Population structure and reproductive cycle of the commercial sea cucumber Holothuria mexicana (Echinodermata: Holothuroidea) in Belize / Estructura de la población y ciclo reproductivo del pepino de mar comercial Holothuria mexicana (Echinodermata: Holothuroidea) en Belice

Abstract The population and reproductive biology of the commercial sea cucumber Holothuria mexicana (Ludwig, 1875) was studied in Southern Belize (Caribbean Sea), including the sex ratio, size at sexual maturity and reproductive cycle, as well as the size structure among habitats located inside and outside protected areas. Individuals found inside marine protected areas were consistently larger than individuals found outside these boundaries. The male:female sex ratio was 1.1:1.0 with a unimodal size distribution composed mainly of sexually mature individuals (87 %). Size at sexual maturity was established to be ~10 cm based on measures of gamogenetically mature individuals during the peak of the gametogenic maturity period. Juveniles and small adults measuring ≤ 15 cm (13 %), were collected exclusively in sandy and muddy areas of seagrass habitats associated with mangroves. Larger adults were commonly found on hard substrates in both seagrass-associated and coral-reef-associated habitats. Based on histology and gonad indices, the first sign of early gametogenesis was detected in August in both sexes. Gametes developed and matured throughout the colder months between November and February. Decreases in gonad index in both years suggest annual spawning, starting in MarchApril 2014 (single major event) and March-April and July-August 2015 (two smaller events) for both males and females. The spawning periods were correlated with warmer or increasing temperatures, low rainfall and increasing or high chlorophyll-a concentrations. These data will hopefully guide management and protection of the natural populations of H. mexicana, which are already suffering from overfishing in Belize and neighboring countries.(AU)

Resumen La población y la biología reproductiva de pepino de mar comercial Holothuria mexicana (Ludwig, 1875) fue estudiado en el sur de Belice (Mar Caribe), incluyendo la proporción de sexo, talla de madurez sexual y el ciclo reproductivo, así como la estructura de tamaño entre hábitats situados dentro y fuera de áreas marinas protegidas. Los individuos dentro de las áreas marinas protegidas fueron siempre mayores que los individuos encontrados fuera de estos límites. La proporcion de machos a hembras fue de 1.1:1.0, con una distribución de tamaño unimodal compuesta principalmente de individuos sexualmente maduros (87 %). La talla de madurez sexual fue ~10 cm basada en medidas de individuos con gametos maduros durante el período del pico de maduracion de gametos. Los juveniles y adultos pequeños de medidas ≤ 15 cm (13.1 %), fueron recogidos exclusivamente en zonas fangosas y arenosas en pastos marinos asociados con los manglares. Los adultos mayores se encontraban comúnmente sobre substratos duros tanto en pastos marinos asociados como en los arrecifes de coral. Basada en la histología y gónada de índices, el primer signo de la gametogénesis temprana fue detectado en Agosto en ambos sexos. Los gametos en desarrollo y maduros se encontraron durante los meses fríos entre Noviembre y Febrero. Las disminuciones en el índice gonadal en ambos años sugieren desove anual, el cual comenzó en Marzo y Abril de 2014 (único gran evento) y en Marzo-Abril y Julio-Agosto de 2015 (dos pequeños eventos) tanto para ambos sexos durante temperaturas más cálidas, escasas precipitaciones y altas concentraciones de clorofila-a. Con estos datos esperamos orientar la gestión y la protección de las poblaciones naturales de H. mexicana, que ya están sufriendo los efectos de la sobrepesca en Belice y países vecinos.(AU)

The Belize national plan of action for the prevention and control of non communicabled Diseases 2013-2023

The Belize National Plan of Actionfor the Prevention and Control of Non communicable Diseases (NCDs) 2013-2023(NCDs)aims to reduce the premature mortality caused by the four major NCDs (cardiovascular diseases, cancer, diabetes and lung disease) by 25% by 2023. This will be achieved through policy and advocacy; health promotion and risk factor reduction of the four common risk factors (tobacco, alcohol, unhealthy diet, physical inactivity); improving disease management and patient self-management; and strengthening surveillance, monitoring.

