Publications by authors named "Juan J Montenegro-Idrogo"

We report the case of two girls from a rural community in the Peruvian Amazon who were exposed to the rabies virus, with fatal outcomes in both cases. The reemergence of rabies in this endemic area after more than 11 years of successful control through massive immunization policies is highlighted in this report. In these cases, exposure occurred through contact with a domestic cat, although bat bites remain the most common source of rabies transmission in the region.

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Background: Decentralizing HIV services is an evidence-based strategy recommended by the World Health Organization to expand healthcare access by shifting most HIV care from specialty (SHCs) to primary health centers (PHCs) with the goal of maximizing health outcomes. To accelerate Peru Ministry of Health's 2020 priority to transition from specialty to primary health centers, we assessed multilevel stakeholders' perspectives on barriers and opportunities for scaling-up decentralization of HIV care.

Methods: Between January and March 2024, we used nominal group technique (NGT), a mixed-methods research strategy, to rapidly identify barriers and rank potential solutions to decentralizing HIV services among two groups of patients (N = 16) and four groups of healthcare providers (N = 49) in Lima, Peru.

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  • * The article reviews the historical spread, transmission, and various determinants (epidemiological, social, and climatic) affecting yellow fever outbreaks over time.
  • * Despite the widespread distribution of yellow fever vectors, outbreaks are largely confined to endemic areas, influenced by complex interactions between the virus, host, and vector immune responses.
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  • HIV stigma negatively impacts health outcomes like adherence to antiretroviral therapy (ART) and engagement in HIV care, especially among men who have sex with men (MSM) and transgender women (TGW) in Peru.
  • A study involving 400 MSM and TGW at specialized HIV clinics assessed various factors influencing ART adherence and care engagement.
  • Results showed that while some health factors were associated with good outcomes, stigma did not significantly affect ART adherence or care engagement when LGBTQ-affirming care was provided.
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Background: Leptospirosis is an endemic zoonosis in tropical areas that is mainly related to rural activities; nevertheless, human leptospirosis (HL) outbreaks differ among regions. In Colombia, HL notifications are mandatory. Our objective was to determine the spatiotemporal distribution of HL in Colombia during 2007-2018 and its relationship with the main hydroclimatic variables.

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Introduction: The COVID-19 pandemic has had a significant impact on mental health globally, with limited access to mental health care affecting low- and middle-income countries (LMICs) the most. In response, alternative strategies to support mental health have been necessary, with access to green spaces being a potential solution. While studies have highlighted the role of green spaces in promoting mental health during pandemic lockdowns, few studies have focused on the role of green spaces in mental health recovery after lockdowns.

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Background: Actinomycosis is an unusual chronic bacterial infection, even rarer in people living with HIV. It is not considered an AIDS-defining disease. However, the role in co-presentation or overlap with other opportunistic conditions of advanced HIV is unknown.

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Malignant syphilis is an infrequent secondary manifestation in patients with human immunodeficiency virus (HIV), with polymorphous and disseminated skin lesions being related to severe immunosuppression. Lesions have intense inflammatory circinate, ulcer-crusted and nodular skin lesions of diffuse distribution throughout the body, that can be confused with vasculitis or cutaneous lymphomas. We report a patient recently diagnosed with HIV infection in the acquired immunodeficiency syndrome stage with malignant syphilis as the debut of HIV.

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  • A significant portion of the 2022 mpox outbreak involved individuals with HIV, particularly those with low CD4 cell counts, suggesting the need to understand their clinical outcomes.
  • Data from a network of clinicians across 19 countries was analyzed, focusing on adults living with HIV and CD4 counts below 350 cells per mm to assess their presentation and complications from mpox.
  • Out of 382 cases analyzed, most individuals were men, with a median age of 35, and those with CD4 counts under 100 cells per mm experienced more severe complications, highlighting the risks associated with advanced HIV.
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Introduction: Alphaviruses may cause arthritis, but there is a lack of studies assessing it in flaviviruses such as dengue. Through the 28 Joint Disease Activity Score (DAS-28), incorporating swollen joint counts, and through the Arthritis Index from Western Ontario and McMaster Universities (WOMAC), we assessed pain, stiffness, and dimensions of arthritic function in post-DENV patients. Methods: Prospective study of a cohort of participants who were diagnosed with dengue in centres in Honduras from December 2019 to February 2020, with a follow-up period of 4 months to evaluate post-dengue rheumatological disease through the WOMAC and DAS-28 questionnaires.

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Background: Mucormycosis is a life-threatening invasive fungal infection most commonly observed in immunocompromised patients. Throughout the COVID-19 pandemic, a growing number of associated infections, now termed COVID-19 associated mucormycosis (CAM), have been reported. Despite an increase in fatality reports, no cases of rhino-orbital CAM complicated with gangrenous bone necrosis have been described in the literature to date.

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In Peru, diphtheria infection was eradicated in the last two decades. However, recently, diphtheria pharyngeal infection was confirmed and reported in a 5-year-old boy (index case). We report two more cases of this outbreak (in the index case parents) with confirmed diphtheria infection and tox gene identified by molecular assay, who were in close contact with the index case and never presented any symptoms.

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Motor neuron disease (MND) have an incidence of 2 in 100 000 persons, resulting in the death of 1 in every 500 people affected. The most common disease in MND spectrum is amyotrophic lateral sclerosis (ALS). We describe the case of an ALS-like syndrome in a HIV patient.

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We report the case of a 38 year-old man living with well-controlled HIV on antiretroviral therapy who developed cerebellar symptoms and was admitted to hospital for management of an intraventricular cryptococcoma. During his hospital stay he contracted SARS CoV-2 infection within the hospital setting with a fatal outcome.

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Article Synopsis
  • Disseminated histoplasmosis (DH) is a severe fungal infection that often affects immunocompromised HIV patients and can lead to a life-threatening condition known as haemophagocytic syndrome (HFS), which has a high mortality rate.
  • In a study of 597 HIV patients from 2014-2015, only 8 were diagnosed with DH, most of whom were not on antiretroviral therapy, and a significant number exhibited symptoms and criteria for HFS.
  • The findings highlight the importance of clinical awareness for early diagnosis and treatment, as DH-HIV co-infection can present similarly to other systemic infections and carries a 50% mortality rate.
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