Angel A Escobedo

• MD, MSc
• Medical Parasitologist at National Institute of Gastroenterology

BACKGROUND: Intestinal parasitic infections are one of the most prevalent and persistent infections among childhood worldwide. These infections may have important health consequences, but morbidity – especially for school-aged children – is often underestimated. In this study we determined the prevalence of intestinal parasitic infections in school...

Giardiasis is one of the commonest intestinal parasitic infections in Cuba. In order to determine care-seeking behaviour and diagnostic processes in paediatric in-patients with giardiasis, structured questionnaires were administered by interview mothers of children with giardiasis during January to December 2010. During the study period, 97 childre...

Advances in our understanding of chronic giardiasis (CG) may improve our care of patients in this stage of the disease. This review proposes a new concept of CG and highlights the recent advances in our understanding and management of this condition. According to this review, management requires, initially, an accurate diagnosis, which may exclude...

Climate change and variability are common phenomena affecting various infectious diseases. Many studies have been performed on vector-borne diseases; however, few studies have addressed such influences on intestinal parasitic diseases (e.g., giardiasis). In this study, using nonlinear Poisson regression models, we assessed the potential association...

Giardiasis is one of the most common causes of diarrheal disease worldwide and 5-nitroimidazoles (5-NI) are the most commonly prescribed drugs for the treatment of giardiasis. We evaluated the efficacy of 5-nitroimidazoles (5-NI) in the treatment of giardiasis in a systematic review of randomized controlled trials (RCTs). We conducted a comprehensi...

Human migration is a dynamic, multifaceted and complex phenomenon shaped by economic, political, social, climatic and environmental factors [1], [2], [3], [4]. Migration refers to the relocation of individuals from their habitual residence to a new location, while travel involves journeying between destinations for various purposes [5]. In recent y...

On 14 August 2024, the World Health Organization declared for a second time mpox as a Public Health Emergency of International Concern (PHEIC) (https://www.who.int/news/item/14-08-2024-who-director-general-declares-mpox-outbreak-a-public-health-emergency-of-international-concern). This is a zoonotic disease, endemic to central and western Africa, b...

La infección con el coronavirus del síndrome respiratorio agudo grave de tipo 2 (SARS-CoV-2), el agente causal de la enfermedad por coronavirus 2019 (COVID-19) tiene implicación mundial y las islas del Caribe no son la excepción. En esta área geográfica, se pre- sentan una serie de desafíos relacionados con su control; entre ellos, los sistemas de...

Background: We systematically assessed beneficial and harmful effects of monoclonal antibodies for COVID-19 treatment, and prophylaxis in exposed to SARS-CoV-2. Methods: We searched five engines and three registries until November 3, 2021 for randomized controlled trials evaluating monoclonal antibodies vs. control in hospitalized or non-hospita...

Still without ceasing the Coronavirus Disease 2019 (COVID-19) pandemic, a new viral threat has now emerged outside its endemic niche in Africa affecting multiple countries and continents. After its appearance in May 2022, a multi-country outbreak of monkeypox disease (MPX) has triggered significant concerns due to its rapid spread and potential for...

Introduction We systematically assessed benefits and harms of tocilizumab (TCZ), which is an antibody blocking IL-6 receptors, in hospitalized COVID-19 patients. Methods Five electronic databases and two preprint webpages were searched until March 4, 2021. Randomized controlled trials (RCTs) and inverse probability treatment weighting (IPTW) cohor...

Introduction In 1993, Cuba achieved leprosy elimination according to the World Health Organization’s (WHO) indicator of less than one case per 10,000 population. Despite this achievement, detection of new cases occurs every year among all age groups including children. Detection of new cases in children reveals persistent transmission of the infect...

Un metaanálisis comparó los resultados de otros seis ECA en los que examinaron 10 722 pacientes, los cuales demostraron que el tratamiento con plasma de convaleciente versus placebo o el tratamiento estándar, no se asoció significativamente con una disminución de la mortalidad por todas las causas, ni con ningún beneficio para otros resultados clín...