A comprehensive needs assessment to identify priority program targets for mosquito vector control and related diseases in Belmopan, Belize

This was a mixed-methods study aimed to comprehensively assess factors associated with mosquito control in Belmopan, Belize, in order to better inform stakeholders on the effectiveness of their efforts. A knowledge, attitudes, and perceptions (KAP) survey was employed within the four target communities of San Martin, Salvapan, Maya Mopan, and Las Flores. Additional epidemiological and entomological data was provided by relevant stakeholders. A total of 228 households were surveyed among the four target communities. Only 1/3 of respondents were able to demonstrate proficient knowledge. Knowledge was attained mostly through TV, Ministry of Health, hospital, and radio sources. Over 90% of respondents believed that mosquitos and the diseases they carry were a real issue for the community. Respondents living in Salvapan and Las Flores were more likely to have contracted Dengue Fever, Malaria, Chikungunya, or Zika than in other areas. Fan usage and regularly cleaning the yard were the two most employed practices for preventing mosquito bites and breeding. Approximately 85% of those surveyed viewed insecticide spraying to be effective. This assessment provides valuable insight into the needs of at- risk communities in regards to vector control. An increased focus on community outreach, education, and behavioral change can greatly impact the effectiveness of current vector control efforts. Stakeholders must work together and pool resources in order to effectively employ control interventions. Continued evaluation and community involvement is necessary to control mosquitos and prevent disease outbreaks...(AU)

Orange Walk zika classification by sex 2017

The document is a compilation of the weekly surveillance of the confirmed and suspected (clinical and test) cases of Zika in the Orange Walk district recorded by the EPI Unit of the Ministry of Health, Belize for 2017. This information is captured and reported according to sex.

A study to identify the presence of Aedes Spp. using BG-Sentinel® Traps and larval/pupal surveys in communities around Belmopan, Cayo District.

The knowledge of the presence of Aedes Spp. mosquitoes is very important for the prevention and control of emerging and remerging diseases caused by Arboviruses such as: Yellow fever, Dengue, Chikungunya and Zika. While Chikungunya and Dengue are endemic to Belize, Zika is currently a threat with local transmission having been established in several Caribbean and Central American Countries. The objective of the study is to survey the presence of Ae. aegypti and Ae. albopictus in the communities of San Martin, Salvapan and Las Flores, Belmopan City. The study was conducted from March 14 to April 2, 2016 whereby adult mosquitoes were captured using BG-Sentinel® Traps and larvae/pupae collection surveys were also done. Three hundred meter zone(s) were determined within localities and 1 BG-Sentinel® trap was deployed for 3 days at 24-hour intervals both indoors and outdoors at 2 residences randomly selected in each community. Larvae/Pupae collection surveys were done at 5 private premises within the predetermined zones in each of the three communities. Captured larvae and Pupae were reared for 6 days and adults obtained were used for identification. The identification of adult Ae. aegypti and Ae. albopictus was done using a stereoscopic microscope and pictorial keys that are used for the identification of mosquitoes. The presence of Ae. aegypti was identified in all 3 communities through both adult mosquito and larvae/pupae collections. However, Ae. albopictus was present only in San Martin and Salvapan communities. The presence of Ae. aegypti and/or Ae. albopictus will determine which appropriate vector control interventions are needed considering the different characteristic breeding habitats of these mosquitoes.(AU)

The effects of socio-economic status, dengue knowledge and perception on source reduction and protective behavior in selected marginal areas of Belmopan

