BACKGROUND & AIMS: BACKGROUND:We present a picture of the biodiversity of Mycobacterium tuberculosis in Paraguay, an inland South American country harboring 5 million inhabitants with a tuberculosis notification rate of 38/100,000. RESULTS:A total of 220 strains collected throughout the country in 2003 were classified by spoligotyping into 79 different patterns. Spoligopatterns of 173 strains matched 51 shared international types (SITs) already present in an updated version of SpolDB4, the global spoligotype database at Pasteur Institute, Guadeloupe. Our study contributed to the database 13 new SITs and 15 orphan spoligopatterns. Frequencies of major M. tuberculosis spoligotype lineages in our sample were as follows: Latin-American & Mediterranean (LAM) 52.3%, Haarlem 18.2%, S clade 9.5%, T superfamily 8.6%, X clade 0.9% and Beijing clade 0.5%. Concordant clustering by IS6110 restriction fragment length polymorphism (RFLP) and spoligotyping identified transmission in specific settings such as the Tacumbu jail in Asuncion and aboriginal communities in the Chaco. LAM genotypes were ubiquitous and predominated among both RFLP clusters and new patterns, suggesting ongoing transmission and adaptative evolution in Paraguay. We describe a new and successfully evolving clone of the Haarlem 3 sub-lineage, SIT2643, which is thus far restricted to Paraguay. We confirmed its clonality by RFLP and mycobacterial interspersed repetitive unit (MIRU) typing; we named it "Tacumbu" after the jail where it was found to be spreading. One-fifth of the spoligopatterns in our study are rarely or never seen outside Paraguay and one-tenth do not fit within any of the major phylogenetic clades in SpolDB4. CONCLUSION:Lineages currently thriving in Paraguay may reflect local host-pathogen adaptation of strains introduced during past migrations from Europe.

背景与目标：

BACKGROUND & AIMS: :Between 1997 and 2012, Paraguay achieved not only remarkable improvements in child nutrition, but also a surprising elimination of the rural-urban differential in child height-for-age Z score (HAZ) and stunting. Our decomposition analysis, applied to four rounds of Paraguayan National Household Surveys, allows us to directly infer not only the contributions of changes in determinants of child nutritional status to the improvements in child nutritional status in rural and urban areas, but also their contribution to closing the rural-urban gap. We find that while common determinants of child nutritional status such as income, maternal education, sanitation, and access to piped water are strongly associated with improvements in child nutrition, they have contributed little to reducing the rural-urban gap (10%, p < 0.05). Improvements in health care utilization, family planning, and demographics have been the main drivers in closing the rural-urban gap in child nutritional status in Paraguay (32%, p < 0.05). The results highlight the potential need for multipronged nutritional strategies that consider the distinct needs of rural and urban communities.

背景与目标： : 在1997年至2012年之间，巴拉圭不仅在儿童营养方面取得了显着改善，而且在儿童年龄身高Z评分 (HAZ) 和发育迟缓方面也令人惊讶地消除了城乡差异。我们的分解分析应用于四轮巴拉圭全国家庭调查，不仅使我们能够直接推断出儿童营养状况决定因素的变化对改善农村和城市地区儿童营养状况的贡献，而且还可以推断出它们对缩小城乡差距的贡献。我们发现，虽然儿童营养状况的共同决定因素，如收入、孕产妇教育、卫生和获得自来水与儿童营养的改善密切相关，但它们对缩小城乡差距的贡献不大 (10%，p <  0.05)。保健利用、计划生育和人口结构的改善是缩小巴拉圭儿童营养状况城乡差距的主要驱动力 (32%，p <  0.05)。结果强调了考虑农村和城市社区独特需求的多管齐下营养战略的潜在需求。

