Diseases In Colombia Research Articles

Prediabetes in Colombia: Expert Consensus

The prevalence of Prediabetes in Colombia is high, and despite being recognized and categorized in the main Medical Guidelines and included in the International Classification of Diseases in Colombia, knowledge and awareness of it is limited amongst healthcare professionals and in the community. Our expert group recommends that educational programs emphasize a global approach to risk which includes a recognition of the importance of prediabetes and its evaluation along with and other risk factors such as a family history of DM2, overweight and obesity, dislipidemia and hypertension. Studies conducted in Colombia demonstrate the value of the FINDRIS questionnaire as a tool to identify subjects at risk of prediabetes and DM2, and we recommend that it should be systematic applied throughout the country as part of government policy.Prediabetes progresses to DM2 at an annual rate of 10%, but it has also been shown that prediabetes is an independent risk factor for cardiovascular outcomes. On this basis, the Committee recommends that once prediabetes is detected and diagnosed, immediate management of the disease begins through lifestyle changes, with follow up assessments performed at 3 and 6 months. If the patient does not respond with a weight loss of at least 5% and if the HbA1C values ​​are not normalized, pharmacological management should be initiated with a metformin dose of 500 mg / day, increasing up to 1,500 - 1,700 mg / day, according to tolerance.

Disease-management indicators to improve gastric and colorectal cancer control in the Colombian National Health System.

e18288 Background: Gastric (GC) and colorectal cancer (CRC) are major health problems worldwide due to their high incidence and lethality associated with late presentation. The aim of this study was to develop a set of clinical, quality and administrative measures, for gastric and colorectal cancer based on evidence to assist health care insurers, providers and policy makers in controlling these diseases in Colombia. Methods: A systematic evidence-based literature search was performed to identify the initial list of indicators, which were then selected and developed using an adaptation of the RAND/UCLA appropriateness method by a panel of multidisciplinary expert panels with expertise in CRC and GC care, quality and public health. The following institutions participated in the study: The Ministry of Health and its High Cost Disease Office, medical professional societies, National Health Institute, Institute of evaluation of technologies in health, health care insurers and providers. A total of 1589 cases of GC and 2025 of CRC from the national administrative cancer registry, representing all new cases of these diseases in the country in 2015, were used to define the viability of the proposed measures, which the involved parties developed taking in consideration the whole disease spectrum from diagnosis to treatment. Results: After reviewing relevant articles and holding an in-person expert discussion the panel generated an initial proposed set of 45 disease-management indicators. A total of 15 disease-management measures for CRC and 16 for GC were developed and approved by the expert panel after two rounds of discussion and voting; these are related to opportunities to improve time between diagnoses to treatment and also include measures assessing clinical outcomes and administrative processes. Conclusions: We developed disease-management indicators for GC and CRC in a consensus with healthcare system stakeholders that are feasible and applicable in Colombia. In time, through continuous efforts towards improving the quality of care provided, these will allow all parties to monitor and decrease the burden of GC and CRC in the country and may serve as a model to other low and middle income countries.

Epidemiología de las principales enfermedades transmitidas por vectores en Colombia, 1990-2016

Introduction: Vector-borne diseases account for more than 17% of all infectious diseases and annually they cause one million deaths worldwide. In Colombia, malaria, dengue, Chagas disease, and leishmaniasis are persistent endemo-epidemic events.Objective: To determine the behavior and transmission scenarios of vector-borne diseases in Colombia between 1990 and 2016.Materials and methods: We conducted a descriptive study on the epidemiological behavior of the main vector-borne diseases in Colombia between 1990 and 2016 based on information from official secondary sources.Results: During the study period, there were 5,360,144 cases of vector-borne diseases, 54.7% of which were due to malaria and 24.9% to dengue, accounting for 80% of the cumulative disease burden of vector-borne disease cases. The median incidence rates were 1,371 and 188 per 100,000 inhabitants for malaria and dengue, respectively. In addition, emerging events such as Chikungunya registered 774,831 cases since its introduction in 2014, while 117,674 Zika fever cases were reported since its emergence in 2015. In rural settings, parasitic vector-borne diseases such as malaria, leishmaniasis and Chagas disease predominated, while in urban scenarios dengue, chikungunya and Zika were predominant.Conclusions: Persistent epidemic and endemic transmission of vector-borne diseases in urban and rural settings in Colombia was observed mainly in the case of malaria, dengue, leishmaniasis and Chagas disease. Such transmission was focused and had variable intensity patterns. On the other hand, the conditions that have favored the emergence of new arboviruses persist.