Dengue, a mosquito-borne disease is a major health concern worldwide. The Belize Ministry of Health mosquito control strategies include fumigating, distributing bed nets, conducting educational campaign, among other activities. The educational campaign, specifically, aims to increase both the source reduction of mosquito breeding sites and the protective behavior against mosquito bites. To understand the relationship between educational campaign and the mosquito preventative practices, a Knowledge, Attitude, and Practice (KAP) survey was conducted in two marginal areas of Belmopan that were considered high risk areas for dengue by the Ministry of Health. The two marginal areas were selected through stratified sampling according to their socio-economic status and within each area the houses were then randomly selected and questions pertaining to their knowledge, attitude and preventative practices for dengue were asked. By analyzing the relationship between demographic background, knowledge, attitude, and practice using bivariate analysis the results demonstrated that although the knowledge of dengue did not have a significant impact on the preventative practice of individuals, their attitudes had. Forty-eight percent of individuals who were considered to have a high concern towards dengue were practicing preventative and protective measures against mosquitos. We conclude that more educational programs should focus on increasing the concern towards dengue along with awareness and encouragement of conducting mosquito source reduction.(AU)

Survey of container breeding mosquito larvae (Dengue vector) in Salvapan and Las Flores

Dengue is one of the most important vector borne diseases, with millions of cases occurring yearly and with billions found in risk areas. Eliminating water-holding containers where mosquitoes oviposit and develop can help manage urban disease-vector mosquitos. Thus, a water holding container eradication campaign was implemented by the Ministry of Health of Belize to eliminate the outburst of a dengue epidemic in known risk areas. A study was conducted in two selected communities, Salvapan and Las Flores, to determine the preferred container breeding habitat of the dengue vector and which of the site is more susceptible to a dengue epidemic. A number of households per site were randomly selected and a survey was carried out to identify water-holding containers breeding mosquito larvae and to identify the dengue vectors Aedes aegypti and Aedes albopictus. Mosquito larvae from different types of artificial and natural containers were collected and were identified using taxonomical keys. Aedes aegypti was the most abundant species in 74% of positive containers (water tanks, buckets, waste tire, etc). Culex spp. with 13%, Aedes albopictus with 12%, and Anopheles spp. with 0.48% in positive containers. The most abundant positive container was the bucket with 31% out of all positive containers. Twenty-six percent of the houses in Salvapan were positive compared to the thirty-seven percent in Las Flores. The study concluded that the dengue vector preferred breeding habitat was the bucket and that Las Flores is more prone to a dengue epidemic than Salvapan.(AU)

Belize zika classification by epidemiological week 2016

This report represents a compilation of 2016 statistics based on 52 weeks of epidemiologic surveillance of the Zika virus disease by the EPI Unit, Ministry of Health, Belize. Four tables with corresponding graphs provide a breakdown of the confirmed, suspected (clinical), and suspected (by test)) cases of zika according to epidemiological week, community within the Belize district, age group and sex. The incidence of Zika virus disease was presented for each of the 24 communities that comprise the Belize district as well as for one unknown location within that district. The grand total of Zika virus cases in Belize for 2016 was 349.

New leafhopper species of Jikradia from Mesoamerica with new records, revised key to species, distribution, origin, and checklist (Hemiptera: Cicadellidae: Coelidiinae: Teruliini)

The following four new species of leafhoppers are described and illustrated: Jikradia dentata n. sp. and J. trispinata n. sp. from Guatemala, J. variabilis n. sp. from Belize, and J. exilis n. sp. from Costa Rica. Jikradia basipendula Nielson and J. krameri Nielson are new records for Guatemala. Belize is a new record for the genus. A record of the first introduction of the genus in the Old World is reviewed. A revised key to the known species is provided with a review of its possible origin. A checklist of all known species is also given. Rev. Biol. Trop. 62 (4): 1375-1383. Epub 2014 December 01.

Las siguientes cuatro nuevas especies de chicharritas son descritas e ilustradas: Jikradia dentata n. sp. y J. trispinata n. sp. de Guatemala, J. variabilis n. sp. de Belice, y J. exilis n. sp. de Costa Rica. Jikradia basipendula Nielson y J. krameri Nielson son nuevas especies reportadas para Guatemala. El género Jikradia es un nuevo registro para Belice. Un registro de la primera introducción del género en el Viejo Continente es revisado. Se presenta una clave revisada de las nuevas especies con una revisión de su posible origen. También se presenta una lista revisada de todas las especies conocidas.

