Introduction:Accurate diagnosis of tuberculosis (TB) infection is essential for TB control, particularly in high-risk populations. Interferon-gamma release assays (IGRAs) are widely used for TB infection screening. This study assesses the diagnostic agreement between the STANDARD™ F TB-Feron fluorescence immunoassay (FIA) and the WHO-approved STANDARD E TB-Feron ELISA in penitentiary settings in Paraguay. Methods:A cross-sectional study was conducted among 737 participants (642 incarcerated individuals and 95 staff members). Both assays were performed on the same blood samples from each participant. Agreement was assessed using the Kappa coefficient, with stratified analyses across predefined risk groups: G1, no known TB exposure (n = 71); G2, TB exposure (n = 525); G3, active TB (n = 67); and G4, previously treated and cured TB (n = 74). Results:Overall positivity was 57.7% with FIA and 56.9% with ELISA. Positivity rates for FIA/ELISA were: G1 (22.9%/22.9%), G2 (57.7%/58.4%), G3 (79.1%/79.1%), and G4 (71.6%/71.6%). Overall agreement was excellent (κ = 0.851; 95% CI: 0.812-0.889; p < 0.0001). Stratified analyses showed moderate agreement in G1 (κ = 0.595) and excellent agreement in the remaining groups. Conclusion:The STANDARD F TB-Feron FIA demonstrated excellent concordance with ELISA, supporting its use as a reliable alternative for TB infection screening. In addition, the FIA offers key operational advantages, including reduced hands-on time (approximately 15 min compared with several hours for ELISA), the ability to process single samples without batch runs, and the use of portable equipment requiring less laboratory infrastructure, making it particularly suitable for decentralized and resource-limited settings.
Introducción: el hipotiroidismo es uno de los trastornos hormonales más frecuentes. El diagnóstico del tipo subclínico en adultos mayores puede ser dificultoso debido al aumento de los niveles de TSH con la edad. Objetivo: determinar las características clínicas, de laboratorio y demográficas de los adultos mayores con estadía permanente en el Complejo Santo Domingo para personas mayores, con diagnóstico de hipotiroidismo subclínico en 2023. Material y métodos: estudio observacional, descriptivo, transversal, con muestreo no probabilístico de 60 casos de adultos de 60 años o mayores con estadía permanente en el Complejo Santo Domingo para personas mayores de Asunción (Paraguay), en el periodo de enero a abril 2023. Resultados y discusión: se estudiaron 60 casos de los cuales 20 (33,3%) presentaron hipotiroidismo subclínico. Las características demográficas, clínicas y de laboratorio de los pacientes con hipotiroidismo subclínico fueron edad 76,9±8,1 años, sexo masculino 12 (60%), 14 diabetes tipo 2 (70%), ictus 5 (25%) e hipertensión arterial 6 (30%). Los niveles de TSH fueron de 8,5±3,2 mU/L, T3 1,2±0,4 mU/L y fT4 2,5±3,5 mU/L. Conclusión: el hipotiroidismo subclínico presenta una importante frecuencia en las personas mayores con estancias permanentes en residencias para adultos mayores.
El embarazo en la adolescencia constituye un problema de salud pública prioritario con graves implicaciones socioeconómicas. El objetivo de este estudio fue describir los factores asociados al embarazo precoz según la percepción de estudiantes de Educación Media de instituciones educativas de la ciudad de Concepción, Paraguay, en el año 2025. Se empleó un diseño cuantitativo, descriptivo y de corte transversal con una muestra censal de 159 estudiantes. Los resultados evidencian que el 73% de los encuestados reconoce la influencia de los medios de comunicación y el 52% la falta de comunicación familiar adecuada sobre sexualidad como factores de riesgo determinantes. Se concluye que existe una alta demanda por estrategias preventivas integrales y un apoyo social insuficiente para las adolescentes gestantes, lo que exige una intervención multisectorial urgente.
Hepatitis B virus (HBV) and Hepatitis C virus (HCV) remain major global health challenges, together accounting for approximately 1.1 million deaths annually and representing leading causes of chronic liver disease, cirrhosis, and hepatocellular carcinoma. In Paraguay, the true burden remains poorly defined, hindering effective public health planning toward the WHO’s 2030 elimination goal. This cross-sectional study aimed to establish a comprehensive, nationally representative epidemiological baseline among blood donors. We prospectively analyzed 85,811 blood donor samples. Screening involved chemiluminescent immunoassays for anti-HBc, HBsAg, and anti-HCV, followed by confirmatory Nucleic Acid Amplification Testing (NAT) for HBV-DNA and HCV-RNA. The age-standardized seroprevalences were: 1.66% for anti-HBc, 0.079% for HBsAg, and 0.261% for anti-HCV. However, significant regional variations were noted, with anti-HBc prevalence ranging from 0.70% to 3.86% (p < 0.001). Anti-HBc also increased with age (0.27% in < 20 years to 3.10% in > 50 years). Critically, no HBV markers were detected in donors born after the national 2003 vaccination program. Only 1 of 229 anti-HCV reactive samples was HCV-RNA detectable. While low overall seroprevalence confirms blood safety standards, pronounced regional disparities require targeted public health interventions focused on specific epidemiological hotspots. The absence of HBV markers in the post-vaccination cohort provides strong evidence of the national immunization program’s success, offering an invaluable baseline for future elimination strategies.
Yellow fever remains a major public health threat in endemic and re-emerging regions of Africa and South America, with recent outbreaks highlighting persistent gaps in prevention and surveillance. Pregnant women represent a particularly vulnerable population, yet the epidemiology, clinical impact, and preventive strategies for yellow fever in pregnancy are insufficiently characterized. Physiological and immunological changes during gestation may influence host responses to infection; however, current evidence does not demonstrate increased susceptibility to or severity of yellow fever during pregnancy. Adverse materno-fetal outcomes, including miscarriage, stillbirth, preterm birth, and, in rare cases, perinatal transmission, have been reported but remain poorly characterized. Diagnostic challenges, overlapping clinical presentations with other arboviral and hepatic diseases, and limited access to specialized care further complicate clinical management in many endemic settings. This perspective provides a comprehensive overview of yellow fever in pregnancy during the 2024–2026 outbreak in the Americas, including a risk-stratification framework for prevention. We summarize current evidence on epidemiology, pathophysiology, diagnosis, and supportive care, and examine prevention strategies with particular emphasis on vaccination. Accumulated observational evidence and substantial real-world experience have not demonstrated an increased risk of serious adverse events and generally support the effectiveness of yellow fever vaccination during pregnancy when administered with appropriate clinical judgment. In high-risk settings, the benefits of maternal immunization clearly outweigh theoretical concerns, supporting a flexible, risk-based approach, despite relatively limited evidence. We also discuss national and international policies, post-pregnancy booster recommendations, and the importance of integrating vaccination assessment into antenatal care. Finally, we highlight critical knowledge gaps and research priorities, including the need for prospective registries and strengthened pharmacovigilance. Coordinated clinical and public health strategies are essential to protect maternal and neonatal health and to reduce the burden of yellow fever in endemic and re-emerging settings.