BACKGROUND & AIMS: :Genetic and phylogenetic relationships among seven piranha species of the genera Serrasalmus and Pygocentrus from the Paraná-Paraguay, São Francisco and Tocantins River basins were evaluated in the present study by partial sequences of two mitochondrial genes, Cytochrome b and Cytochrome c Oxidase I. Phylogenetic analysis of Maximum-Likelihood and Bayesian inference were performed. Results indicated, in general, greater genetic similarity between the two species of Pygocentrus (P. nattereri and P. piraya), between Serrasalmus rhombeus and S. marginatus and between S. maculatus, S. brandtii and S. eigenmanni. Pygocentrus nattereri, S. rhombeus and S. maculatus showed high intraspecific genetic variability. These species have each one, at least two different mitochondrial lineages that, currently, occur in sympatry (S. rhombeus) or in allopatry (P. nattereri and S. maculatus). Species delimitation analysis and the high values of genetic distances observed between populations of S. rhombeus and of S. maculatus indicated that each species may corresponds to a complex of cryptic species. The non-monophyletic condition of S. rhombeus and S. maculatus reinforces the hypothesis. The geographic distribution and the genetic differentiation pattern observed for the piranha species analyzed herein are discussed regarding the geological and hydrological events that occurred in the hydrographic basins.

背景与目标： : 本研究通过两个线粒体基因的部分序列评估了来自巴拉那-巴拉圭，圣弗朗西斯科和托坎廷斯河流域的Serrasalmus属和Pygocentrus属的7种食人鱼的遗传和系统发育关系，细胞色素b和细胞色素c氧化酶I。进行了最大似然性的系统发育分析和贝叶斯推断。结果表明，总的来说，两种Pygocentrus (P. nattereri和P. piraya)，Serrasalmus rhombeus和S. marginatus之间以及S. maculatus，S. brandtii和S. eigenmanni之间的遗传相似性更大。Pygocentrus nattereri，S. rhombeus和S. maculatus表现出很高的种内遗传变异性。这些物种具有至少两个不同的线粒体谱系，目前发生在同胞 (S. rhombeus) 或异种 (P. nattereri和S. maculatus) 中。物种定界分析和在S. rhombeus和S. maculatus种群之间观察到的高遗传距离值表明，每个物种可能对应于一个隐秘物种的复合体。菱形S. rhombeus和S. maculatus的非单系条件强化了这一假设。讨论了本文分析的食人鱼物种的地理分布和遗传分化模式，涉及水文流域发生的地质和水文事件。

BACKGROUND & AIMS: :Trypanosoma cruzi II is associated with Chagas disease in the southern part of South America. We analyzed T. cruzi variants in field-collected triatomines and congenitally infected infants living in the same disease-endemic region in Paraguay. Results of polymerase chain reactions for T. cruzi kinetoplast DNA and satellite DNA were positive in 83 triatomine feces samples and 58 infant blood samples. However, lineages were detected in 33 and 38 samples, respectively. Trypanosoma cruzi genotypes were determined in 56 (97%) blood samples after hybridization by using specific probes. The Tc I genotype was not detected. The prevalent sublineage was Tc IId in triatomines (27 of 33) and infant blood (36 of 58) as assessed by amplification of the 24Salpha ribosomal RNA and the mini-exon region genes. The Tc IIc genotype was detected in 20 infant blood samples and in 1 triatomine. This study shows T. cruzi II is the predominant lineage circulating in triatomines and humans in endemic areas of eastern region of Paraguay.

背景与目标： : 克氏锥虫II与南美南部的南美锥虫病有关。我们分析了野外收集的triatomics和生活在巴拉圭同一疾病流行地区的先天性感染婴儿中的T. cruzi变体。在83份三甲胺粪便样本和58份婴儿血液样本中，克氏T. cruzi激酶体DNA和卫星DNA的聚合酶链反应结果为阳性。然而，分别在33个和38个样本中检测到谱系。使用特异性探针杂交后，在56 (97%) 个血液样品中测定克氏锥虫基因型。未检测到Tc I基因型。通过扩增24个Salpha核糖体RNA和迷你外显子区域基因来评估，在三核蛋白 (33个中的27个) 和婴儿血液 (58个中的36个) 中，普遍存在的亚链是Tc IId。在20个婴儿血液样本和1个triatomin中检测到Tc IIc基因型。这项研究表明，T. cruzi II是巴拉圭东部地区流行地区的triatomics和人类中流行的主要谱系。

