Previous studies have shown that variation in the distribution of vectors associated to the transmission of Leishmania species may be related to climatic changes. However, the potential implications of these ecological changes in human health need to be further defined in various endemic populations where leishmaniasis carries a substantial burden of disease such as in Northeastern Colombia. Herein, we report the impact of El Niño Southern Oscillation climatic fluctuations during 1985-2002 in the occurrence of cases of leishmaniasis in two northeastern provinces of Colombia. During this period, we identified that during El Niño, cases of leishmaniasis increased, whereas during La Niña phases, leishmaniasis cases decreased. This preliminary data show how climatic changes influence the occurrence of leishmaniasis in northeastern Colombia and contributes to the growing body of evidence that shows that the incidence of vector-borne diseases is associated with annual changes in weather conditions.

Leishmaniasis in the Americas is transmitted by Lutzomyia spp., which have many animal reservoirs. Previous studies indicated potential changes in vectors of climate-related distribution, but impact outcomes need to be further studied. We report climatic and El Niño events during 1985-2002 that may have had an impact on leishmaniasis in 11 southern departments of Colombia: Amazonas, Caquetá, Cauca (Ca), Huila, Meta (Mt), Nariño, Putumayo (Py), Tolima, Valle (Va), Vaupes (Vp), and Vichada. Climatic data were obtained by satellite and epidemiologic data were obtained from the Health Ministry. NOAA climatic classification and SOI/ONI indexes were used as indicators of global climate variability. Yearly variation comparisons and median trend deviations were made for disease incidence and climatic variability. During this period there was considerable climatic variability, with a strong El Niño for 6 years and a strong La Niña for 8. During this period, 19,212 cases of leishmaniasis were registered, for a mean of 4756.83 cases/year. Disease in the whole region increased (mean of 4.98%) during the El Niño years in comparison to the La Niña years, but there were differences between departments with increases during El Niño (Mt 6.95%, Vp 4.84%), but the rest showed an increase during La Niña (1.61%-64.41%). Differences were significant in Va (P= 0.0092), Py (P= 0.0001), Ca (P= 0.0313), and for the whole region (P= 0.0023), but not in the rest of the departments. The importance of climate change is shown by shifts in insect and animal distributions. These data reflect the importance of climate on transmission of leishmaniasis and open further investigations related to forecasting and monitoring systems, where understanding the relationship between zoonoses and climate variability could help to improve the management of these emerging and reemerging diseases.

Field populations of Colombian malaria vector Anopheles (N.) nuneztovari were studied using World Health Organization (WHO) and Center for Disease Control and Prevention (CDC) bioassay techniques and through the use of biochemical microplate-based assays for resistance enzymes. Insecticides evaluated included the pyrethroids lambda-cyhalothrin and deltamethrin, organophosphates malathion and fenitrothion, and the organochlorine dichlorodiphenyltrichloroethane (DDT). Study sites selected were based upon malaria incidence, vector presence, and control activities in Colombia. Early stage selection for reduced susceptibility was observed in the bioassays for some locations. Data from the WHO and CDC bioassay methods were broadly consistent, with some differences noted. Evidence is presented for low-level initial selection of some resistance mechanisms such as mixed-function oxidases and modified acetylcholinesterase. Data from the site Encharcazón implies that selection for DDT-pyrethroid cross-resistance has occurred, though not likely at a level that currently threatens vector control by either class of insecticides, and further implies that knockdown resistance (kdr) may be present in those populations. Further studies using synergists and development of a kdr-specific assay for A. nuneztovari thus become priorities. The resistance levels to lambda-cyhalothrin and deltamethrin found in the Encharcazón population are of concern since these two insecticides are currently used for both indoor spraying and treated nets. In addition, the resistance to fenitrothion, the indoor spray insecticide mostly used for this species due to their exophilic behavior, found in the El Zulia population, makes urgent to find alternatives for chemical control in these areas. These data provide the initial baselines for insecticide susceptibility profiles for A. nuneztovari in Colombia and the first report of insecticide resistance in this vector.

Rich countries used In the Covid-19 pandemic lockdown and physical distancing policies for transmission control. However, are these measures also suitable in countries with a fragile economy resting mainly on the informal sector? The impact of lockdown measures in disadvantaged population strata in six Low-and Middle-Income Countries (LMICs) was reviewed using i) systematic review of 17 published papers and ii) review of 90 media reports. Those who most suffered from the lockdown were migrants, workers in the informal sector (which is huge), small businesses, slum dwellers, women and elderly revealing the social, cultural and economic inequalities of societies.Financial and food support for the poor was inadequate and sometimes mismanaged. In the better organized societies, the resilience was stronger (South Korea, Kerala/India) but also here the poor had to suffer most. It is strongly recommended that outbreak response strategies should particularly focus on the poor and vulnerable population.