entomological evaluation and an inventory of phlebotomine fauna was made. The captures of phlebotomines were carried out with Shannon type traps and aspirators which collected the sand flies on human bait, in the Tikuna native community, on the banks of the Pupuña River an affluent of the Putumayo River among the department of Amazon. Five hundred and sixty phlebotomine specimens belonging to 20 species were captured in this place and the presence of Lutzomyia reducta Feliciangeli, Ramirez-Pérez & Ramirez recorded in Colombia for the first time and Lutzomyia carrerai carrerai (Barreto) and Lutzomyia nocticola Young were identified as new records for the zone. An updated inventory of phlebotomine species in Amazon department of Colombia is included.

Durante el desarrollo de un estudio epidemiológico para evaluar el riesgo de infección por Leishmania, se realizo una evaluación entomológica y el inventario de la fauna flebotomínea utilizando trampa Shannon y capturador bucal sobre cebo humano, en la comunidad indígena Tikuna residentes a orillas del río Pupuña, afluente del río Putumayo, departamento del Amazonas. En este mismo lugar se capturaron 560 ejemplares, de flebotomíneos pertenecientes a 20 especies, entre las cuales se identificaron por primera vez para Colombia a Lutzomyia reducta Feliciangeli, Ramirez-Pérez & Ramirez y Lutzomyia carrerai carrerai (Barreto) y Lutzomyia nocticola Young como nuevos registros para la zona. Se presenta un inventario actualizado de las especies de flebótomos del departamento del Amazonas Colombia.

The presence of Lutzomyia (Helcocyrtomyia) hartmanni, as a vector of Leishmania colombiensis and L. columbiana (Verrucarum group), recently incriminated in the transmission of leishmaniasis, and L. pia (Verrucarum group) are reported for the first time in a periurban area of Medellín city. There is thus a risk of leishmaniasis transmission in this town.