BACKGROUND & AIMS: AIM:To evaluate the distribution of refractive error in young subjects in a rural area of Paraguay in the context of an international cooperation campaign for the prevention of blindness. METHODS:A sample of 1466 young subjects (ranging from 3 to 22 years old), with a mean age of 11.21±3.63 years old, were examined to assess their distance visual acuity (VA) and refractive error. The first screening examination performed by trained volunteers, included visual acuity testing, autokeratometry and non-cycloplegic autorefraction. Inclusion criteria for a second complete cycloplegic eye examination by an optometrist were VA <20/25 (0.10 logMAR or 0.8 decimal) and/or corneal astigmatism ≥1.50 D. RESULTS:An uncorrected distance VA of 0 logMAR (1.0 decimal) was found in 89.2% of children. VA <20/25 and/or corneal astigmatism ≥1.50 D was found in 3.9% of children (n=57), with a prevalence of hyperopia of 5.2% (0.2% of the total) in this specific group. Furthermore, myopia (spherical equivalent ≤-0.5 D) was found in 37.7% of the refracted children (0.5% of the total). The prevalence of refractive astigmatism (cylinder ≤-1.50 D) was 15.8% (0.6% of the total). Visual impairment (VI) (0.05≤VA≤0.3) was found in 12/114 (0.4%) of the refracted eyes. Main causes for VI were refractive error (58%), retinal problems (17%, 2/12), albinism (17%, 2/12) and unknown (8%, 1/12). CONCLUSION:A low prevalence of refractive error has been found in this rural area of Paraguay, with higher prevalence of myopia than of hyperopia.

背景与目标：

BACKGROUND & AIMS: BACKGROUND:Official figures of mortality in children under five years of age in the Americas, report that infectious and parasitic diseases caused most of the deaths. OBJECTIVE:To evaluate the frequency of intestinal parasites in vulnerable children, indigenous and non-indigenous, and their socio-environmental characteristics. PATIENTS AND METHODS:We evaluated 247 children under five years of age, of both sexes. Descriptive study with an analytical component, transverse cutting. Copro-parasitological examinations were carried out and semi-structured interviews to collect socio-demographic data were conducted. RESULTS:The frequency of intestinal parasitic diseases was 56.1% and 35.5% in indigenous and non-indigenous children, respectively. In both populations, the most common pathogens were Blastocystis hominis and Giardia lamblia. CONCLUSION:We found a high frequency of parasitism in indigenous children at the expense of protozoa. Non-indigenous children still present the same parasitic species found in previous studies, suggesting the need to implement more control and prevention. The poor conditions in which they live favor the development of these diseases.

背景与目标：

BACKGROUND & AIMS: :In Paraguay, cancer is among the leading causes of death among children. We report challenges and solutions for building the country's first pediatric cancer center at the National University School of Medicine (PCC-SM) and describe the outcomes of the National Network for Pediatric Cancer. We found that children with acute lymphoblastic leukemia treated between 2008 and 2012 had higher 3-year survival rates and lower treatment abandonment rates than did children treated between 2000 and 2007 before the network was established. This improvement directly coincided with the increased treatment capacity of the PCC-SM. Herein, we describe the role of local, national, and international contributors in improving the health care at Paraguay's PCC-SM and discuss how expediting access to specialized cancer diagnosis and care and implementing a system for referral and follow-up visits can improve cancer outcomes in other low-resource countries.

