Prevalence of mild serum vitamin B12 deficiency in rural and urban Costa Rican young adults.

OBJECTIVE: Recent studies have shown an increase of mild serum cobalamin (vitamin B12) deficiency in some Latin American countries; however, no data are available from Costa Rica. The purpose of this work was to establish the prevalence of serum vitamin B12 deficiency among Costa Rican young adults and to study some factors that may help explain the serum cobalamin concentrations. METHODS: A cross-sectional survey was conducted among 400 adults aged 20 to 40 years old from urban and rural areas of the central valley of Costa Rica to determine serum vitamin B12 levels. Additionally, cobalamin dietary intake and the detection of Helicobacter pylori IgG antibodies were studied as possible determinants of the serum vitamin B12 concentrations. RESULTS: The mean serum concentration of vitamin B12 was 268 ± 125 pmol/L, and no significant differences were found by gender or area. Study data indicate an overall prevalence of inadequate serum cobalamin levels of 42.4% (11.2% deficient and 31.2% marginal); more than 50% but less than 75% of individuals had an intake of vitamin B12 below the U.S. Estimated Average Requirement (EAR) and 61.2% had IgG antibodies to H. pylori. CONCLUSIONS: The prevalence of mild serum vitamin B12 deficiency in young Costa Rican subjects is as high as in other Latin American countries. More investigation should be done to elucidate the etiological factors that are generating deficient and marginal serum cobalamin levels in Costa Rican adults in order to define appropriate public health actions.

Comparison of mosquito control programs in seven urban sites in Africa, the Middle East, and the Americas

Mosquito control programs at seven urban sites in Kenya, Egypt, Israel, Costa Rica, and Trinidad are described and compared. Site-specific urban and disease characteristics, organizational diagrams, and strengths, weaknesses, obstacles and threats (SWOT) analysis tools are used to provide a descriptive assessment of each mosquito control program, and provide a comparison of the factors affecting mosquito abatement. The information for SWOT analysis is collected from surveys, focus-group discussions, and personal communication. SWOT analysis identified various issues affecting the efficiency and sustainability of mosquito control operations. The main outcome of our work was the description and comparison of mosquito control operations within the context of each study site's biological, social, political, management, and economic conditions. The issues identified in this study ranged from lack of inter-sector collaboration to operational issues of mosquito control efforts. A lack of sustainable funding for mosquito control was a common problem for most sites. Many unique problems were also identified, which included lack of mosquito surveillance, lack of law enforcement, and negative consequences of human behavior. Identifying common virtues and shortcomings of mosquito control operations is useful in identifying "best practices" for mosquito control operations, thus leading to better control of mosquito biting and mosquito-borne disease transmission.

Dengue in Costa Rica: the gap in local scientific research

Globalization has affected the reemergence of infectious diseases, with increased human travel and trade facilitating the introduction of diseases into new areas and the resurgence of diseases that had been eliminated in some places (1). However, the increased availability of scientific information from various research groups can help in the development of new and improved disease control measures. The combination of scientific research and reliable field assessments that consider different areas of knowledge and different geographic locations (world regions, countries, and communities) is essential for building greater understanding. This combination can also provide evidence that guides prevention and control measures at the local, national, regional, and global levels. Dengue is a reemerging and uncontrolled disease. With dengue, there is a need for more scientific research on the local factors that affect the disease system and the relationships among those factors. There is also a need to develop new or improved dengue control approaches (2). In this paper, the situation of scientific research on dengue is analyzed for the developing country of Costa Rica. Although dengue has become the most important vector-borne disease in Costa Rica over the last decade, published scientific research dealing with the local situation is scarce (3). This could be due to various factors such as the historical and political context and limited financial and human resources. Filling this gap in Costa Rica and other developing countries would benefit local control programs and help efforts around the world to develop best practices for dengue prevention and control. Making this new knowledge broadly available could help improve the global dengue situation.

A preliminary survey of antibiotic residues and viable bacteria in milk from three Caribbean Basin countries

There is widespread concern about the presence of antimicrobial drugs in milk. The presence of drug residues in milk may have public health implications. Milk samples (n = 25 to 65/country) were collected from bulk tanks and commercial vendors in Barbados, Costa Rica, and Jamaica between February 1996 and August 1997. Bulk tank samples were collected from high milk-producing regions of Jamaica and Costa Rica and from 26 dairy farms in Barbados. Milk pH, bacterial growth (total CFU/ml and the presence of Streptococcus agalactiae and Staphylococcus aureus), and the presence of antimicrobials were determined. Milk samples were tested by a microbial inhibition test (Delvotest-P, Gist-Brocades Food Ingredients, Inc.) to screen for antimicrobial drugs. All positives were retested for the presence of beta-lactam antibiotics after incubating with penicillinase and some positives were identified by high-pressure liquid chromatography-UV. Mean pH values ranged from 6.5 to 6.7. S. aureus was identified in bulk tank samples from Costa Rica (52 percent), Barbados (44 percent), and Jamaica (46 percent). S. agalactiae was identified in bulk tank samples from Barbados (8 percent) and Jamaica (10 percent) but not in samples from Costa Rica. All positives in milk from Jamaica and Barbados were determined to be beta-lactams. No residues were detected in pasteurized milk samples from Barbados or ultrahigh-temperature milk from Jamaica. The presence of beta-lactam residues in some of these samples suggests the appropriateness of testing milk prior to processing for consumption.(Au)

Adolescent sexual activity and childbearing in Latin America and the Caribbean: risks & consequences

Adolescent

A randomized double blind study of two oral contraceptives

To study the question of whether one brand of oral contraceptives may be as acceptable as another for use in publicly-assisted family planning programs, a double blind study of two well-known brands, Ovral and Norinyl, was undertaken in Costa Rica and Trinidad. The pills were randomly assigned to 1,200 women. Common side effects - nausea, dizziness, vomiting, headaches - were associated with both Norinyl and Ovral. Differences in event rates for these conditions were much more marked by country than by pill used. Ovral was associated with increases in skin problems, notably chloasma, in Costa Rica. A higher percentage of women using Norinyl reported intermentstral bleeding and spotting in both countries. In Costa Rica continuation rated for Norinyl were adversely affected by this. With these exceptions there appear to be no important differences between the brands that would affect their use in family planning programs (AU)