Capacity building and policy development in Belize marine protected areas, an example for Caribbean integrated coastal management / Desarrollo de capacidades y desarrollo de políticas en áreas marinas protegidas de Belice, un ejemplo para la gestión integrada de la costa del Caribe

Sustainability science can, through capacity building, allow for integrated stakeholder management of the vital Caribbean marine ecosystems. We did a capacity building exercise in two major coral reef areas in Southern Belize. The key outcome was a six-month personal/professional action plan developed by each participant about tactics for leading, educating and supporting issues regarding sustainable development and tactics for collaboration to influence policy decisions. Our results can be applied across the Caribbean. Rev. Biol. Trop. 62 (Suppl. 3): 287-291. Epub 2014 September 01.

La ciencia de la sostenibilidad puede, a través del desarrollo de capacidades, permitir la gestión integrada de los actores interesados en estos ecosistemas marinos vitales del Caribe. Realizamos un ejercicio de desarrollo de capacidades en dos importantes arrecifes de coral al sur de Belice. El resultado clave fue el desarrollo de un plan de acción personal/profesional de seis meses para cada participante sobre técnicas para liderar, educar y apoyar los problemas acerca del desarrollo sostenible y técnicas para influir en decisiones políticas. Nuestros resultados se pueden ejecutar a lo largo de todo el Caribe.

Instrument N° 2. HRH Program Evaluation Questionnaire: Expanded version

This instrument serves as the core document for evaluation and description of the HRH program selected. In order to complete the information requested, use the documents, reports, evaluations, budgets and HRH data available for program evaluation. Attached is a sample (fictional) of a rural health physician program from Canada. This document should be completed by the Director of HRH or the equivalent person in the Health Authority who has access to national information and is in consultation with the national institutions. (AU)

Dietary habits of juveniles of the Mayan cichlid, Cichlasoma urophthalmus, in mangrove ponds of an offshore islet in Belize, Central America

Foraging habitats of juveniles of the Mayan cichlid, Cichlasoma urophthalmus (Günther, 1862), were investigated in two mangrove ponds located in Twin Cays offshore islet in Belize: Sink Hole pond (SH) and Hidden Lake pond (HL). Sink Hole pond is a semiclosed body of water, whereas Hidden Lake pond is connected by a channel to adjacent seagrass beds that surround the islet. Gut contents of 21 juvenile C. urophthalmus (9.8-13.2 cm total length) were analyzed, and five prey taxa were identified. In both mangrove ponds, C. urophthalmus were opportunistic carnivores and consumed primarily crustaceans. Plant material and detritus present in gut contents were most likely ingested incidentally when the fish foraged on small invertebrates. Carbon isotopic values of fish specimens from the two ponds were similar (mean ± SD of -19.2 ± 0.4‰ in SH and -19.4 ± 0.4‰ in HL), and were close to those of mangrove prey (mean ± SD = -20.2 ± 1.5‰), suggesting that this fish species forages in this habitat. Mixing models showed a higher contribution of mangrove food sources to the fish diet than seagrass food sources. This study reveals that young Mayan cichlids, inhabiting two Belize mangrove ponds, are generalists and opportunistic carnivores that forage on mangrove food sources and do not appear to move to adjacent seagrass beds to complement their diets. Understanding trophic linkages between aquatic consumers and food resources may contribute to better management of threatened coastal ecosystems.