背景与目标： : 在巴拉圭，癌症是儿童死亡的主要原因之一。我们报告了在国立大学医学院 (pcc-sm) 建立该国第一个儿科癌症中心的挑战和解决方案，并描述了国家儿科癌症网络的结果。我们发现，与建立网络之前的2000年和2007儿童相比，2008年和2012治疗的急性淋巴细胞白血病患儿的3年生存率更高，放弃治疗的率更低。这种改善与pcc-sm的治疗能力增加直接吻合。在此，我们描述了地方，国家和国际贡献者在改善巴拉圭pcc-sm的医疗保健方面的作用，并讨论了如何加快获得专门的癌症诊断和护理以及实施转诊和随访系统可以改善癌症结果在其他低资源国家。

BACKGROUND & AIMS: :The crown morphology of 202 dental casts from living Lengua Indians is described and compared with other Amerind, Melanesian, and Caucasoid samples. The Lengua dentition shows a high Mongoloid component with little effects of possible European admixture, thus supporting the theory that despite early Franciscan and Jesuit attempts at missionization, much of the Paraguayan Chaco has remained genetically and culturally relatively intact well into the present century. A finding of note was the apparent sexual dimorphism of the Carabelli cusp, which questions earlier assumptions that no correction for sex need be made in population studies when dealing with this trait. Since mandibular canines show proportionately less wear in the canine distal accessory ridge area than maxillary canines, the value of the incidence of this trait in population and microevolutionary studies is questioned.

背景与目标： : 描述了来自活着的Lengua印第安人的202个牙模的牙冠形态，并将其与其他Amerind，Melanesian和高加索人样本进行了比较。Lengua牙列显示出很高的蒙古人成分，几乎没有可能的欧洲混合物的影响，因此支持了这样的理论，即尽管早期的方济各会和耶稣会尝试将其传信，但到本世纪以来，巴拉圭查科的许多地区在遗传和文化上都保持相对完整。值得注意的发现是Carabelli尖端明显的性二态性，它质疑先前的假设，即在处理这种特征时，在人口研究中无需对性别进行校正。由于下颌骨犬在犬远端副脊区域的磨损比上颌骨犬少，因此该特征在种群和微观进化研究中的发生率价值受到质疑。

BACKGROUND & AIMS: :Leonurus sibiricus L. (Lamiaceae) is a subtropical weed frequently found with golden mosaic symptoms. Leonurus mosaic virus (LeMV) was the first begomovirus reported on L. sibiricus in Brazil (3). Later, a new bipartite species (Tomato yellow spot virus, ToYSV) was reported affecting tomatoes, beans, and also L. sibiricus (1,2). A survey of begomovirus isolates was conducted within tomato fields also displaying high incidence of plants with begomovirus-induced symptoms. Thirty L. sibiricus and 33 tomato samples were collected (2007 to 2012) in nine districts in Paraná State, Brazil. Two L. sibiricus isolates were also obtained within citrus orchards in Major Otaño, Itapúa, Paraguay. Total DNA was extracted from all 65 isolates and PCR assays were conducted with primers for conserved DNA-A (PAL1v1978/PAR1c496) and DNA-B (PBL1v2040/PCRc1) regions (3). Nucleotide sequence identity of the 1,193-bp DNA-A amplicons of our L. sibiricus isolates ranged from 93.4 to 98.2% with LeMV (GenBank Accession No. U925321) and from 92.4 to 94.8% with ToYSV isolates from tomato (DQ336350.1) and bean (FJ538207). None of the 33 tomato samples was found to be infected by ToYSV, with all having high nucleotide sequence identity (92 to 99%) only with Tomato severe rugose virus (GU358449). Complete DNA-A genome sequence was obtained via a rolling circle amplification-based strategy for one Brazilian L. sibiricus isolate (PR-088) and one isolate from Paraguay (PAR-07). The entire DNA-A genome of PR-088 (JQ429791) had 96.8% nucleotide sequence identity with PAR-07 (KC683374) and ranged from 95.6 to 96.3% with ToYSV isolates from bean, tomato, and L. sibiricus (JX513952). The nucleotide sequence identity of the 487-bp DNA-B amplicon ranged from 87 to 92% among PR-088 (KC 683374); PAR-07 (KC740619) and ToYSV isolates from tomato (DQ336351.1) and L. sibiricus (JX513953.1). Leonurus cuttings infected with the ToYSV (PR-088) were caged together with healthy L. sibiricus and tomato 'Alambra' seedlings. Hybridization assays with ToYSV-specific probes (2) and sequencing of PCR amplicons indicated that Bemisia tabaci biotype B adults were able to transmit ToYSV to both hosts as reported (1). Our results suggest that L. sibiricus is the main ToYSV reservoir under natural conditions and tomato seems to be an occasional alternative host. In fact, ToYSV has not often detected in tomatoes as observed in a number of extensive surveys (4). So far, the complete LeMV genome is not available for comparison (3). However, our analyses with a DNA-A segment indicated that LeMV and ToYSV isolates might represent strains of single virus at the current threshold of 89% nucleotide sequence identity for Begomovirus species discrimination (4). Thus, a reappraisal of the taxonomic status of ToYSV is necessary to clarify its genetic relationship with LeMV. This is the first report of ToYSV on L. sibiricus in Paraguay. References: (1) J. C. Barbosa et al. Plant Dis. 97:289, 2013. (2) R. F. Calegario et al. Pesq. Agrop. Bras. 42:1335, 2007. (3) J. C. Faria and D. P. Maxwell, Phytopathology 89:262, 1999. (4) F. R. Fernandes et al. Virus Genes 36:251, 2008.