Editorial. Cuba is a collaborative partner and an international actor that has shown solidarity to facilitate the global response (principally, and not only) through extending support to others with sharing expertise. The decision to both train and offer health professionals to other countries is consistent with the Cuban political philosophy that...

Emerging diseases have significantly marked the last few decades (1-10). The emergence and re-emergence of vector-borne and zoonotic diseases in Africa, Asia, and Latin America which have reshaped these continents' the epidemiological landscape of these continents. The impact of these diseases, the establishment of local transmission in traditional...

Helicobacter pylori infection affects more than half of the world population and it occurs generally in childhood. It is associated with gastroduodenal ulcer, gastric atrophy, intestinal metaplasia, gastric adenocarcinoma and lymphoid tissue-associated lymphoma. It is difficult to eradicate this bacterium due to its high antimicrobial resistance. I...

Gastro-oesophageal reflux disease, eosinophilic oesophagitis and oesophageal motility disorders are among the most common diseases accompanying oesophageal eosinophilia. They have similarities and their limits are frequently not well defined. This article reviews the main characteristics relating to their similarities and differences, highlighting...

Antony van Leeuwenhoek, the Dutch tradesman who first identified Giardia in 1681, has become a legend in Para-sitology. Last November 4 th marked the 338 th anniversary of the submission of his letter, addressed to Sir Robert Hook, the then Secretary of the Royal Society of London, in which he described his observations in his own faecal sample: "[...

Five-nitroimidazole (5-NI) compounds are among the most commonly used medications in the treatment of giardiasis. However, after more than five decades of their initial indication for such treatment, there are some concerns about the efficacy of 5-NIs in giardiasis. This study sought to compare the efficacy of any 5-NI with any other antigiardial d...

Giardia lamblia, the aetiological agent of human giardiasis, is a frequently identified protozoan infection of the upper small intestine. It mainly affects children and has a wide range of clinical manifestations, from asymptomatic carriage to acute or chronic diarrhoea with dehydration, abdominal pain, nausea, vomiting, excessive flatulence and we...

Mebendazole (MBZ), a benzimidazole compound, has received attention in treating patients with giardiasis because it has shown beneficial effects both in vitro and in vivo. The aim of this study was to assess with a systematic review and meta-analysis of randomized controlled trials (RCTs) the efficacy of MBZ compared to other antigiardial agents in...

Although Giardia , the aetiological agent of giardiasis, is one of the most prevalent intestinal parasitic infections world-wide, for industrialised countries, it is mainly appreciated as an imported disease with the minimal local transmission. However, the current evidence challenges this perception; Giardia has relevance beyond the high prevalenc...

We read with great interest the article by Beer et al [1]. They characterized giardiasis diagnosis and treatment in the United States, pointing out differences between pediatric and adult care and diagnosis processes and also considering their impact on public health responses for control.

We present four cases in which probable sexual transmission of Giardia lamblia was suspected. Diagnosing this mode of transmission in endemic areas is often difficult and should be considered only as possible, because exposure to poor sanitation and a potentially contaminated environment are always latent. However, as patients reported, there was n...

There are no meta-analyses specifically describing the prevalence of zoonotic and non-zoonotic genotypes of Giardia intestinalis in cats, which would be useful in defining the importance of cats as a source of zoonotic transmission. We performed a systematic review of the literature in three databases (PubMed, Scopus and SciELO) to assess the propo...

Resumen El trastorno disfórico premenstrual es un trastorno mental aparentemente poco frecuente y en no pocas ocasiones se vuelve discapacitante para quien lo presenta. En estos casos, la terapia farmacológica con antidepresivos inhibidores de la recaptación de serotonina es casi imprescindible para la remisión de este trastorno. En algunos casos l...

Practising evidence based medicine is recognised as essential to ensure that patients receive the best possible treatment. For health professionals to be able to practice evidence based medicine, they need to be able to access scientific information. Unfortunately, many important scientific articles are not freely available. Scientific articles are...

Introduction: Cryptosporidium is a major cause of diarrheal disease in humans and animals. It became clinically first known as a causative agent of profuse and persistent diarrhea and morbidity in immunocompromised patients, particularly those with acquired immunodeficiency syndrome, and as a major cause of waterborne diarrheal disease in outbreaks...

