Eduardo Ticona

Eduardo Ticona
Hospital Nacional Dos de Mayo · Tropical and Infectious Diseases

Doctor of Medicine

About

122
Publications
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3,293
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Publications

Publications (122)
Article
Background There are limited data on influenza vaccine effectiveness (IVE) in preventing laboratory-confirmed influenza illness among healthcare personnel (HCP). Methods HCP with direct patient contact working full-time in hospitals were followed during three influenza seasons in Israel (2016–2017 to 2018–2019) and Peru (2016 to 2018). Trivalent i...
Article
Background: Tuberculosis has been linked to an increased risk of atherosclerotic cardiovascular disease (ASCVD). We assessed whether latent tuberculosis infection (LTBI) is associated with subclinical coronary atherosclerosis in two TB-prevalent areas. Methods: We analyzed cross-sectional data from studies conducted in Lima, Peru, and Kampala, U...
Article
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Background Persons with active tuberculosis (TB) have increased immune activation, which declines with TB treatment. Whether residual immune activation is present after completion of TB treatment is unknown. We conducted immunophenotyping of T cells and monocytes from individuals who had completed TB treatment, and compared them to controls without...
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Cough is a characteristic symptom of tuberculosis, is the main cause of transmission, and is used to assess treatment response. We aimed to identify the best measure of cough severity and characterize changes during initial tuberculosis therapy. We conducted a prospective cohort of recently diagnosed ambulatory adult patients with pulmonary tubercu...
Article
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Background: During antiretroviral treatment (ART) with plasma HIV RNA below the limit-of-quantification, HIV RNA can be detected in genital or rectal secretions, termed "discordant shedding" (DS). We hypothesized that proliferating cells produce virions without HIV replication. Methods: ART-naive Peruvians initiating ART were observed for DS ove...
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Background The Estudio Vacuna de Influenza Peru (VIP) cohort aims to describe the frequency of influenza virus infection, identify predictors of vaccine acceptance, examine the effects of repeated influenza vaccination on immunogenicity, and evaluate influenza vaccine effectiveness among HCP. Methods The VIP cohort prospectively followed HCP in Li...
Article
Objective: This study aimed to evaluate the association between the intensity of menopausal symptoms and highly active antiretroviral therapy (HAART) adherence in middle-aged women with human immunodeficiency virus (HIV) infection. Methods: In this cross-sectional study, 313 Peruvian women with HIV infection (age 40-59 years) were surveyed and clas...
Article
Background: Disseminated histoplasmosis (DH) is an opportunistic fungal infection in severely immunocompromised patients with HIV infection. Haemophagocytic syndrome (HFS), which can occur in these co-infected patients when the immune response is significantly altered, is often associated with high mortality. Aims: To describe the epidemiologica...
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Background TB transmission in healthcare facilities is an important public health problem, especially in the often-overcrowded settings of HIV treatment scale-up. The problem is compounded by the emergence of drug resistant TB. Natural ventilation is a low-cost environmental control measure for TB infection control where climate permits that is sui...
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Background To evaluate the mortality in hospitalized patients with tuberculous meningitis and describe factors associated with an increased risk of mortality. Methods Retrospective study of hospitalized patients with tuberculous meningitis between 2006 and 2015 in Peru performing a generalized linear regression to identify factors predictive of in...
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Access to nucleoside reverse transcriptase inhibitor (NRTI) and non-nucleoside reverse transcriptase inhibitor (NNRTI) first-line antiretroviral therapy (ART) for HIV has been increasing in Peru since a national ART program was initiated in 2004. Between 2007 and 2009, we found a 1% prevalence of pre-ART HIV drug resistance (PDR) among antiretrovir...
Article
La terapia de la infección por el vrn ha tenido una evolución sorprendente, pasando desde el uso medidas paliativas, a lo actual, en que el tratamiento antirretroviral permite la recuperación de la salud del paciente con las consecuencias positivas para su familia y la sociedad. Un beneficio adicional esque eltratamiento disminuye elriesgo de conta...
Article
Hace 26 años ingresó el Cólera en el Perú, ocasionando uno de los brotes más explosivos en la historia de esta enfermedad, el cual se produjo debido al ingreso del Vibrio cholerae O1, a la susceptibilidad de la población a este agente y a las deficientes condiciones de saneamiento del momento. Son diversos los agentes infecciosos responsables de Có...