Transmission scenarios of major vector-borne diseases in Colombia, 1990-2016.

Introducción. Las enfermedades transmitidas por vectores representan más de 17 % de todas las enfermedades infecciosas y causan anualmente un millón de defunciones a nivel mundial. En Colombia, la malaria, el dengue, la enfermedad de Chagas y las leishmaniasis son condiciones endemoepidémicas persistentes.Objetivo. Determinar el comportamiento epidemiológico de las enfermedades transmitidas por vectores en zonas urbanas y rurales de Colombia entre 1990 y 2016.Materiales y métodos. Se hizo un estudio descriptivo del comportamiento epidemiológico de las principales enfermedades transmitidas por vectores en zonas urbanas y rurales de Colombia entre 1990 y 2016, con la información proveniente de fuentes oficiales secundarias.Resultados. En el periodo estudiado se registraron 5'360.134 casos de enfermedades transmitidas por vectores, de los cuales 54,7 % fueron de malaria y 24,9 % de dengue. Estos casos concentraron el 80 % de la carga acumulada de casos de enfermedades transmitidas por vectores. Las medianas de las tasas de incidencia fueron 1.371 y 188 por 100.00 habitantes para malaria y dengue, respectivamente. Además, los casos de chikungunya fueron 774.831 desde su introducción en el 2014 y, los de Zika, 117.674 desde su aparición en 2015. En las zonas rurales predominaron las enfermedades parasitarias transmitidas por vectores como la malaria, las leishmaniasis y la enfermedad de Chagas. A nivel urbano, predominaron el dengue, el chikungunya y el Zika.Conclusiones. La transmisión en Colombia de estas enfermedades es persistente en las zonas urbanas y en las rurales, y de tipo endemoepidémico en los casos de malaria, dengue, leishmaniasis y enfermedad de Chagas. Dicha transmisión se ha dado de manera focalizada y con patrones variables de intensidad. Asimismo, se mantienen las condiciones que han favorecido la transmisión emergente de nuevas arbovirosis.

Situación actual de las enfermedades huérfanas en Colombia 2017

En Colombia las enfermedades complejas y raras, carecen de claridaddentro del sistema de seguridad social en salud vigente, debido a su bajaprevalencia, dificil diagnostico, escaso tratamiento, alto precio de los medicamentos(por lo cual se consideran de alto costo), y ademas de granimpacto economico para el sistema de salud.A pesar de que estas enfermedades fueron reguladas en la ley 1392 de 2010,lo cual es gran avance para Colombia, pues esta ley es muy completa y tieneen cuenta muchos aspectos que favorecen el proceso salud - enfermedadde estos pacientes, es cierto que es poco el avance de esta en relacion conla aplicacion de los referentes que propone, por tal motivo surge la idea deechar un vistazo alrededor de lo que ha pasado con la normatividad y cual esla situacion o grado actual de dificultad a la que se enfrentan pacientes y susfamilias con el sistema de salud Colombiano antes y despues del diagnosticode una enfermedad huerfana, haciendo la claridad frente a la necesidadde hablar de familia, porque estas patologias afectan en gran medida todo elentorno familiar y social de las personas que las padecen.Esta revision tiene como objetivo hacer un poco mas notoria la situacion delas Enfermedades huerfanas en Colombia y el dificil camino de los pacientesy sus familias cuando se enfrentan a estas patologias; aporta tambien conocimientodel estado actual de las Enfermedades huerfanas en Colombia,ademas hace notoria la lentitud con la que avanza el tema y el poco compromisotanto del gobierno, como de las administradoras de planes de beneficiopara llegar a un modelo integral de atencion en salud; para ello se realizaraun revision bibliografica de la normatividad existente en Colombia y algunosplanteamientos de personas y asociaciones de pacientes dedicadas a lograradelantos en el manejo de los pacientes con enfermedades huerfanas, de talmanera que se llegue a una aproximacion para el publico en general en losaspectos basicos de estas enfermedades y aporte conocimiento del estadoactual de estas enfermedades en Colombia.

