ABSTRACT
This study focused on pilgrimages as part of religious tourism and aimed to achieve the following objectives: identify the main motivational factors of religious tourism focused on pilgrimages; analyze the motivational dimensions that predict satisfaction in religious tourism focused on pilgrimages; analyze the motivational dimensions that predict loyalty in religious tourism focused on pilgrimages. The study was conducted during the pilgrimage to the Virgin of Chaguaya in Bolivia. The sample consisted of 384 tourists who were surveyed on-site. The statistical techniques used included factor analysis and multiple regression. The results revealed four motivational dimensions: Tourism and Escape, Religious Experience, Belief Experience, and Shopping. Additionally, specific motivations that influence the satisfaction and loyalty of attendees at religious events such as pilgrimages have been identified, among them the "Religious Experience" and the "Belief Experience" motivational dimensions. The findings will contribute to planning and management guidelines for religious event administrators and provide information to academic literature.
Subject(s)
Motivation , Tourism , Humans , Bolivia , Female , Male , Adult , Religion , Personal Satisfaction , Middle Aged , Young Adult , Surveys and QuestionnairesABSTRACT
Introduction. Asthma is a chronic disease affecting millions of people around the world. Air quality is a major factor in triggering asthma symptoms. Objective. To analyze air quality and asthma in high-altitude residents of La Paz, Bolivia. Materials and methods. In this analytical, descriptive, and retrospective study, we collected data from patients diagnosed with asthma at the Instituto Nacional del Tórax and the Instituto Boliviano de Biología de Altura. In addition, air quality monitoring of particulate matter was carried out at the stations of the Red de Monitoreo de la Calidad del Aire. Results. Women represented 56.9% of cases at the Instituto Nacional del Tórax and the Instituto Boliviano de Biología de Altura. In both institutions, the average age was 47 years and patients were overweight or obese. Increases in PM2.5 were recorded in autumn, winter and spring from 2014, 2016 to 2019 and 2015 in all four seasons. PM10 showed increases in autumn and winter from 2014 to 2020 within the established limits. We observed a positive and significant association between PM2,5 concentration and the spirometry parameters of forced vital capacity, peak expiratory flow, and "reversibility percentage" or "bronchodilator response percentage". The association of PM10 and forced vital capacity, forced expiratory volume in the first second, and peak expiratory flow, was also statistically significant. Conclusion. Asthma cases occur on average at 47 years of age in overweight or obese people. We observed a positive association between particles PM2,5 and PM10 with spirometric parameters, stronger with particulate matter PM2,5.
Introducción. El asma es una enfermedad crónica que afecta a millones de personas en todo el mundo. La calidad del aire es uno de los factores clave que puede desencadenar los síntomas del asma. Objetivo. Analizar la calidad del aire y su relación con el asma en habitantes de grandes altitudes en La Paz (Bolivia). Materiales y métodos. Se desarrolló un estudio analítico, descriptivo y retrospectivo. Se recolectaron datos de pacientes con diagnóstico de asma en el Instituto Nacional del Tórax y en el Instituto Boliviano de Biología de Altura. Además, se monitoreó la calidad del aire y su material particulado en las estaciones de la "Red de monitoreo de la calidad del aire". Resultados. El 56,9 % de los casos fueron mujeres del Instituto Nacional del Tórax y el 45,7 % del Instituto Boliviano de Biología de Altura. En ambas instituciones, la media de edad fue de 47 años y los pacientes presentaban sobrepeso u obesidad. Se registraron incrementos de material particulado fino (PM2,5) en otoño, invierno y primavera, en 2014, 2016-2019 y en las cuatro estaciones del 2015. El material particulado inhalable grueso (PM10) se incrementó en otoño e invierno del 2014 al 2020, dentro de los límites establecidos. Se observó una asociación positiva y significativa entre la concentración de material particulado PM2,5 y los parámetros espirométricos de capacidad vital forzada, flujo espiratorio máximo y el porcentaje de reversión. La relación de partículas PM10 y los parámetros espirométricos de capacidad vital forzada, volumen espiratorio máximo en el primer segundo y flujo espiratorio máximo, también fue estadísticamente significativa. Conclusión. Los casos de asma se presentaron en promedio a los 47 años y en personas con sobrepeso u obesidad. Se observó una asociación positiva entre el material particulado, PM2,5 y PM10, con los parámetros espirométricos, la cual fue más marcada con las partículas PM2,5.