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Quantitative polymerase chain reaction (qPCR) for Toxoplasma gondii multicopy genes has emerged as a promising strategy for sensitive detection of parasite DNA. Quantitative polymerase chain reaction can be performed from blood samples, which are minimally invasive to collect. However, there is no consensus about what type of blood specimen yields...
Article
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Background We previously reported increased unstimulated blood levels of interferon-gamma in persons with latent tuberculosis infection (LTBI) in the United States, suggesting enhanced immune activation in LTBI. To investigate this further in a TB-endemic setting, we assessed interferon-gamma levels in persons with and without LTBI in Peru. Method...
Data
Dataset. This file contains a de-identified dataset related to the findings described in the manuscript. (XLSX)
Article
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Background Meningitis caused by Mycobacterium tuberculosis is a major cause of morbidity and mortality worldwide. We evaluated the performance of cerebrospinal fluid (CSF) testing with the GeneXpert MTB/RIF assay versus traditional approaches for diagnosing tuberculosis meningitis (TBM). Methods Patients were adults (n = 37) presenting with suspec...
Data
DST results among patients with definite TBM. *Minimum of 9 colonies were not obtained for DST. Abbreviations N.A. (Not Applicable), Neg (Negative), Pos (Positive). DST for GeneXpert tests for resistance to Rifampicin, MGIT/LJ tests for resistance to Streptomycin, Isoniazid, Rifampicin, Ethambutol, and Pyrazinamide. Ogawa used Proportions Method te...
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To reduce transmission of tuberculosis (TB) in resource-limited countries where TB remains a major cause of mortality, novel diagnostic tools are urgently needed. We evaluated the fractional concentration of exhaled nitric oxide (FeNO) as an easily measured, noninvasive potential biomarker for diagnosis and monitoring of treatment response in parti...
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Objective: During effective antiretroviral therapy (ART), low-level plasma viremias (LLV) (HIV RNA >30-1000 copies/ml) can be detected intermittently. We hypothesized that systemic inflammation is associated with LLV either as the cause or result of the production of virions from clonally expanded cells. Methods: Prospective cohort study of HIV-...
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Background: Cough frequency, and its duration, is a lab-free biomarker that can be used in low-resource settings and has been associated with transmission and treatment response. Radiological characteristics associated with increased cough frequency may be important in understanding transmission. The relationship between cough frequency and cavita...
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We conducted a cluster-randomized trial to estimate effects of directly observed combination antiretroviral therapy (DOT-cART) on retention with viral suppression among HIV-positive adults in Peru. We randomly allocated facilities to receive the 12-month intervention plus the standard of care, including adherence support provided through accompanim...
Article
Background: Tuberculosis has been associated with an increased risk of cardiovascular disease, including acute myocardial infarction (AMI). We investigated whether latent tuberculosis infection (LTBI) associates with AMI. Methods: We conducted a case-control study in two large national public hospital networks in Lima, Peru between July 2015 and...
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The differential diagnosis for lymphadenopathy is wide and clinical presentations overlap, making obtaining an accurate diagnosis challenging. We sought to characterize the clinical and radiological characteristics, histological findings, and diagnoses for a cohort of patients with lymphadenopathy of unknown etiology. 121 Peruvian adults with lymph...
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Background: Cough is the major determinant of tuberculosis transmission. Despite this, there is a paucity of information regarding characteristics of cough frequency throughout the day and in response to tuberculosis therapy. Here we evaluate the circadian cycle of cough; cough frequency risk factors; and the impact of appropriate treatment on cou...
Article
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Objetivos. Determinar el nivel de estigma relacionado a VIH/SIDA y su asociación con la adherencia al tratamiento antirretroviral (TARV) en pacientes de un hospital nacional de Lima, Perú. Materiales y métodos. Estudio transversal que incluyó a pacientes adultos que seguían el programa de TARV con un mínimo de seis meses. Se consideró el estigma c...
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Accidents caused by urticating or poisonous setae from lepidoptera caterpillars are known as erucism. These accidents are produced by accidental contact, especially in children, with bristles on the insect's body surface, connected to venom glands. Symptoms may be local or systemic, with deadly clinical presentations. The accident caused by Lonomia...