Factors associated to mortality by non-communicable diseases in Colombia, 2008-2012

Non-communicable diseases are the leading cause of premature mortality and disability in the world. To describe the trend pattern and to explore which risk factors were associated with mortality rates in Colombia from 2008 to 2012. A descriptive study was conducted to analyze mortality rate trends from the official vital statistics (death certificates) from 2008 to 2012. Between 2008 and 2012 there were 727,146 deaths due to non-communicable diseases, and 58.5% of them occurred among men aged less than 75 years. The mortality rate during the study period was 319.5 deaths per 100,000 people. The trend showed a statistically significant decline in mortality rates (-3%) across the country. For each woman who died due to external causes (i.e., not related to illness or old age), five men died under the same circumstances (OR=5,295; IC 95%: 5,143-5,454). The five most important causes of mortality were heart diseases, injuries due to aggressions, malignant tumors, chronic lower respiratory diseases and road traffic accidents. The cause of death differed significantly by sex and age. The main causes of death in Colombia were heart diseases and injuries (homicide). Mortality was higher among men of all ages than among women, but 15 to 45 year-old males were more likely to die due to external causes.

Caracterización molecular del Potato virus V (PVV) infectando Solanum phureja mediante secuenciación de nueva generación

Las enfermedades virales son uno de los problemas más limitantes para la producción de papa en el mundo. Uno de los materiales de papa más susceptibles a los virus corresponde a Solanum phureja; sin embargo, en Colombia son pocos los estudios adelantados sobre los agentes causales que lo afectan. En este trabajo se realizó una caracterización molecular del Potato virus V (PVV) infectando plantas de S. phureja en Antioquia, utilizando métodos de secuenciación de nueva generación (NGS), pruebas de DAS-ELISA, RT-PCR en tiempo real (RT-qPCR) y RT-PCR convencional. Los resultados indican la ocurrencia de niveles muy variables de incidencia del virus entre lotes de cultivo (6,7 % a 86 %). El PVV tiene un genoma de 9828 nt que codifica para una poliproteína de 3066 aa y presenta dos variantes principales (Var_A y Var_B) en proporciones de 72 y 28 %. Estas variantes comparten altos niveles de identidad genética (99,7 % en todo el genoma) entre ellas y con respecto a la cepa PVV-Phureja reportada en Colombia, pero no con otras cepas del mundo (82-83 %). Con base en dichos genomas, se diseñaron y evaluaron en muestras foliares de S. phureja, dos pares de cebadores para la detección del virus en pruebas de RT-PCR (459 pb) y RT-qPCR (89 pb, Ct=12,08-21,86 y Tm= 78,7 °C-80,2 °C), confirmándose la presencia de este virus en tejidos sintomáticos y asintomáticos de papa criolla. La ocurrencia generalizada de PVV en los cultivos de S. phureja indica la necesidad de incorporar en los programas de certificación de tubérculos-semilla de S. phureja en Colombia el diagnóstico de este virus.

Rhizoctonia solani AG-1 IA infects both rice and signalgrass in the Colombian Llanos

ABSTRACT Foliar blight and death of signalgrass (Urochloa spp.) pastures are caused by the Rhizoctonia solani fungus. This study aimed at determining which pathogens from the Rhizoctonia species complex are associated with leaf and sheath blight in Urochloa and rice, in the Colombian Llanos. Sympatric areas of Urochloa pastures adjacent to rice cropping areas were sampled using a linear transect system. The pathogens were identified using morphological traits, molecular detection based on specific primers and sequencing of the ITS-5.8S rDNA region. R. solani AG-1 IA predominated as the pathogen associated with foliar blight in all samples from U. brizantha cv. 'Toledo' and hybrid Urochloa cv. 'Mulato'. Besides R. solani AG-1 IA (18 % of the samples), Rhizoctonia oryzae-sativae (71 %) and Sclerotium hydrophilum (11 %) were also detected. In the cross-pathogenicity test, the R. solani AG-1 IA fungus was the most aggressive to Urochloa, while R. oryzae-sativae produced very mild infection symptoms. This is the first report of R. oryzae-sativae and S. hydrophilum associated with the complex of rice sheath blight diseases in Colombia.

Positive 14-3-3 and tau proteins in a sporadic Creutzfeldt-Jakob disease case and a brief perspective of prion diseases in Colombia.