Introduction: Giardia lamblia was defined as a flagellated protozoan. It ́s the most common cause of intestinal parasitic infection in children living in resource- limited settings. The pathogenicity of Giardia has been debated since the parasite was first identified, and clinical outcomes vary across studies. In many times it was defined as a soci...

La depresión es un trastorno mental relativamente frecuente y no en pocas ocasiones se vuelve discapacitante para quien la padece; en estos casos, la terapia farmacológica con antidepresivos es imprescindible para la remisión de esta. En algunos casos, la potenciación con fármacos no antidepresivos propiamente dichos puede ser una alternativa con m...

Giardiasis is one of the most common causes of diarrhoeal disease worldwide. Giardia lamblia, its etiological agent, is a protozoan parasite that infects the small intestine of humans and may be asymptomatic or cause acute or chronic diarrhoea, weight loss, malabsorption, and, in children, failure to thrive. Treatment is primarily with 5-nitroimida...

Treatment failures in patients suffering from giardiasis are not uncommon feature. The most frequent approach in these cases is to treat these patients with longer repeated courses and/or higher doses of the primary therapy, or using drugs from a different class to avoid potential cross-resistance. However, a higher rate of adverse events may limit...

Cuba has excellent health care. Child mortality rates lower than that in the United States of America. Despite having excellent health care, the number of Cuban scientifi c publications is low. In 2015, there were only 559 scientifi c articles published in peer-reviewed journals by Cuban health professionals and scientists. In order to increase th...

Although most individuals with Giardia infection are asymptomatic, this is increasingly recognized as cause of pathologies beyond classic manifestations.1 Morbidities associated with Giardia, including extra-intestinal manifestations and long term consequences, have been steadily identified over the past decades.2-4 The importance that this pathoge...

Background: Giardiasis is one of the most common intestinal infections in the world. There have been no national studies on the morbidity of giardiasis in Colombia. In this study, incidence rates of giardiasis were estimated for the years 2009–2013. Methods: An observational, retrospective study of the giardiasis incidence in Colombia, 2009–2013, w...

Objectives: Multifactorial interventions are crucial to arrest the threat posed by infectious diseases. Public involvement requires adequate information, but determinants such as health literacy can impact on the effective use of such knowledge. The influence of health literacy on infectious diseases is examined in this paper. Methods: Databases we...

Giardiasis La giardiasis es una de las enfermedades parasitarias más frecuentes del tracto gastrointestinal humano. Su agente causal es Giardia lamblia (Giardia duodenalis o Giardia intestinalis), que tiene flagelos y parasita el duodeno y el yeyuno. Es cosmopolita. Se transmite por la ingestión de quistes que llegan al hospedero susceptible por ví...

How to write a scientific paper

With all of the cultural and ethnic information that could affect patient and family care, POCKET GUIDE TO CULTURAL HEALTH ASSESSMENT, 4th Edition is the perfect portable yet complete reference. This guide discusses the clinical implications of ethnic populations from over 170 countries with a wealth of information on each-from languages spoken to...

Las hepatitis víricas son enfermedades infecciosas del hígado que se caracterizan por necrosis hepato-celular e inflamación. Existe una amplia variedad de virus que pueden causar hepatitis, los primariamente hepatotropos, conocidos así porque infectan funda-mentalmente al hígado por su marcada afinidad o tro-pismo por este órgano (virus de las hepa...

INTRODUCCIÓN Ancylostoma duodenale y Necator americanus son dos parásitos presentes en mu-chas partes del mundo, fundamentalmente en países en desarrollo, donde representan un problema para la salud pública. Se trata de dos nematodos que tienen varias diferencias en cuanto a la gravedad de la infección que ocasionan y la respuesta al tratamiento, p...

INTRODUCCIÓN La tenia de los peces, o la tenia ancha, como también se conoce a este parásito, es el gusano plano de mayor longitud entre los que afectan al hombre. Es un parásito hermafrodi-ta, común en personas que viven en los países bálticos, áreas de Escandinavia, Rusia y Finlandia, también en zonas de Alaska y Canadá. Agente etiológico 1. Rein...