Habitats de alimentação de juvenis do ciclídeo-maia, Cichlasoma urophthalmus (Günther, 1862), foram investigados em duas lagoas de mangue localizadas nas ilhas Twin Cays em alto mar em Belize: Sink Hole Lake (SH) e Hidden Lake (HL). Sink Hole é um corpo d'água parcialmente isolado, enquanto Hidden Lake é ligada por um canal com bancos de sargaços que cercam a ilhota. O conteúdo estomacal de 21 juvenil de C. urophthalmus (9,8-13,2 cm de comprimento total) foram analisados e cinco táxons de presas foram identificados. Em ambas as lagoas de mangue, 'C.' urophthalmus foram carnívoros oportunistas e consumiram principalmente crustáceos. Material vegetal e detritos presentes no conteúdo digestivo foram provavelmente ingeridos acidentalmente quando o peixe se alimentava de pequenos invertebrados. Os valores de isótopos estáveis do carbono em espécimes de peixes das duas lagoas foram semelhantes (média ± SD -19,2 ± 0,4 ‰ em SH e -19,4 ± 0,4 ‰ em HL), e foram próximos aos de presas de mangue (mean ± SD = -20.2 ± 1.5 ‰), sugerindo que esta espécie de peixe vai à procura de alimentos neste habitat. Modelos mistos mostraram uma maior contribuição de fontes alimentares de mangue para a dieta dos peixes do que de fontes alimentares de algas marinhas. Este estudo revela que juvenis do ciclídeo-maia que habitam duas lagoas de mangue em Belize, são carnívoros generalistas e oportunistas que se ingerem alimentos dos manguezais e não parecem se mover para leitos de algas marinhas adjacentes para complementar suas dietas. Compreender as ligações tróficas entre consumidores aquáticos e recursos alimentares pode contribuir para uma melhor gestão dos ecossistemas costeiros ameaçados.

Mental health policy and service system development in the English-speaking Caribbean / Políticas para la salud mental y desarrollo de sistemas de servicio en el Caribe anglófono

The countries and territories comprising the English-speaking Caribbean (ESC) have made some strides in the development of mental health policy, services and systems with the expenditure in mental health as a percentage of health budgets ranging from 1% to 7%. The ESC countries have well developed primary healthcare systems. However, mental health legislations in many countries are in need of reform. Some countries have developed an innovative community based, secondary care treatment model: treatment in the medical wards of general hospitals. These countries have made progress in integrating mental health into primary healthcare and have made psychotropic medication widely available at the primary care level. Notwithstanding the progress in some countries, greater effort is required in phasing out mental hospitals and integrating mental health into primary care in other ESC countries.

Los países y territorios que comprenden el Caribe Anglófono (CAF) han dado pasos extraordinarios en relación con el desarrollo de políticas, servicios y sistemas de salud mental, de modo tal que los gastos en salud mental en término del porcentaje de presupuestos de salud fluctúan entre el 1% y el 7%. Los países del CAF poseen sistemas de atención primaria de la salud bien desarrollados. Sin embargo, las legislaciones con respecto a la salud mental en muchos países necesitan reformas. Algunos países han desarrollado un modelo innovador comunitario para tratamientos de atención secundaria: tratamiento en las salas de los hospitales generales. Estos países han tenido progresos en cuanto a integrar la salud mental a la atención primaria de la salud, y han puesto la medicación psicotrópica ampliamente a la disposición del nivel de atención primaria. A pesar del progreso en algunos países, se requiere un mayor esfuerzo en cuanto a reducir gradualmente los hospitales psiquiátricos y acelerar la integración de la atención a la salud mental con la atención primaria en otros países anglófonos.