Prion diseases are rare neurodegenerative disorders occurring worldwide and affecting both humans and animals. Herein, we present the case of a patient diagnosed with definite sporadic Creutzfeldt-Jakob disease in Cali, Colombia. Besides neurological examination, 14-3-3 and tau proteins were valuable tools supporting the diagnosis. We also present a brief perspective of the prion diseases reported in Colombia to date. Although the incidence of prion diseases is unknown in Colombia, our literature review revealed that one case of scrapie in 1981 and 29 human sporadic cases of Creutzfeldt-Jakob disease have been documented and published in our country.

Alcohol use disorders and psychiatric diseases in Colombia

An accurate understanding of co-occurrence and comorbidity of alcohol use disorders (AUD) in Colombia is crucial for public health. A secondary analysis was conducted, using a 2003/2004 government´s population database to determine the lifetime associations between AUD and other mental and addictive disorders in people of Colombia aged 18-65 years. Several statistical analysis were performed: testing prevalence difference in mental disorders by whether the individual had an AUD; a stratified analysis by gender and logistic regression analyses accounting for differences in demographic, socio-economic, behavioral and self-reported health status variables. People with AUD comprised 9% of the population, of which 88% were males and on average 37 years old. They were more likely to be males, be working, and be current smokers; and less likely to be at home or retired. The population with AUD had greater chance to comply with criteria for all disorders but minor depressive disorder, post-traumatic stress disorder, nicotine dependence, and oppositional defiant disorder. This study demonstrates a high prevalence of mental disorders in the adult population with AUD in Colombia. The findings highlight the importance of comorbidity as a sign of disease severity and impact on public health and supports the need for training of more professionals and developing appropriate interventions and services.

Cuidadores y cuidadoras familiares de personas con enfermedad crónica en Colombia: más similitudes que diferencias

Objective: To describe and compare the burden level of the male and female relative caregivers of people with chronic diseases in Colombia. Methodology: A descriptive and comparative cross-sectional study that was carried out between 2012 and 2014 with 1,555 relative caregivers of people with chronic disease living in the five geographical regions of Colombia. The GCPC-A-C instruments for characterization and the Caregiver Perception of Burden Survey of Zarit in order to determine the perceived burden were used. Results: In the group of relative caregivers of the study, 80.3% belong to the Andean region, 5.6% were from the Pacific region, 3.6 % from the Orinoco region, 6.6% from the Caribbean region, and 3.6% from the Amazon region. The average age is 50. Most of them are spouses, children or parents of the care receiver and they spend at least a quarter of the day for his/ her work as caregivers. Most of them have more than 36 months caring for the sick relative. 31% of male caregivers and 33% of female careers expressed to be experiencing an overload with the care of his/her relative. Conclusions: The findings reflect the existence of a majority of female relative caregivers of people with chronic disease, as reported in another studies in Latin America. Unlike previous research, there is no strong difference in the perceived and the expressed load by caregivers, according to gender.

Health interventions used by major resource companies operating in Colombia

Resource extractive companies are providing an increasing amount of information about their corporate social responsibility (CSR) interventions, which often include diverse health initiatives provided to mine workers, mine workers׳ families and neighboring communities. This paper undertakes a review of the health initiatives of Colombia׳s leading mining, oil and gas companies, reported between 2005 and 2012. These interventions aim to improve the life of individuals both at work and in neighboring communities (including artisanal miners). Outcomes of this study were that companies preferred to use interventions that prevent disease rather than diagnose or treat it. Sixty percent of interventions targeted the health of mine workers, another 14% of interventions were directed to improve the health of the families of mine workers and the remaining 25% addressed the health needs of the wider community. Non-communicable diseases now account for more deaths than communicable diseases in Colombia, and perhaps in response to this we found that most interventions were associated with the control of non-communicable diseases (75%). Companies were more likely to address the health needs of indigenous peoples, if large populations of indigenous people lived near to their sites.All of the Colombian districts with resource extraction activity had evidence of considerable levels of poverty and studied resource companies were attempting to alleviate health-related needs to some degree, above the provision of royalties to central or regional government. Artisanal mining plays an important role in the Colombian economy, and these miners are exposed to a multitude of health and safety risks. One larger scale gold mining company reported interventions that target improving conditions of artisanal miners. This study highlights the importance of all stakeholders in the economy (including MOG companies, local district governments, NGOs, etc.) actively participating in developing and implementing health interventions to improve the human development of communities impacted by resource extraction activities in Colombia.