背景与目标： : Leonurus sibiricus L.(唇形科) 是一种亚热带杂草，经常发现有金色花叶症状。Leonurus花叶病毒 (LeMV) 是巴西sibiricus上报道的第一种begomo病毒 (3)。后来，报道了一种新的二分物种 (番茄黄斑病毒，ToYSV) 影响番茄，豆类和西伯利亚杆菌 (1,2)。在番茄田中进行了begomovirus分离株的调查，也显示出begomovirus诱导症状的植物的发生率很高。在巴西巴拉那州的9个地区收集了30个sibiricus和33个番茄样品 (2007个2012年)。在巴拉圭itap ú a的主要ota ñ o的柑橘园中也获得了两个sibirius分离株。从所有65个分离物中提取总DNA，并用保守DNA-A (PAL1v1978/PAR1c496) 和DNA-B (PBL1v2040/PCRc1) 区域的引物进行PCR测定 (3)。我们的sibiricus L. sibiricus分离株的1,193-bp DNA-A扩增子的核苷酸序列同一性与LeMV (GenBank登录号U925321) 和ToYSV分离株 (来自番茄 (DQ336350.1) 和bean (FJ538207)。发现33个番茄样品中没有一个被ToYSV感染，所有样品都具有高核苷酸序列同一性 (92至99%)，仅被番茄严重皱纹病毒 (GU358449) 感染。通过基于滚动环扩增的策略获得了完整的DNA-A基因组序列，用于一种巴西西伯利亚乳杆菌分离株 (PR-088) 和一种来自巴拉圭的分离株 (PAR-07)。PR-088的整个DNA-A基因组 (JQ429791) 与PAR-07 (KC683374) 具有96.8% 的核苷酸序列同一性，并且与来自豆类，番茄和西比氏杆菌的ToYSV分离株 (JX513952) 在95.6至96.3% 之间。在PR-088 (KC 683374) 中，487 bp dna-b扩增子的核苷酸序列同一性范围为87至92%; PAR-07 (KC740619) 和ToYSV分离株来自番茄 (DQ336351.1) 和西比氏杆菌 (JX513953.1)。将感染ToYSV (PR-088) 的Leonurus插条与健康的西伯利亚乳杆菌和番茄 'Alambra' 幼苗一起关在笼子里。使用ToYSV特异性探针 (2) 进行的杂交分析和PCR扩增子的测序表明，烟粉虱生物型b型成年人能够将ToYSV传播给两个宿主，如报道 (1)。我们的结果表明，西伯利亚乳杆菌是自然条件下的主要ToYSV水库，番茄似乎是偶尔的替代宿主。实际上，在许多广泛的调查中观察到的ToYSV并不经常在西红柿中检测到 (4)。到目前为止，完整的LeMV基因组还不能用于比较 (3)。然而，我们对DNA-a片段的分析表明，LeMV和ToYSV分离株可能代表了在当前Begomo病毒种类区分的89% 核苷酸序列同一性阈值下的单个病毒株 (4)。因此，有必要重新评估ToYSV的分类地位，以阐明其与LeMV的遗传关系。这是ToYSV关于巴拉圭的L. sibiricus的第一份报告。参考文献 :( 1) J.C.巴博萨等人。97:289，2013。(2) R。F.Calegario等人。Agrop。胸罩。42:1335，2007。(3) J。C.法里亚和D.P。麦克斯韦，植物病理学89:262，1999。(4) F。R。Fernandes等人，病毒基因36:251，2008。

