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Background The Dermatology Life Quality Index (DLQI) is a valuable tool for assessing the quality of life in adult patients with psoriasis. Aims To analyse the reliability and validity of the DLQI to measure the quality of life in patients with mild to moderate-severe psoriasis. Methods This was a secondary validation study nested in a follow-up study. The Rasch-Andrich model was utilised to perform response function, item and person fit, differential item functioning, dimensionality, and reliability analyses. Results A total of 1439 patients were analysed, 52.1% male, mean age of 48.7 years (SD 16.1). Psoriasis vulgaris was the phenotype in 43.1% of patients, and 86% had a mild Psoriasis Area Severity Index (PASI). Adequate adjustment of the response function and the items was observed in the best-fit sample, except for item 7 (work and study). The measure explained 60.9% of the variance and presented a reliability of 0.86. Differential item functioning was identified by age, with a relevant bias in the estimation for older adults. Item-person maps are provided. Limitations This study was performed at a single centre, with most patients presenting a mild PASI score, limiting generalisation of the findings. Conclusion The validity evidence favours the use of the DLQI in moderate-severe psoriasis. However, the instrument biases the estimate of older adults. This population group should consider a specific version of the instrument.

Background: Malaria is a public health concern in the Amazonian Region, where Anopheles darlingi is the main vector of Plasmodium spp. Several studies hypothesised the existence of cryptic species in An. darlingi, considering variations in behaviour, morphological and genetic aspects. Determining their overall genetic background for vector competence, insecticide resistance, and other elements is essential to better guide strategies for malaria control., Objectives: This study aimed to evaluate the molecular diversity in genes related to behaviour and insecticide resistance, estimating genetic differentiation in An. darlingi populations from Amazonian localities in Brazil and Pacific Colombian region., Methods: We amplified, cloned and sequenced fragments of genes related to behaviour: timeless (tim) and period (per), and to insecticide resistance: voltage-gated sodium channel (Na V ) and acetylcholinesterase (ace-1) from 516 An. darlingi DNA samples from Manaus, Unini River, Jaú River and Porto Velho - Brazil, and Chocó - Colombia. We discriminated single nucleotide polymorphisms (SNPs), determined haplotypes and evaluate the phylogenetic relationship among the populations., Findings: The genes per, tim and ace-1 were more polymorphic than Na V . The classical kdr and ace-1 R mutations were not observed. Phylogenetic analyses suggested a significant differentiation between An. darlingi populations from Brazil and Colombia, except for the Na V gene. There was a geographic differentiation within Brazilian populations considering per and ace-1., Conclusions: Our results add genetic data to the discussion about polymorphisms at population levels in An. darlingi. The search for insecticide resistance-related mechanisms should be extended to more populations, especially from localities with a vector control failure scenario.

Background: Triatomine bugs are responsible for the vectorial transmission of the parasite Trypanosoma cruzi, etiological agent of Chagas disease, a zoonosis affecting 10 million people and with 25 million at risk of infection. Several triatomine species of the genus Rhodnius have been found inhabiting palm crowns where insects can find shelter in leaves axils and blood from palm-associated vertebrates. Rhodnius prolixus insects have been collected in oil palms in Colombia, and high T. cruzi infection rates were found. Since pest control is carried out in oil palm plantations, continuous exposure to insecticides could be occurring in these triatomines. Some insecticides suggested for pest control in oil palm plantations are also recommended for triatomine control in human dwellings. In this study, our objective was to assess if triatomines inhabiting oil palms exhibit resistance to deltamethrin, an insecticide used for vector control., Methods: Rhodnius prolixus nymphs were sampled in oil palms located in Tauramena, Colombia. To determine deltamethrin resistance, biological and biochemical assays were carried out on fifth-instar nymphs from the F1 generation. For biological assays, pure and commercial deltamethrin were used, and in biochemical assays, activities of detoxifying enzymes related to pyrethroid resistance, such as oxidases, esterases and transferases, were quantified., Results: Deltamethrin lethal dosage 50 and 90 in R. prolixus from oil palms was significantly higher than in those from a susceptible colony suggesting possible deltamethrin resistance. Moreover, mortality with commercial deltamethrin was very low in insects from oil palms. In biochemical assays, the activity of evaluated detoxifying enzymes was significantly higher in R. prolixus from oil palms than in those from the susceptible colony., Conclusions: Possible deltamethrin resistance found in R. prolixus insects from oil palms could threaten traditional vector control strategies in urban settings if insecticide-resistant triatomines can migrate from oil palms plantations. In palm oil producer countries such as Colombia, the oil palm plantations are growing constantly during the last years. We suggest that pest control strategies in oil palm crops should include triatomine surveillance and toxicological monitoring, especially in zones with several Chagas disease cases.

In the wake of the Zika epidemic, there has been intensified interest in the surveillance and control of the arbovirus vectors Aedes aegypti and Aedes albopictus , yet many existing surveillance systems could benefit from improvements. Vector control programs are often directed by national governments, but are carried out at the local level, resulting in the discounting of spatial heterogeneities in ecology and epidemiology. Furthermore, entomological and epidemiological data are often collected by separate governmental entities, which can slow vector control responses to outbreaks. Colombia has adopted several approaches to address these issues. First, a web-based, georeferenced Aedes surveillance system called SIVIEN AEDES was developed to allow field entomologists to record vector abundance and insecticide resistance data. Second, autocidal gravid oviposition (AGO) traps are deployed as an alternative way to measure vector abundance. Third, data collected by SIVIEN AEDES are used to develop mathematical models predicting Ae. aegypti abundance down to a city block, thus allowing public health authorities to target interventions to specific neighborhoods within cities. Finally, insecticide resistance is monitored through bioassays and molecular testing in 15 high-priority cities, providing a comprehensive basis to inform decisions about insecticide use in different regions. The next step will be to synchronize SIVIEN AEDES data together with epidemiological and climatic data to improve the understanding of the drivers of local variations in arbovirus transmission dynamics. By integrating these surveillance data, health authorities will be better equipped to develop tailored and timely solutions to control and prevent Aedes -borne arbovirus outbreaks., Competing Interests: Conflicts of interests. None declared.

