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Diseño De Un Programa De Vigilancia Entomológica En Bases Aéreas Y Zonas De Operaciones Militares

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Diseño De Un Programa De Vigilancia Entomológica En Bases Aéreas Y Zonas De Operaciones Militares UNIVERSIDAD COMPLUTENSE DE MADRID FACULTAD DE VETERINARIA Departamento de Sanidad Animal TESIS DOCTORAL Diseño de un programa de vigilancia entomológica en bases aéreas y zonas de operaciones militares MEMORIA PARA OPTAR AL GRADO DE DOCTOR PRESENTADA POR Javier Lacasa Navarro Directores Rosario Melero Alcíbar Ricardo Molina Moreno José Luis Vega Pla Madrid, 2015 © Javier Lacasa Navarro, 2015 UNIVERSIDAD COMPLUTENSE DE MADRID FACULTAD DE VETERINARIA Departamento de Sanidad Animal DISEÑO DE UN PROGRAMA DE VIGILANCIA ENTOMOLÓGICA EN BASES AÉREAS Y ZONAS DE OPERACIONES MILITARES TESIS DOCTORAL JAVIER LACASA NAVARRO MADRID, 2015 Madrid, 2015 UNIVERSIDAD COMPLUTENSE DE MADRID FACULTAD DE VETERINARIA Departamento de Sanidad Animal DISEÑO DE UN PROGRAMA DE VIGILANCIA ENTOMOLÓGICA EN BASES AÉREAS Y ZONAS DE OPERACIONES MILITARES MEMORIA PARA OPTAR AL GRADO DE DOCTOR PRESENTADA POR: Javier Lacasa Navarro Bajo la dirección de los doctores Rosario Melero Alcíbar Ricardo Molina Moreno José Luis Vega Pla Madrid, 2015 “La ciencia, a pesar de sus progresos increíbles, no puede ni podrá nunca explicarlo todo. Cada vez ganará nuevas zonas a lo que hoy parece inexplicable. Pero las rayas fronterizas del saber, por muy lejos que se eleven, tendrán siempre delante un infinito mundo de misterio” Gregorio Marañón A Mariví por su infinito apoyo y comprensión y a nuestros hijos, Álvaro y Jaime. A mis padres AGRADECIMIENTOS Este apartado va dedicado a todas aquellas personas sin cuya ayuda no habría sido posible la realización de este trabajo. En primer lugar quiero agradecer la dedicación de mis directores de tesis: a la Dra. Rosario Melero, que ha sido quien ha dirigido y corregido de forma más directa mi trabajo, con disponibilidad permanente, certeras recomendaciones y enorme paciencia; al Dr. José Luis Vega, por sus revisiones, contagioso entusiasmo y por la seguridad que logró transmitirme; y por supuesto, al Dr. Ricardo Molina, que aceptó también dirigir la tesis, dedicando mucho de su valioso tiempo para aconsejarme en las revisiones periódicas y final de la misma. No puedo dejar de mostrar enorme agradecimiento hacia mis jefes, compañeros y amigos en la Escuela Militar de Sanidad, Alberto Pérez Romero y Mª José Presa, pues juntos iniciamos hace años el apasionante camino por la entomología sanitaria, y no han dejado de apoyarme en todo este tiempo. Gracias de todo corazón. Durante los años de estudio, numerosas personas me ayudaron con los trabajos de campo: Ángel Losa, siempre dispuesto a acompañarme en los muestreos de Torrejón; y por supuesto, los compañeros de la gran familia Veterinaria Militar, que colaboraron en los muestreos de Afganistán, recogida de datos o en alguna otra labor que les solicité: Ángel Santos, Alberto Cique, Almudena García del Portillo, Antonio Alcón, Fernando Salgado, Constantino Alvarado, Sonsoles Fuentes, Almudena Pérez Rico, Lourdes Sanmartín, Paula García y Pilar Lisbona. También le agradezco a José Carlos Presa la aportación de información sobre la base de Qala i Naw. Al Coronel Luis Martín Otero, gracias al cual tuve la oportunidad de comenzar a realizar los trabajos en la Base Aérea de Torrejón, y me animó en todo momento a emprender el camino que hoy culmino; y al Coronel Carlos Mediavilla Bravo, que desde la Dirección de Sanidad del Ejército del Aire, continuó mostrándome su apoyo incondicional. Al General Luis Ángel Moreno Fernández-Caparrós, que desde la Jefatura de Apoyo Veterinario de la Inspección General de Sanidad de la Defensa, me facilitó todo lo necesario para desarrollar el trabajo en Zona de Operaciones. Al Laboratorio de Control de Mosquitos de la Diputación de Huelva, que sumnistró muestras de mosquitos para extracción del ADN y a la Diputación de Córdoba que contribuyó con sus infraestructuras. A Cría Caballar de las Fuerzas Armadas, a la Inspección General de Sanidad de la Defensa, al Centro de Coordinación de Alertas y Emergencias Sanitarias, del Ministerio de Sanidad, Servicios Sociales e Igualdad y al Instituto de Salud Carlos III, que suministraron equipamiento necesario en las distintas fases de este trabajo. INDICE ÍNDICE Abreviaturas y siglas ........................................................................................ VII Índice de figuras ................................................................................................ IX Índice de tablas ............................................................................................ XXIII Resumen ...................................................................................................... XXIX Abstract ...................................................................................................... XXXIII I. INTRODUCCIÓN ............................................................................................ 