BACKGROUND & AIMS: :A neutralizing antibody (NTAb) survey on UNA and Mayaro viruses in black howler monkeys (Aloutta caraya) from subtropical regions of Argentina and Paraguay was carried out. Risk factors for infection in monkeys were analyzed. No positive sera for Mayaro virus were detected. A prevalence of 73% (61/84) of NTAb against UNAV was detected with titers ranging from 20 to 1280. According to the statistical analysis performed, the monkey's age was a significant risk factor, but not the origin or sex. This is the first report of Alouatta caraya infection by UNAV and the first record of its activity in Paraguay.

背景与目标： : 对来自阿根廷和巴拉圭亚热带地区的黑吼猴 (Aloutta caraya) 的UNA和Mayaro病毒进行了中和抗体 (NTAb) 调查。分析了猴子感染的危险因素。未检测到Mayaro病毒阳性血清。检测到针对UNAV的NTAb的73% (61/84) 患病率，滴度为20至1280。根据进行的统计分析，猴子的年龄是一个重要的危险因素，但不是起源或性别。这是UNAV感染Alouatta caraya的首次报告，也是其在巴拉圭活动的首次记录。

BACKGROUND & AIMS: OBJECTIVE:To identify maternal factors associated with the rise in the cesarean delivery rate in Paraguay. METHODS:Retrospective analysis of the 1995 and the 2008 National Survey on Demographic and Sexual and Reproductive Health data using multivariable logistic regression. RESULTS:In 2008, 1094 (37.3%) deliveries were cesarean compared with 781 (19.3%) in 1995. Home births had decreased by 72.9%, accounting for 33.3% of the change in the proportion of cesarean deliveries. Private facilities were associated with an increased odds ratio of cesarean delivery of 2.60 (95% confidence interval [CI], 2.02-3.34) and 4.89 (95% CI, 3.67-6.51) in 1995 and 2008, respectively, and accounted for 32.8% of the increase in cesarean deliveries between 1995 and 2008. Cesarean delivery was also associated with a prior cesarean, insurance status, and maternal higher educational and economic status. CONCLUSION:Between 1995 and 2008 the cesarean delivery rate in Paraguay almost doubled. More than one-third of deliveries were cesarean. Shifts toward facility- (particularly private) based deliveries and repeat cesarean for women with a previous cesarean influenced this increase. Practice guidelines, regulation, and oversight of facilities, along with education and information for pregnant women, are needed to curb unnecessary and potentially harmful surgical delivery interventions.