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Hospital infection control measures are crucial to tuberculosis (TB) control strategies within settings caring for human immunodeficiency virus (HIV)-positive patients, as these patients are at heightened risk of developing TB. Pyrazinamide (PZA) is a potent drug that effectively sterilizes persistent Mycobacterium tuberculosis bacilli. However, PZ...
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Ascaris lumbricoides is considered the largest intestinal nematode with a higher incidence in the childhood, representing a truly medical and public health problem, principally in undeveloped countries. We present the case of an 83 year old man, born and coming from the amazon region, without any relevant previous history of disease, admitted in th...
Article
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Multidrug-resistant tuberculosis (MDRTB) rates in a human immunodeficiency virus (HIV) care facility increased by the year 2000-56% of TB cases, eight times the national MDRTB rate. We reported the effect of tuberculosis infection control measures that were introduced in 2001 and that consisted of 1) building a respiratory isolation ward with mecha...
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Introduction: Cough is a key symptom of tuberculosis (TB) as well as the main cause of transmission. However, a recent literature review found that cough frequency (number of coughs per hour) in patients with TB has only been studied once, in 1969. The main aim of this study is to describe cough frequency patterns before and after the start of TB...
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Chikungunya is an arthropod-borne virus transmitted by Aedes mosquito bites. A viral mutation has allowed Aedes albopictus to become the preferred vector extending the geographic spread of the condition. The virus causes an acute febrile illness occasionally followed by a chronic rheumatic condition causing severe impairment. The diagnosis is usual...
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The burden of tuberculosis and cardiovascular disease (CVD) is enormous worldwide. CVD rates are rapidly increasing in low- and middle-income countries. Public health programs have been challenged with the overlapping tuberculosis and CVD epidemics. Monocyte/macrophages, lymphocytes and cytokines involved in cellular mediated immune responses again...
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In this study, 132 patients with lymphadenopathy were investigated. Fifty-two (39.4%) were diagnosed with tuberculosis (TB). The microscopic observation drug susceptibility (MODS) assay provided rapid (13 days), accurate diagnosis (sensitivity, 65.4%) and reliable drug susceptibility testing (DST). Despite its lower sensitivity than that of other m...
Article
Objective: Inflammatory biomarkers associated with cardiovascular disease are elevated in HIV-infected persons. These biomarkers improve with antiretroviral therapy (ART) but do not normalize to values observed in HIV-uninfected adults. Little is known regarding biomarkers of inflammation in HIV-infected Peruvians, in whom an increased burden of i...
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Con el objetivo de determinar la asociación entre el número de rutas formales de transporte público urbano y la situación de la tuberculosis (TB) en cada distrito de Lima, se realizó un análisis correlacional y un modelo de regresión lineal entre ambas variables. Asimismo, se determinó el número de rutas de transporte público de mayor probabilidad...
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In order to determine the association between the number of formal urban public transport routes and the situation of tuberculosis (TB) in each district of Lima, a correlational analysis and linear regression model between the two variables was performed. Also determined were the number of public transport routes most likely to transmit TB, the are...
Conference Paper
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Background: Understanding mechanisms that allow HIV infection to persist despite suppressive antiretroviral therapy (ART) may help develop cure strategies. We observed that cells with HIV integrated into genes associated with cell proliferation or cancer form persistent clones, defined as multiple cells with identical proviruses (HIV env C2-V5) and...
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Cholera is a disease of poverty that remains prevalent in resource-limited countries. The abrupt emergence of an epidemic frequently takes communities and health systems by surprise. Spread is rapid and initial mortality high: delays in organizing an appropriate response, lack of health worker training, and high patient numbers contribute to high r...
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The Cystoisospora belli, before denominated as Isospora belli, is the etiologic agent of cystoisosoporiasis, an opportunistic infection affecting immunocompromised patients, characterized by chronic diarrhea and weight loss. The incidence of chronic diarrhea for this agent, in HIV patients, has decreased considerably. This thanks to the advent of h...
Article
Objective: To increase the adherence of health care workers to three infections control practices through an educational intervention. Methods: 440 health care workers were trained in infection control during the period of 11 months. The methodology training Video-based Supplemental Instruction (VSI) affecting three infection control practices: Was...
Article
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La tuberculosis (TB) es la infección oportunista más común en los pacientes infectados con el VIH en países en desarrollo. La isoniacida (INH) es recomendada para la prevención de la TB latente, sin embargo el cumplimiento representa un problema. Objetivo: Identificar la tasa de cumplimiento de la quimioprofilaxis (QP) con INH y factores personales...
