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.
OBJECTIVES:To evaluate continuity of once-weekly isoniazid plus rifapentine for 12 weeks (3HP) tuberculosis preventive treatment in a Paraguayan prison cohort, focusing on adherence, strict completion, safety and institutional transitions as drivers of non-completion. METHODS:We conducted a longitudinal implementation cohort study at Coronel Oviedo Penitentiary Center, Paraguay, during July-October 2025. Persons with QuantiFERON-TB Gold Plus-confirmed tuberculosis infection and active tuberculosis excluded by the program algorithm were offered 3HP under directly observed therapy. Weekly dose administration, missed-dose reasons and self-reported adverse reactions were recorded. RESULTS:Of 1846 people incarcerated in the facility, 240 accessed QuantiFERON testing and 170 tested positive. Among QFT-positive individuals, 50 did not initiate 3HP because of transfer, release or refusal. A total of 120 initiated 3HP; 90 achieved acceptable adherence, defined as receipt of at least 11 of 12 doses (75.0%), and 82 completed all 12 doses (68.3%). Medication was administered in 1195 of 1440 scheduled person-weeks (83.0%). Non-completion occurred in 30 participants; 28 cases (93.3%) were attributable to release or transfer. Fifty-seven participants (47.5%) reported at least one adverse reaction, mostly mild or moderate. CONCLUSION:High adherence was achieved with 3HP, but institutional transitions interrupted completion, highlighting the need for prison-to-community continuity mechanisms after incarceration.
Introducción: El uso de Sistemas Electrónicos de Administración de Nicotina (SEAN) ha aumentado notablemente en los últimos años, especialmente entre los jóvenes. En Paraguay, su comercialización no está regulada, y existe poca información sobre su uso en estudiantes universitarios, especialmente en ciencias de la salud. Objetivo: Determinar el nivel de conocimiento, actitudes y prácticas relacionadas al uso de SEAN en estudiantes de medicina de la Facultad de Ciencias Médicas de la Universidad Nacional de Caaguazú en el año 2024. Metodología: Estudio observacional, descriptivo de corte transversal con componente analítico. Mediante muestreo aleatorio estratificado por curso, se seleccionaron 151 estudiantes de una población de 247. Se aplicó un cuestionario auto-administrado en línea, validado mediante prueba piloto y juicio de expertos, que incluía variables sociodemográficas, de conocimiento, actitudes y prácticas. Se realizó un análisis descriptivo y pruebas de chi-cuadrado para explorar asociaciones, utilizando el software Stata 17.0©. Resultados: La prevalencia de uso de SEAN en el último mes fue del 13,25% (n=20), significativamente mayor en hombres (29,17% vs. 5,83%; p<0,001). El 30% de los estudiantes considera erróneamente que los SEAN son más seguros que los cigarrillos convencionales. El uso en el entorno familiar se asoció significativamente con el consumo personal, tanto para SEAN (24,24% vs. 10,17%; p=0,035) como para cigarrillos convencionales (25% vs. 10,08%; p=0,027). El 22% de los estudiantes reportó exposición a aerosoles de SEAN en el último mes. La curiosidad y la influencia social fueron las principales motivaciones de uso. Conclusión: Existe una prevalencia de uso de SEAN del 13,25% en estudiantes de medicina. Se identificaron percepciones erróneas sobre su seguridad, una fuerte influencia del entorno familiar y exposición significativa a aerosoles de segunda mano. Estos hallazgos subrayan la necesidad de intervenciones educativas específicas en esta población.
Background The Intensive Care Unit (ICU) is an environment where multiple factors that predispose to the transmission of Antimicrobial Resistance (AMR) coexist. Genomic sequencing is a technology that enables a better understanding of how AMR genes are transmitted within the ICU environment.Objective To evaluate the genomic dynamics of the transmission of antimicrobial resistance genes between bacteria from ICU surfaces and bacteria from critically ill patients.Methods A cross-sectional analytical study. Surface swab samples were collected from the ICU, including suction units, infusion pumps, stethoscopes, dialysis machines, monitors, ventilators and gas valves, as well as samples from critically ill patients with infections. Species were identified using microbiological microplate panels; antibiotic susceptibility testing was carried out to assess AMR; and whole-genome sequencing was performed on isolates that were multidrug-resistant (MDR). The sequencing was carried out using a nanopore long-read sequencer and the results were analysed using specialised bioinformatics tools.Results A total of 130 positive isolates were identified, of which 96 (73.85%) were from environmental samples and 34 (26.15%) from patient samples. Forty (30.76%) MDR species were identified. The most common MDR species were Klebsiella pneumoniae and Acinetobacter baumannii. The most frequently detected AMR genes were blaNDM-5 and blaOXA-23. The most common plasmids were IncFIB(K)_1_Kpn3, Col440I and IncL/M(pMU407)_1_pMU407. A clonal outbreak of Acinetobacter baumannii ST 2 was detected on the dialysis machine, stethoscopes and patient samples. Evidence of horizontal transfer of resistance genes via plasmids conjugation was found in samples taken from suction units, oxygen valves and tracheal secretion in three cases.Conclusion The findings of this research show that antimicrobial resistance genes are transferred between bacteria on surfaces and bacteria in critically ill patients, and that this transfer occurs in both directions.
Introducción: El cuidado neonatal temprano constituye un componente esencial para reducir la morbimortalidad en el período neonatal. El conocimiento fundamentales materno sobre prácticas como lactancia, higiene, cuidado del cordón umbilical, termorregulación y sueño seguro influye directamente en la salud del recién nacido. Objetivo: Determinar el nivel de conocimiento sobre los cuidados del recién nacido en madres puérperas Material y métodos: Estudio cuantitativo, descriptivo y de corte transversal, realizado entre julio a septiembre de 2025 con 144 puérperas seleccionadas por caso consecutivo. Se utilizó un cuestionario estructurado validado que evaluó conocimientos en alimentación, higiene, cuidado del cordón umbilical, termorregulación y sueño del recién nacido. Los datos fueron analizados mediante estadística descriptiva. El 94% reconoció la lactancia materna exclusiva como la forma adecuada de alimentación; el 96% identificó correctamente las prácticas de higiene; y el 94% conocía los cuidados del cordón umbilical. Sin embargo, s e observaron vacíos en aspectos como la posición segura para dormir y el manejo domiciliario de la fiebre. Conclusión: Las madres puérperas poseen conocimientos básicos sobre el cuidado neonatal, persisten brechas que requieren interve nciones educativas estructuradas y adaptadas al contexto sociocultural. Fortalecer la educación antes del alta hospitalaria e integrar la participación de las parejas podría contribuir a mejorar las prácticas de cuidado y la seguridad del recién nacido.