背景与目标：

BACKGROUND & AIMS: BACKGROUND:Dengue is the most important mosquito-borne viral disease worldwide. Dengue virus comprises four antigenically related viruses named dengue virus type 1 to 4 (DENV1-4). DENV-3 was re-introduced into the Americas in 1994 causing outbreaks in Nicaragua and Panama. DENV-3 was introduced in Brazil in 2000 and then spread to most of the Brazilian States, reaching the neighboring country, Paraguay in 2002. In this study, we have analyzed the phylogenetic relationship of DENV-3 isolated in Brazil and Paraguay with viruses isolated worldwide. We have also analyzed the evolutionary divergence dynamics of DENV-3 viruses. RESULTS:The entire open reading frame (ORF) of thirteen DENV-3 isolated in Brazil (n = 9) and Paraguay (n = 4) were sequenced for phylogenetic analysis. DENV-3 grouped into three main genotypes (I, II and III). Several internal clades were found within each genotype that we called lineage and sub-lineage. Viruses included in this study belong to genotype III and grouped together with viruses isolated in the Americas within the lineage III. The Brazilian viruses were further segregated into two different sub-lineage, A and B, and the Paraguayan into the sub-lineage B. All three genotypes showed internal grouping. The nucleotide divergence was in average 6.7% for genotypes, 2.7% for lineages and 1.5% for sub-lineages. Phylogenetic trees constructed with any of the protein gene sequences showed the same segregation of the DENV-3 in three genotypes. CONCLUSION:Our results showed that two groups of DENV-3 genotypes III circulated in Brazil during 2002-2009, suggesting different events of introduction of the virus through different regions of the country. In Paraguay, only one group DENV-3 genotype III is circulating that is very closely related to the Brazilian viruses of sub-lineage B. Different degree of grouping can be observed for DENV-3 and each group showed a characteristic evolutionary divergence. Finally, we have observed that any protein gene sequence can be used to identify the virus genotype.

背景与目标：

BACKGROUND & AIMS: OBJECTIVE:Report preliminary results of the application of the BONIS system in community tele-epidemiological surveillance in Paraguay. METHODS:A study of viability and implementation carried out in the Family Health Unit located in Bañado Sur in the city of Asunción by the Paraguay River. The system automatically records personal data and symptoms of individuals who make telephone reports, and suspected cases of dengue are classified and prioritized. This information goes to community agents for follow-up and to specialists in charge of epidemiological surveillance. RESULTS:From April 2010 to August 2011, 1 028 calls to the system were logged. Of 157 reported cases of fever, home visits were made to 140 (89.2%); of these, fever and headache or body ache were confirmed in 52 (37.1%) cases, and headache or body ache without fever in 58 (41.4%) cases. Community agents referred 49 (35.0%) of them for medical consultation and blood tests, and they took blood samples in the homes of 19; of these, 56 (82.3%) were positive for dengue and 12 (17.4%) for influenza. CONCLUSIONS:Paraguay has a low-cost community tele-epidemiological surveillance system based on information and communication technologies and open-source software, which is scalable to other health symptoms and disorders of interest. To enable its acceptance and application, education programs should be developed to strengthen the management and promotion of community health.

背景与目标：

BACKGROUND & AIMS: :HIV subtypes B, F, and BF recombinants have been previously reported in South America. This report describes the presence of HIV-1 subtype C infection in the countries of Argentina, Uruguay, and Paraguay dating back to at least 1999. Surveillance for uncommon non-B/non-F subtype viruses circulating in South America has been conducted in samples obtained from nine countries. Peripheral blood mononuclear cells (PBMC), dried filter paper (FP), and fresh blood (FB) samples were collected from HIV-positive patients from Ecuador, Colombia, Venezuela, Peru, Chile, Bolivia, Argentina, Uruguay, and Paraguay. From a total of 2962 HIV seropositive samples examined during a 9-year period (1995-2003), only 11 (0.4%) were found to be infected with non-B/non-F HIV variants. Eight of these 11 strains were determined to be subtype C by heteroduplex mobility assay (HMA). Five of these 8 strains were further characterized by sequencing and phylogenetic analysis of the protease (Pro) and reverse transcriptase (RT) region of the genome and two were sequenced full length. One of the strains was found to be a unique BC recombinant. The spread of a third subtype of HIV, subtype C, should raise the question of its potential future role in the HIV epidemic in this region.