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Transmission of drug-resistant HIV (TDR) has been associated with virologic failure of "first-line," nonnucleoside reverse transcriptase inhibitor (NNRTI)-based antiretroviral therapy (ART). A national ART program began in Peru in 2004. We evaluated the prevalence of TDR in individuals initiating ART and their virologic outcome during 2 years of AR...
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Overcrowded emergency departments (EDs) are used by undiagnosed tuberculosis (TB) patients. TB infection control measures are seldom prioritized, making EDs potential foci of unrecognised nosocomial transmission. To quantify TB infection risk among health care workers in an ED in a high TB-burden setting, Lima, Peru, and to evaluate TB infection co...
Article
We report the case of a male newborn, product of a 36 week pregnancy, with diagnosis of congenital pneumonia and with a confirmatory test for influenza A (H1N1) virus, without any other suspicious contact. The mother was admitted to the hospital with respiratory failure and the history of a flu-like episode of 5 days of evolution, during the first...
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Se reporta el caso de un recién nacido varón, producto de embarazo de 36 semanas, con diagnóstico de neumonía congénita y examen confirmatorio de infección por el virus de la influenza A (H1N1), sin ningún otro tipo de contacto sospechoso. La madre ingresó al hospital con insuficiencia respiratoria y antecedente de proceso gripal de cinco días de e...
Article
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We describe a case of a 47 years old male, with a history of 2 days of progressive, ascendant, symmetrical weakness in the lower extremities; a lumbar puncture was performed after the brain CT scan, as well as an electromyography, evidencing pure motor polyradiculopathy with axonal pattern, compatible with Guillain Barre syndrome. Afterwards, he re...
Article
We describe a case of a 47 years old male, with a history of 2 days of progressive, ascendant, symmetrical weakness in the lower extremities; a lumbar puncture was performed after the brain CT scan, as well as an electromyography, evidencing pure motor polyradiculopathy with axonal pattern, compatible with Guillain Barre syndrome. Afterwards, he re...
Article
Full-text available
Active tuberculosis (TB) must be excluded before initiating isoniazid preventive therapy (IPT) in persons infected with human immunodeficiency virus (HIV), but currently used screening strategies have poor sensitivity and specificity and high patient attrition rates. Liquid TB culture is now recommended for the detection of Mycobacterium tuberculos...
Article
Human bartonellosis is a South American anthroponosis caused by Bartonella bacilliformis. The disease has an acute phase characterized by invasion of red blood cells by parasites, and consequent severe anemia; and a chronic phase presenting with benign vascular tumors. During the acute phase, affected individuals are prone to developing opportunist...
Article
Full-text available
To fight the pandemic of novel influenza A (H1N1) virus an appropriate management of cases is required, in that sense, the Peruvian Society of Infectious and Tropical Diseases has developed a guide which is summarized in this article. We detail clinical diagnosis and flows for decision making, therapeutic considerations and elements to take in acco...
Article
The management of TB patient in close settings, that guarantee a decrease in transmission risk, an adequate surveillance to treatment, and to opt for social support measures, this one becoming a proposal for the management of MDR TB or XDR TB patients and specially in the management of cases that do not comply with an adequate treatment and/or have...
Data
Wells-Riley Calculation Methodology and Room Air Mixing and UV Lamp Effectiveness Schematic (74 KB DOC)
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Background: Institutional tuberculosis (TB) transmission is an important public health problem highlighted by the HIV/AIDS pandemic and the emergence of multidrug- and extensively drug-resistant TB. Effective TB infection control measures are urgently needed. We evaluated the efficacy of upper-room ultraviolet (UV) lights and negative air ionizati...
Article
Full-text available
The management of TB patient in close settings, that guarantee a decrease in transmission risk, an adequate surveillance to treatment, and to opt for social support measures, this one becoming a proposal for the management of MDR TB or XDR TB patients and specially in the management of cases that do not comply with an adequate treatment and/or have...
Article
To fight the pandemic of novel influenza A (H1N1) virus an appropriate management of cases is required, in that sense, the Peruvian Society of Infectious and Tropical Diseases has developed a guide which is summarized in this article. We detail clinical diagnosis and flows for decision making, therapeutic considerations and elements to take in acco...