Implementación de técnicas moleculares para diagnóstico y epidemiología de la Enfermedad de Chagas y Leishmaniasis en Colombia

dc.contributorRamírez González, Juan David
dc.creatorHernández Castro, Diana Carolina
dc.date.accessioned2021-02-08T21:20:00Z
dc.date.accessioned2023-06-05T14:43:55Z
dc.date.available2021-02-08T21:20:00Z
dc.date.available2023-06-05T14:43:55Z
dc.date.created2021-02-08T21:20:00Z
dc.date.issued2016
dc.identifierhttp://hdl.handle.net/20.500.12495/5273
dc.identifierinstname: Universidad El Bosque
dc.identifierreponame: Repositorio Institucional Universidad El Bosque
dc.identifierrepourl: https://repositorio.unbosque.edu.co
dc.identifier.urihttps://repositorioslatinoamericanos.uchile.cl/handle/2250/6640861
dc.description.abstractLa enfermedad de Chagas y las leishmaniasis son enfermedades de gran importancia epidemiológica en Colombia. Las técnicas moleculares proporcionan herramientas que facilitan el estudio de estas enfermedades. Por esta razón, el objetivo de este estudio fue la implementación de técnicas moleculares que permitan mejorar el diagnóstico y realizar estudios de epidemiología molecular en el país. Se recolectaron 708 muestras de pacientes con enfermedad de Chagas, 245 triatominos y 39 reservorios. Se aplicaron las siguientes técnicas moleculares: PCR convencional y tiempo real para diagnóstico, cuantificación y genotipificación de T. cruzi en muestras de pacientes, triatóminos y reservorios. PCR-HRM para determinación de fuentes alimenticias de triatóminos. Análisis de microsatélites en muestras de pacientes, triatominos y reservorios involucrados en brotes de transmisión oral. Lo anterior, con el fin de determinar las capacidades operativas de las técnicas moleculares, cargas parasitarias y DTUs en pacientes con enfermedad de Chagas. Adicionalmente, conocer los índices de infección triatominica, DTUs y preferencias alimenticias de triatominos en el país y realizar análisis de epidemiología molecular en dos brotes de transmisión oral en Colombia. En cuanto a Leishmaniasis, se incluyeron en el estudio aislamientos obtenidos de pacientes con Leishmaniasis cutánea, flebótomos y reservorios. Se realizó el diseño de un PCR-HRM para la identificación de las seis especies de Leishmania spp descritas previamente en el país. Se implementó la amplificación y secuenciación del gen citocromo b para identificación de especies de Leishmania spp. En enfermedad de Chagas, el desempeño diagnóstico de las pruebas moleculares fue mejor en fase aguda que en fase crónica de la enfermedad. Se observaron diferencias estadísticamente significativas entre las cargas parasitarias según la fase clínica. Se reafirma la amplia distribución de la DTU TcI en pacientes, triatominos y reservorios. Se encontraron altos porcentajes de infección por T. cruzi y alimentación con sangre humana en especies de triatominos consideradas secundarias en el país. Se encontró que el posible origen de uno de los brotes de transmisión oral fue la contaminación de alimentos con heces de triatóminos, mientras que en el segundo brote el posible origen corresponde a la contaminación de alimentos con secreciones odoríferas de zarigüeyas. En las leishmaniasis, la PCR-HRM de HSP-70 permite la identificación de L. amazonensis en el subgénero L. Leishmania y de L. panamensis en el subgénero L. Viannia; mientras ITS-1 permite la discriminación entre L. amazonensis y L. infantum y entre L. braziliensis y L. guyanensis. Mediante secuenciación del gen citocromo b se logró la detección de dos especies de Leishmania spp. que no habían sido previamente reportadas en el país L. equatoriensis y L. lainsoni y se realizaron mapas de distribución de todas las especies detectadas, así como su distribución en todo el circuito epidemiológico. Se logró la implementación exitosa de diferentes técnicas moleculares que fueron de utilidad para diagnóstico y epidemiología molecular de la enfermedad de Chagas y de las leishmaniasis, proporcionando nuevo conocimiento y dejando disponibles dichas técnicas para su uso en el país mediante el Instituto Nacional de Salud.
dc.languagespa
dc.publisherMaestría en Ciencias Básicas Biomédicas
dc.publisherUniversidad El Bosque
dc.publisherFacultad de Medicina
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dc.titleImplementación de técnicas moleculares para diagnóstico y epidemiología de la Enfermedad de Chagas y Leishmaniasis en Colombia


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