背景与目标： : HIV亚型B，F和BF重组体以前在南美已有报道。该报告描述了至少可追溯到1999年的阿根廷，乌拉圭和巴拉圭国家中存在的HIV-1亚型C感染。在从9个国家/地区获得的样本中，对在南美流行的罕见非B/非F亚型病毒进行了监测。从厄瓜多尔，哥伦比亚，委内瑞拉，秘鲁，智利，玻利维亚，阿根廷，乌拉圭和巴拉圭的HIV阳性患者中收集了外周血单核细胞 (PBMC)，干滤纸 (FP) 和新鲜血液 (FB) 样本。在9年 (1995-2003年) 期间检查的总共2962个HIV血清阳性样本中，发现只有11个 (0.4% 个) 感染了非B/非F HIV变体。通过异源双链迁移率测定 (HMA) 确定了这11个菌株中的8个为C亚型。通过对基因组的蛋白酶 (Pro) 和逆转录酶 (RT) 区域进行测序和系统发育分析，进一步表征了这8个菌株中的5个，并对2个进行了全长测序。发现其中一种菌株是独特的BC重组体。艾滋病毒的第三种亚型C亚型的传播应引起其在该地区艾滋病毒流行中的潜在未来作用的问题。

BACKGROUND & AIMS: :Rineloricaria is the most species-rich genus of the Loricariinae (armored catfish) with 65 valid species. However, the karyotype structure is known only for eight species in this group. This study provides cytogenetic data for Rineloricaria lanceolata collected from the upper Paraguay basin (Mato Grosso do Sul). The specimens revealed extensive chromosomal polymorphism constituting 10 karyotypes, which differed in the diploid number (48 to 45 chromosomes) and fundamental number (FN) between 52 and 55. Three types of chromosome variants were observed: a medium-sized submetacentric, a large submetacentric, and a small acrocentric form. Internal telomere sequences were demonstrated by a telomeric (TTAGGG)n probe in submetacentric chromosome variants, suggesting Robertsonian and tandem fusions. Considering the karyotype 2n=48 (4m+2st+42a, FN=54) as the starting point for this polymorphism, these rearrangements contributed to the reduction in diploid number (48-45). Furthermore, a remarkable polymorphism of 18S rDNA resulted in three nucleolus organizer region phenotypes (I, II, and III) with variable frequencies. Interestingly, this polymorphism has remained in the population through interbreeding between specimens, resulting in different viable combinations. The data obtained confirm that diversification/karyotype evolution in Rineloricaria was marked by numerous chromosomal rearrangements which appear to be well tolerated in the panmitic population.

背景与目标： : Rineloricaria是Loricariinae (装甲cat鱼) 中物种最丰富的属，有65个有效物种。但是，核型结构仅针对该组中的八个物种。这项研究提供了从上巴拉圭盆地 (南马托格罗索州) 收集的lanceolata Rineloricaria lanceolata的细胞遗传学数据。标本显示出广泛的染色体多态性，构成10个核型，其二倍体数 (48至45条染色体) 和基本数 (FN) 在52至55之间有所不同。观察到三种类型的染色体变体: 中等大小的亚中心，大的亚中心和小的亚中心形式。内部端粒序列被亚中心染色体变体中的端粒 (TTAGGG)n探针证实，表明罗伯逊和串联融合。考虑到核型2n = 48 (4m 2st 42a，FN = 54) 作为这种多态性的起点，这些重排有助于二倍体数量的减少 (48-45)。此外，18S rDNA的显著多态性导致了三个具有可变频率的核仁组织区表型 (I，II和III)。有趣的是，这种多态性通过标本之间的杂交而保留在种群中，产生不同的可行组合。获得的数据证实，Rineloricaria的多样化/核型进化以许多染色体重排为标志，这些染色体重排在panmitic种群中似乎具有良好的耐受性。