The occurrence of treatment failures to first-line treatment for giardiasis, one of the most widespread although neglected parasitic disease, has long been recognised. Nowadays, it starts to represent a great challenge to clinicians, especially in endemic countries. This requires the introduction of new drug interventions, but the development of no...

Introduction: Despite years of relative neglect, interest in Giardia infection seems to be recently growing, perhaps in part due to its inclusion into the World Health Organization’s Neglected Diseases Initiative since 2004. The purpose of this study was to provide an overview of Giardia and giardiasis research over time, as represented by the quan...

It has been suggested that the clinical features of giardiasis might vary in patients of different age groups. Objective: To compare clinical presentation of giardiasis in children less than 5 years of age and older children. Methods: A retrospective study of patients hospitalized with giardiasis during 2007 was performed. The clinical features of...

Introducción: La giardiosis es una enfermedad frecuente a escala internacional. Se ha sugerido por algunos autores que su presentación clínica puede variar con la edad. Objetivo: Comparar las manifestaciones clínicas de la giardiosis en los niños hospitalizados bajo 5 años de edad con las de niños de 5 años o más. Métodos: Estudio retrospectivo rea...

. Giardia lamblia is an important cause of diarrhoeal disease throughout the world. Giardiasis— a mild and self-limiting disease that this protozoan causes— is perceived as a harmful disease. Aim. To explore the general level of awareness about giardiasis, clinical features, mode of transmission, prevention, and consequences and describe the source...

Keynote sessions and Symposia: Update in the treatment of intestinal parasitic diseases A.A. Escobedo *. Department of Gastroenterology, Parasitology and Nutrition, Academic Paediatric Hospital, Havana City, Cuba E-mail address : escobedo@infomed.sld.cu Intestinal parasitic infections (IPIs) are a worldwide problem in both industrialised and unind...

Introduction: Celiac disease (EC) not diagnosed or treated affect histological, immunological and nutritional status of patients who suffer it. These changes allow infection by parasites that cause no symptoms in immunocompetent patients, such as Blastocystis hominis (Bh). OBJETIVE. To analyze the presence of Bh in symptomatic celiac patients and...

The medical records of the 185 children who, in 2007, were admitted to the Academic Paediatric Hospital 'Centro Habana', in the Cuban capital of Havana, because of giardiasis were analysed retrospectively. A standardized form was used to collect data on the socio-demographic characteristics, clinical features, laboratory diagnosis, treatment and le...

The risk factors associated with Giardia infection, in children hospitalized in Havana, Cuba, were recently explored. Children aged ≥5 years were more likely to be positive for Giardia infection than the younger children, with an odds ratio (OR) of 3·41 [95% confidence interval (CI) = 1·36-9·69]. The risk factors found to be associated with Giardia...

To compare the efficacy and safety of mebendazole and secnidazole in the treatment of giardiasis in adult patients, a single-centre, parallel group, open-label, randomized non-inferiority trial was carried out. One-hundred and 26 participants who had symptomatic Giardia mono-infection took part in the study. Direct wet mount and/or Ritchie concentr...

Giardia duodenalis is among the commonest protozoan parasites in the intestinal tract of humans and may cause significant morbidity worldwide. Although there are several antigiardial agents, treatment failures have been commonly reported. To compare the efficacy and safety of chloroquine (CQ) versus metronidazole (MTZ) in the treatment of children...

Although giardiasis has been a threat to mankind for thousands of years, this protozoan infection was, until recently, relatively neglected. Giardia duodenalis is recognised as a major cause of parasite-induced diarrhoea in humans and animals, and is currently an important public health problem, placing a heavy burden on both diagnostic and treatme...

Although giardiasis is considered by most medical practitioners to be an easily treated infection, prolonged symptoms due to, or following, Giardia duodenalis infection can have a significant impact on quality of life. Symptom recurrence, including abdominal symptoms and fatigue, can result from re-infection, treatment failure, disturbances in the...