Distribution of some Calanoida (Crustacea: Copepoda) from the Yucatán Peninsula, Belize and Guatemala

Southern Mexico and Central America have many water bodies of different morphology and water chemistry with an interesting zooplankton fauna, originating from North or South America. A set of 63 samples, taken in 2005 and 2008, from water bodies of the Yucatan Peninsula karst, Belize and Guatemala, were studied for the content of calanoid copepods. Old and recent literature was used to determine animals to species level. Drawings were prepared with a microscope and a camera lucida. A total of 32 samples with totally six species contained calanoid copepods: one estuarine pseudodiaptomid and five freshwater diaptomids. Pseudodiaptomus marshi was found at different salinities. It is confirmed that the commonest diaptomids in the Yucatan Peninsula are Arctodiaptomus dorsalis and Mastigodiaptomus nesus. The former was also recorded from Lake Amatitlan. Mastigodiaptomus nesus is as widespread as A. dorsalis but it is absent from the Lake Peten area in Guatemala. Mastigodiaptomus reidae was found in two shallow habitats, these specimens differ from those from the type locality by having a set of peculiar large spine-like processes on the last thoracic and the urosome segments of the females. Leptodiaptomus siciloides was found only in Lake Ayarza with high salinity. Prionodiaptomus colombiensis occurred in the highlands of Guatemala in Lago de Güija and in the Peten area in Laguna Sacpuy. We contributed with our occurrence records to a better knowledge of the geographic distribution of some calanoid copepods. Morphological findings in some species are of value for taxonomic differentiation between species.

El sur de México y América Central tienen varios cuerpos de agua con diferente morfología, composición química y una interesante fauna de zooplancton procedente de América del Norte o del Sur. Un grupo de 63 muestras, fueron tomadas en 2005 y 2008 para conocer la cantidad de copépodos calanoides en los cuerpos de agua del karst Península de Yucatán, Belice y Guatemala. Se utilizó literatura antigua y reciente para la identificación de los especímenes a nivel de especie y se preparon dibujos con un microscopio y una cámara lúcida. En un total de 32 muestras se obtuvieron seis especies de copépodos calanoides: un pseudodiaptomidos estuarino y cinco diaptomidos de agua dulce. Pseudodiaptomus marshi fue encontrado a diferentes salinidades. Además, se confirmó que los diaptomidos más comunes en la Península de Yucatán fueron: Arctodiaptomus dorsalis y Mastigodiaptomus nesus. El primero se registró también en el lago de Amatitlán. Mastigodiaptomus nesus está ampliamente distribuido al igual que A. dorsalis, pero se encuentra ausente en el área del Lago Petén en Guatemala. Mastigodiaptomus reidae fue localizado en dos hábitats poco profundos, éstos especímenes difieren de los tipos de la localidad, por tener un grupo de espinas de gran tamaño en la última parte de la caja toráxica y los segmentos del urosoma de las hembras. Leptodiaptomus siciloides se encontró sólo en el Lago Ayarza, el cual contiene alta salinidad. Prionodiaptomus colombiensis se localizó en las tierras altas de Guatemala en el Lago de Güija y en la zona del Petén en Laguna Sacpuy. Se contribuye con registros de presencia de especies para un mejor conocimiento de la distribución geográfica de algunos copépodos calanoides. De la misma forma, los hallazgos morfológicos en algunas especies son de gran valor taxonómico para la diferenciación de especies.

Dengue tests done by epi week & district 2011

This document is a compilation of the dengue tests done by and recorded by the EPI Unit of the Ministry of Health, Belize for 2011. This information has been captured, collated and reported according to district, sex and age group.

Economic impact of fatal and nonfatal road traffic injuries in Belize in 2007 / Repercusiones económicas de los traumatismos mortales y no mortales por accidentes de tránsito en Belice en 2007