Allergy prevention over treatment: A needed step and an urgent approach in the management of allergic diseases in Colombia

Allergy prevention over treatment: A needed step and an urgent approach in the management of allergic diseases in Colombia

Detection and molecular characterization of porcine circovirus type 2 from piglets with porcine circovirus associated diseases in Colombia.

BackgroundThe porcine circovirus-associated disease (PCVAD) has been known since 1991 in Canada, but the first outbreak of PCVAD in Colombia was reported in 2007. In order to understand the molecular epidemiology of the disease and to establish the origin of the virus in the country, the study presented here intended to evaluate the presence of PCV2-associated systemic infection in piglets from different geographical regions over a period of 9-years (2002 -2010). The analysis included samples collected before, during and after outbreaks of PCVAD in pigs from Colombia. The PCV2 ORF2 from the positive samples was sequenced and used to determine the genotypes of the strains and to study the dynamic of these genotypes throughout the time.ResultsPCV2 DNA was detected in cases related to PCV2-associated systemic infection as well as in healthy pigs with a presumable persistent infection. The analysis of the ORF2 nucleotide full length sequence of twenty-three strains allowed to divide them into two groups: PCV2a and PCV2b. At the amino acid level the main variations in the sequence of the capsid protein were found in regions located within the immunoreactive areas.ConclusionsThe results of this study demonstrated for the first time, that the two subgroups: PCV2a and PCV2b have been circulating in swine from Colombia. In addition, the study showed that genotype PCV2b is present in Colombian pigs suffering from both clinical and presumable persistent infection and that the PCV2b genotype was present in the Colombian pig population even before recognition of the disease in the country and it became predominant through time.

Risk Factors for Squamous Cell Carcinoma, A Study by the National Dermatology Centre of Colombia

IntroductionNonmelanoma skin cancer is the most common malignancy in white individuals. The risk factors for squamous cell carcinoma, which belongs to the family of nonmelanoma skin cancers, have not been studied in Colombia. ObjectiveTo determine the risk factors for squamous cell carcinoma in patients at a national referral center for skin diseases in Colombia. Material and methodsWe conducted a case-control study that evaluated sociodemographic, epidemiological, and clinical factors among 332 individuals. Risk was calculated as odds ratio (ORs) using the multivariate conditional logistic regression analysis method. ResultsThe following risk factors were identified: family history of skin cancer (OR, 6.55; 95% CI, 1.4-28.9), living in a rural area after the age of 30 years (OR, 3.13; 95% CI, 1.3-7.2), a lifetime working outdoors (OR, 2.98; 95% CI, 1.5-5.7), smoking more than 10 cigarettes a day (OR, 2.96; 95% CI, 1.3-6.5), actinic conjunctivitis (OR, 2.68; 95% CI, 1.2-5.9), poikiloderma of Civatte (OR, 3.29; 95% CI, 1.7-6.1), numerous facial actinic keratoses (OR, 9.23; 95% CI, 4.9-17.1), and numerous freckles (OR, 3.68; 95% CI, 1.3-10.1). ConclusionsWe have documented clinical characteristics and personal history factors that should guide the physician in making decisions on the preventive and follow-up measures to be adopted for individuals at risk of squamous cell carcinoma. These findings may help guide policy for controlling the disease using local information.

Factores de riesgo de carcinoma espinocelular, un estudio del Centro Nacional de Dermatología de Colombia

IntroductionNonmelanoma skin cancer is the most common malignancy in white individuals. The risk factors for squamous cell carcinoma, which belongs to the family of nonmelanoma skin cancers, have not been studied in Colombia. ObjectiveTo determine the risk factors for squamous cell carcinoma in patients at a national referral center for skin diseases in Colombia. Material and methodsWe conducted a case-control study that evaluated sociodemographic, epidemiological, and clinical factors among 332 individuals. Risk was calculated as odds ratio (ORs) using the multivariate conditional logistic regression analysis method. ResultsThe following risk factors were identified: family history of skin cancer (OR, 6.55; 95% CI, 1.4-28.9), living in a rural area after the age of 30 years (OR, 3.13; 95% CI, 1.3-7.2), a lifetime working outdoors (OR, 2.98; 95% CI, 1.5-5.7), smoking more than 10 cigarettes a day (OR, 2.96; 95% CI, 1.3-6.5), actinic conjunctivitis (OR, 2.68; 95% CI, 1.2-5.9), poikiloderma of Civatte (OR, 3.29; 95% CI, 1.7-6.1), numerous facial actinic keratoses (OR, 9.23; 95% CI, 4.9-17.1), and numerous freckles (OR, 3.68; 95% CI, 1.3-10.1). ConclusionsWe have documented clinical characteristics and personal history factors that should guide the physician in making decisions on the preventive and follow-up measures to be adopted for individuals at risk of squamous cell carcinoma. These findings may help guide policy for controlling the disease using local information.