1 II. JUSTIFICACIÓN Y OBJETIVOS .................................................................... 5 II.1. Potencial introducción de mosquitos vectores no autóctonosen Territorio Nacional (TN). ................................................................................................. 7 II.2. Amenaza que suponen las enfermedades vectoriales (en especial la malaria) para los contingentes de las Fuerzas Armadas desplegados en Zona de Operaciones (ZO). Afganistán ................................................................... 8 III. REVISIÓN BIBLIOGRÁFICA ....................................................................... 11 III.1. Expansión global de los mosquitos vectores y reemergencia de las enfermedades transmitidas por ellos. ........................................................... 13 III.2. Importancia del tráfico aéreo en la introducción de vectores. ............... 18 III.3. Amenaza de las enfermedades transmitidas por vectores para los efectivos militares que despliegan en Zona de Operaciones (ZO). ............... 22 III.3.1. Enfermedades transmitidas por pulgas ........................................... 22 III.3.2. Enfermedades transmitidas por garrapatas .................................... 23 III.3.3. Enfermedades transmitidas por flebotomos .................................... 27 III.3.4. Enfermedades transmitidas por mosquitos ..................................... 28 III.3.5. Vigilancia entomológica en operaciones ......................................... 29 III.4. La malaria ............................................................................................. 30 III.4.1. El parásito ....................................................................................... 32 III.4.2. Ciclo biológico ................................................................................. 33 III.4.3. El vector .......................................................................................... 36 I INDICE III.4.3.1. Clasificación taxonómica .......................................................... 36 III.4.3.2. Breve descripción morfológica del estadio imaginal del género Anopheles .............................................................................................. 36 III.4.3.3. Capacidad y competencia vectorial ......................................... 39 III.4.3.4. Principales vectores a nivel mundial ......................................... 40 III.4.4. Determinación de la infección por Plasmodium sp. en anofelinos .. 42 III.4.4.1. Técnicas basadas en la observación microscópica del parásito en el interior del mosquito. ..................................................................... 42 III.4.4.2. Técnicas basadas en el ELISA ................................................. 44 III.4.4.3. Técnicas basadas en reacciones inmunocromatográficas con tiras de papel reactivas. .......................................................................... 45 III.4.4.4. Técnicas basadas en la Reacción en Cadena de la Polimerasa (PCR). .................................................................................................... 45 III.4.5. Importancia desde el punto de vista militar. .................................... 46 III.5. Malaria en Afganistán. .......................................................................... 47 III.5.1. Introducción. ................................................................................... 47 III.5.2. Evolución histórica de la malaria en Afganistán. ............................. 47 III.5.3. Epidemiología de la malaria en Afganistán. .................................... 49 III.5.3.1. El parásito y la distribución de la enfermedad. ......................... 50 III.5.3.2. El vector. ................................................................................... 54 III.5.4. Presencia de tropas en Afganistán. ................................................ 56 III.5.4.1. Orígenes y situación actual. ..................................................... 56 III.5.4.2. Incidencia de malaria en las tropas desplegadas. .................... 56 III.5.4.3. Medidas preventivas adoptadas. .............................................. 57 III.5.4.4. Problemas de la profilaxis ......................................................... 59 IV. MATERIAL Y MÉTODOS............................................................................ 63 IV.1. Descripción y caracterización del área de estudio. ............................... 65 IV.1.1. Territorio nacional: Base Aérea de Torrejón. .................................. 65 II INDICE IV.1.1.1. Localización y biogeografía. ..................................................... 65 IV.1.1.2. Bioclimatología. .......................................................................
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