OBJECTIVE: To estimate the economic cost of road traffic injuries in Belize in 2007. METHODS: A cross-sectional study was conducted using secondary cost data, assuming the health system and social perspectives. Epidemiologic information was obtained from the mortality database, the national hospital discharge database, and administrative records from police and the Ministry of Health. A health provider survey was carried out in order to estimate the postdischarge ambulatory utilization figures. Direct cost was estimated with the World Health Organization WHO-CHOICE (CHOosing Interventions that are Cost Effective) database. Prehospital costs were obtained from the Belize emergency response team. After estimating years of potential life lost using the Belize life expectancy for 2008 and methodology proposed by the Pan American Health Organization, the indirect cost associated with premature death was estimated with the human capital approach. Total estimation of road traffic injuries' economic costs used a decision tree model approach. Multiway sensitivity analysis was used to incorporate uncertainty in the estimations. RESULTS: Sixty-one people died due to road traffic injuries during 2007, 338 were hospitalized, and 565 people were estimated to be slightly injured. A total of 2 501 years of potential life were lost in Belize due to premature death, with a total economic cost of US$11-062-544. This figure represents 0.9 percent of the Belize gross domestic product. Direct cost was estimated at US$163-503, of which 2.4 percent was spent on fatalities, 46.7 percent on the severely injured, and 50.9 percent on the slightly injured. CONCLUSIONS: The economic cost estimations make clear the need to prevent road traffic injuries with a strategic and multisectoral approach that focuses on addressing the main problems identified.

OBJETIVO: Calcular el costo económico de los traumatismos por accidentes de tránsito registrados en Belice durante el año 2007. MÉTODOS. Se realizó un estudio transversal a partir de datos secundarios sobre los costos, tanto desde la perspectiva social como desde la del sistema de salud. La información epidemiológica se obtuvo a partir de la base de datos de mortalidad, la base de datos nacional de egresos hospitalarios y los expedientes administrativos de la policía y el Ministerio de Salud. Se llevó a cabo una encuesta a los prestadores de servicios de salud para calcular las cifras correspondientes a la atención ambulatoria posterior al egreso. Para calcular los costos directos, se utilizó la base de datos del proyecto WHO-CHOICE (elección de intervenciones eficaces en función de los costos) de la Organización Mundial de la Salud. El equipo de respuesta a las urgencias médicas de Belice aportó los datos sobre los costos prehospitalarios. Después de calcular los años de vida potencial perdidos tomando como parámetro la esperanza de vida de Belice correspondiente al año 2008 y empleando el método propuesto por la Organización Panamericana de la Salud, se calculó el costo indirecto asociado a la muerte prematura desde el enfoque del capital humano. Se utilizó un modelo de árbol de decisiones para calcular el costo económico total derivado de los traumatismos causados por el tránsito y se hizo un análisis de sensibilidad multivariado y probabilístico para incorporar los parámetros de incertidumbre en las estimaciones. RESULTADOS: En Belice, durante el año 2007, los traumatismos causados por el tránsito provocaron la muerte de 61 personas, la hospitalización de 338 y, según se calcula, lesiones menores a 565. Se perdieron 2 501 años de vida potencial a causa de las muertes prematuras, lo que se tradujo en un costo económico total de US$11 062 544. Esta cifra representa 0,9 por ciento del producto interno bruto de Belice. Se calculó que el costo directo fue de US$ 163 503, del cual 2,4 por ciento fue ocasionado por las muertes, 46,7 por ciento por la atención de las personas que sufrieron traumatismos graves y 50,9 por ciento por la atención de quienes presentaron lesiones menores. CONCLUSIONES: El costo económico calculado en este estudio pone de manifiesto la necesidad de prevenir los traumatismos causados por el tránsito adoptando un método estratégico y multisectorial que se centre en abordar los principales problemas detectados.

Desarrollo de recursos humanos en la agenda de integración centroamericana / Development of human resources in the Central American integration agenda

La gestión de políticas de Recursos Humanos en Salud es factor fundamental para garantizar la operación efectiva de los sistemas de salud en los países. El objeto de la política en este campo es modular los procesos de educación y el trabajo en salud, de manera tal que se consiga adecuar y mantener una fuerza de trabajo en salud suficiente, competente, comprometida y valorada por las redes de salud en los países. El presente documento recoge la discusión y propuesta de trabajo del equipo de Directores Nacionales de RHUS de los países centroamericanos y Republica Dominicana, los consultores de la OPS en dichos países y el equipo de coordinación en OPS ELS responsable de la cooperación técnica en RHUS de la región.(AU)