Botryosphaeriaceae associated with Eucalyptus canker diseases in Colombia

SummaryThe identities of Botryosphaeriaceae causing cankers on Eucalyptus in Colombia were investigated using morphological and DNA sequence comparisons. The pathogenicity of the species was also assessed on 42 Eucalyptus grandis clones planted at four different sites. Two species of the Botryosphaeriaceae were found to occur on E. grandis in Colombia. Neofusicoccum ribis was the more common species, and also the most pathogenic. Botryosphaeria dothidea was found only in one zone of Colombia, and was also less pathogenic than N. ribis. These two species could be distinguished easily based on DNA sequences of the ITS1/ITS2 rDNA region and EF1‐α, in addition to conidial sizes. Significant differences in resistance of clones to these pathogens were also evident from the various trials.

Identificación de ácaros del polvo casero en colchones y almohadas de niños alérgicos de Santa Marta, Colombia

The increasing prevalence of allergic diseases in Colombia makes necessary to research about factors that influence their etiology. The aim of this study was to investigate the mite fauna present in homes of allergic child from Santa Marta. A total of 70 samples were collected from 42 houses through vacuuming mattresses and pillows, during the months of July to October 2007. Mites were identified under light microscopy using taxonomic keys, count and expressed as mites per gram of dust. The prevalent mite family was Pyroglyphidae (84.58%), having Dermatophagoides farinae as the major specie (23.85%), followed by D. pteronyssinus. Other mites prevalent were Cheyletus spp, Euroglyphus maynei and Blomia tropicalis, with levels up to 500 mites/ gram, considered like of high risk for the allergic sensitization. These results improve the knowledge of house dust mite fauna in Santa Marta, important by the diagnosis and therapy of allergies..

Estimación de la incidencia de enfermedades ocupacionales en Colombia, 1985-2000

The occurrence of labor related diseases in Colombia is unknown. The objective of this study was to estimate the incidence of occupational disease in Colombia in the period 1985-2000. The annual incidence was estimated with the methodology recommended by Leigh et al. based upon the population estimates of the National Administrative Statistics Department (DANE). The results showed an increase in the incidence of occupational diseases from 68,063 cases in 1985 to 101,645 in 2000. The economic losses caused to the social security health system by underreporting of occupational diseases are estimated.

Genetic structure and phylogenetic relationships of Colombian Trypanosoma cruzi populations as determined by schizodeme and isoenzyme markers.

Twenty-four Trypanosoma cruzi stocks isolated from vectors and from human and Didelphis marsupialis hosts from highly separated sylvatic localities in Colombia were characterized by isoenzyme and schizodeme analyses. The stocks were collected primarily from sylvatic ecotopes representing areas of low, moderate, and high endemicity for Chagas' diseases in Colombia. Parasites were characterized mainly by schizodeme analysis with the restriction enzyme Eco RI and the isoenzyme analysis was performed at 10 genetic loci. These analyses demonstrated an agreement between the classifications based on the isoenzyme analysis and on the restriction fragment length polymorphism patterns obtained with the Colombian stocks. There is clear evidence of demic subdivision between the eastern (E) and western (W) stocks separated by the Andean Mountains and Magdalena River, which is likely due to the geographic isolation generated by these topographic features. Heterozygosity estimates indicate that the E group could be more ancient than the W group. As was postulated in a previous study, these results are also compatible with the existence of a clonal population structure in Colombian sylvatic T. cruzi. Evidence presented here failed to demonstrate a correlation between the degree of endemy and genetic clustering. Finally, schizodeme and isoenzymatic analyses comparing Colombian T. cruzi stocks with others from Chile confirm that Colombian isolates are genetically related to zymodeme 1 and distant from zymodeme 2.