Introduction: Physiological resistance of Aedes aegypti is a major threat to effective control programs in the transmission of dengue virus., Objective: To determine the status of susceptibility to insecticides used in public health, in natural populations of A. aegypti from three endemic dengue localities of Casanare., Materials and Methods: Adult mosquitoes were recovered from A. aegypti immature stages from seven natural populations collected for three municipalities. The first filial generation was used to assess the biochemical mechanisms associated with loss of susceptibility: nonspecific esterase (NSE) and enzyme cytochrome P450 monooxygenases group. The second filial generation allowed us to evaluate the susceptibility to insecticides from bioassays using the CDC 1998 methodology for adult mosquitoes and WHO 1981 technique for larvae., Results: IN the seven adult populations recorded loss of susceptibility to organochlorine DDT and pyrethroids lambda-cyhalothrin and permethrin. Two populations showed susceptibility to deltamethrin and five populations showed susceptibility to cyfluthrin. There was a susceptibility to organophosphates temephos, malathion and fenitrothion in all populations. No population showed increased NSE but an increase of P450 in two populations, Conclusions: It appears that the P450 may play an important role in resistance to pyrethroids and DDT, still other resistance mechanisms may be acting in populations. Susceptibility to organophosphate allows continued use of this chemical group to interrupt transmission of dengue in Casanare.

Introduction: Physiological resistance of natural population of Aedes aegypti to insecticides contribute to the decreased efficacy of chemical control as a main control strategy during dengue outbreaks., Objective: The susceptibility status of Ae. aegypti was assessed for the carbamate propoxur, the adulticide malathion and the larvicide temephos on 13 natural populations of Ae. aegypti immature forms were taken from 8 Colombian localities. These included the following: Bucaramanga (1), Sabana de Torres (2), Girardot (2), La Mesa (2), Villavicencio (2), Puerto López (2), San José del Guaviare (1) and Florencia (1)., Materials and Methods: Susceptibility tests mainly consisted of the standardized bioassay outlined by WHO (1981) and CDC bottles (1998). Colorimetric tests were undertaken to determine enzyme levels possibly responsible for the reduction of susceptibility to organophosphate and carbamate insecticides., Results: All specimens demonstrated susceptibility to malathion and propoxur insecticides. Four of the 13 populations revealed susceptibility to the temephos larvicide. Seven of 11 populations showed a limited increase in values for nonspecific esterase enzymes. The Bucaramanga population was the only one which showed an increase in the cytochrome P450 monooxygenases enzymes. Neither population was found with modified acetilcolinesterase., Conclusions: The widespread susceptibility to organophosphates used as adulticides indicated that malathion, the most used insecticide in Colombia, remains effective in interrupting the transmission of dengue. Physiological resistance to insecticides occurring in communities of a single township proved to be a localized phenomenon.

Introduction: Physiological resistance to insecticides used in public health is the main factor to define strategies for malaria vector control., Objective: To determine the physiological status of insecticide susceptibility of natural populations of An. darlingi from two localities in the Santander and Caquetá departments., Materials and Methods: Wild adult Anopheles darlingi females were collected and bioassays using technical grade insecticides were performed following the methods recommended both by the World Health Organization (WHO, 1981) and the Centers for Diseases Control and Prevention (CDC, 1998)., Results: The natural populations of An. darlingi from the villages of Gerumano, Solano, Caqueta and Las Margaritas, San Vicente de Chucurí, Santander, showed susceptibility to the pyrethroids lambdacyhalothrin and deltamethrin, to the organochlorate DDT and to the organophosphate fenitrothion with 100% mortality rates in all of the CDC tests and between 95 and 100% in the tests performed following the WHO methods. For the carbamate propoxur the 88% mortality rate obtained in the village of Gerumano following the methods recommended by WHO coincides with the surveillance methods established for surveillance of this molecule., Conclusions: Chemical products whose active ingredients are the molecules tested are effective for control of An. darlingi in the study sites.

The observation of an increasing number of methicillin-resistant Staphylococcus aureus (MRSA) isolates in some population groups prompted us to study the risk factors and the epidemiological profile of S. aureus nasal carriage in healthy adults 65 years of age and older residing in the province of Segovia. Attention was particularly focused on the possibility that some of the infections were community-acquired. We conducted a prospective and observational study of people who usually visited senior citizen centers in the province of Segovia (Carbonero, Cuéllar, Cantalejo) and its capital. The analysis period took place between January and May 2003. Infections were classified as community-acquired, hospital-acquired or health-care associated. Isolates of methicillin-resistant (MRSA) and methicillin-susceptible S. aureus (MSSA) were studied by pulsed-field gel electrophoresis (PFGE). There were 34 (19.5%) The prevalence of nasal carriage of S. aureus was 19.5% and that for MRSA was 1.1%. Female sex was significantly associated with the carriage state. All S. aureus isolates were mupirocin-susceptible. 100% susceptibility and specificity was obtained through latex agglutination testing. The molecular study showed that the transmission for MRSA was monoclonal and that for MSSA was more policlonal. The results presented here form the basis for similar studies in other Spanish senior citizen centers and provide evidence that MRSA strains are beginning to circulate and are becoming significantly established within the community, thus highlighting the need for implementing control strategies to prevent dissemination.