Intestinal protozoan infections are a worldwide problem in both industrialised and unindustrialised countries; in the latter they may be the cause of significant morbidity and mortality. Children, in particular, are more likely to experience considerable morbidity. Most intestinal protozoan infections can cause acute or chronic diarrhoea in healthy...

Mebendazole, a benzimidazole carbamate compound, is currently in use for human medical practice against soil-transmitted helminthiasis (STH) and enterobiasis. However, it has been demonstrated that its spectrum of activity is broad and goes beyond those infections. Several studies provide evidence that this drug, taken at higher doses than used for...

A cross-sectional study was carried out in 200 children aged 5-15 years, to examine the presence of intestinal parasitic infections (IPIs) and to assess the risk factors and clinical features associated with them in children in San Juan y Martinez (SIM), Cuba. Three fresh faecal samples were collected from each child and were examined by direct wet...

Giardia lamblia is among the commonest intestinal protozoa world-wide and may cause significant morbidity, especially in children. Although 5-nitroimidazole compounds have formed the mainstay of giardiasis treatment for several years, the increasing number of reports of refractory cases given these and other antigiardial agents has raised concern a...

To examine the relationship of past and current intestinal helminth infections with asthma, allergic rhinoconjunctivitis, atopic dermatitis and atopy. Cross-sectional study of 1320 children aged 4-14 years from two Cuban municipalities. Helminth infections were determined by stool examination and parental questionnaire. Asthma, rhinoconjunctivitis...

Share With all of the cultural and ethnic information that could affect patient and family care, "Pocket Guide to Cultural Health Assessment, 4th Edition" is the perfect portable yet complete reference. This guide discusses the clinical implications of ethnic populations from over 170 countries with a wealth of information on each - from languages...

Las enfermedades causadas por geohelmintos, tales como Ascaris lumbricoides, ancilostomídios y Trichuris trichiura son un problema de salud pública cuya naturaleza y alcance son bien conocidos. Se sabe que la presen-cia de estos agentes en el interior del organismo condiciona trastornos en el equilibrio nutricional, crecimiento y desarrollo físico...

A cross-sectional study was carried out to determine the prevalence of intestinal parasitic infections and the intensity of soil-transmitted helminths (STHs) among children who attend the educational centres of San Juan y Martinez, Cuba. Ascaris lumbricoides, Blastocystis hominis and Giardia lamblia were the most common parasites found, with preval...

Giardia lamblia, the cause of human giardiasis, is among the most common intestinal protozoa worldwide. Human infection may range from asymptomatic shedding of giardial cysts to symptomatic giardiasis, being responsible for abdominal cramps, nausea, acute or chronic diarrhoea, with malabsorption and failure of children to thrive. At present, treatm...

Giardia duodenalis is the most commonly detected parasite in the intestinal tract of humans and 5-nitroimidazole compounds, quinacrine and furazolidone have been used against giardiasis. However, cases refractory to treatment with these drugs are becoming more common worldwide. To compare the efficacy and safety of mebendazole versus tinidazole in...

To compare the efficacy and safety of five days apostrophe therapy of mebendazole (MBZ) versus quinacrine (QC) on human giardiasis in children. A clinical trial was carried out in paediatric patients (aged 5-15 years) with confirmed symptomatic G. duodenalis mono-infection. Patients were randomly assigned to receive either MBZ [200 mg taken three t...

RESUMEN Se realizó un estudio a 456 niños con edades de 1 a 5 años, pertenecientes a 4 guarderías infantiles del municipio San Miguel del Padrón, en el mes de noviembre de 1998; para evaluar el diagnóstico de Giardia lamblia y otros protozoos intestinales, utilizando comparativamente los métodos de diagnóstico coproparasitológicos de examen directo...

A study of 456 children aged 1-5 from 4 day care centers of San Miguel del Padron municipality was conducted in 1998, to evaluate the diagnosis of Giardia lamblia and other intestinal protozoa by using comparatively the coproparasitological diagnostic methods of direct examination and Ritchie's concentration technique or formol-ether. Besides, a th...