Subject(s)
Air Pollution , Altitude , Asthma , Particulate Matter , Humans , Asthma/epidemiology , Bolivia/epidemiology , Middle Aged , Female , Retrospective Studies , Particulate Matter/analysis , Particulate Matter/adverse effects , Male , Adult , Air Pollution/analysis , Air Pollution/adverse effects , Seasons , AgedABSTRACT
The study focuses on identifying and understanding the ecological dynamics of Triatoma breyeri in Bolivia. Morphological identification and molecular analysis using gene fragments (COI, CytB and 16S) confirms T. breyeri's presence and its relation to other species. The species has been consistently found in the Estancia-Mataral-La Palma region since 2010 but has not spread to other regions in Bolivia. The region of occurrence is a small characteristic dry inter-Andean valley. A MaxEnt model suggests part of the Bolivian Montane Dry Forest ecoregion serves as a unique habitat within its range. The infrequent presence in Bolivia and the distance from its main range in Argentina suggest recent accidental introduction, possibly through human transport. Further research is needed to comprehend its persistence in this small area of Bolivia.
Subject(s)
Triatoma , Animals , Bolivia , Triatoma/genetics , Triatoma/physiology , Ecosystem , PhylogenyABSTRACT
BACKGROUND: The COVID-19 pandemic prompted varied policy responses globally, with Latin America facing unique challenges. A detailed examination of these policies' impacts on health systems is crucial, particularly in Bolivia, where information about policy implementation and outcomes is limited. OBJECTIVE: To describe the COVID-19 testing trends and evaluate the effects of quarantine measures on these trends in Cochabamba, Bolivia. METHODS: Utilizing COVID-19 testing data from the Cochabamba Department Health Service for the 2020-2022 period. Stratified testing rates in the health system sectors were first estimated followed by an interrupted time series analysis using a quasi-Poisson regression model for assessing the quarantine effects on the mitigation of cases during surge periods. RESULTS: The public sector reported the larger percentage of tests (65%), followed by the private sector (23%) with almost double as many tests as the public-social security sector (11%). In the time series analysis, a correlation between the implementation of quarantine policies and a decrease in the slope of positive rates of COVID-19 cases was observed compared to periods without or with reduced quarantine policies. CONCLUSION: This research underscores the local health system disparities and the effectiveness of stringent quarantine measures in curbing COVID-19 transmission in the Cochabamba region. The findings stress the importance of the measures' intensity and duration, providing valuable lessons for Bolivia and beyond. As the global community learns from the pandemic, these insights are critical for shaping resilient and effective health policy responses.
Main findings: The findings highlight the importance of stringent quarantine measures in managing infectious disease outbreaks, offering valuable insights for policymakers worldwide in strategizing effective public health interventions.Added knowledge: By providing a detailed analysis of testing disparities and quarantine policies' effectiveness within a specific Latin American context, our research fills a critical gap in understanding their impacts on health system responses and disease control.Global health impact for policy and action: The findings highlight the importance of stringent quarantine measures in managing infectious disease outbreaks, offering valuable insights for policymakers worldwide in strategizing effective public health interventions.
Subject(s)
COVID-19 , Interrupted Time Series Analysis , Quarantine , SARS-CoV-2 , Humans , COVID-19/prevention & control , COVID-19/epidemiology , Bolivia/epidemiology , Health Policy , COVID-19 Testing/statistics & numerical data , Pandemics/prevention & controlABSTRACT
Charcoal fragments preserved in soils or sediments are used by scientists to reconstruct fire histories and thereby improve our understanding of past vegetation dynamics and human-plant relationships. Unfortunately, most published methods for charcoal extraction and analysis are incompletely described and are therefore difficult to reproduce. To improve the standardization and replicability of soil charcoal analysis, as well as to facilitate accessibility for non-experts, we developed a detailed, step-by-step protocol to isolate charcoal from soil and to efficiently count and measure charcoal fragments. The extraction phase involves the chemical soaking and wet sieving of soils followed by the collection of macrocharcoal (≥500 µm). The analysis phase is performed semi-automatically using the open-source software ImageJ to count and measure the area, length, and width of fragments from light stereo microscope images by means of threshold segmentation. The protocol yields clean charcoal fragments, a set of charcoal images, and datasets containing total charcoal mass, number of fragments, and morphological measurements (area, length, and width) for each sample. We tested and validated the protocol on 339 soil samples from tropical savannas and forests in eastern lowland Bolivia. We hope that this protocol will be a valuable resource for scientists in a variety of fields who currently study, or wish to study, macroscopic charcoal in soils as a proxy for past fires.
Subject(s)
Charcoal , Soil , Charcoal/chemistry , Soil/chemistry , Bolivia , Reproducibility of Results , HumansABSTRACT
BACKGROUND: Community engagement is recognized as a vital component of health-related research and programs, particularly during infectious disease outbreaks and epidemics. Despite the importance of engaging communities in the response to COVID-19, relatively little research has examined how this was (or was not) achieved, and even less in low- and middle-income countries. This article describes the community engagement that accompanied efforts to strengthen COVID-19 diagnosis and treatment as part of the ECO Project in Cochabamba, Bolivia and highlights lessons for future pandemic response. METHODS: Community engagement involved formative assessment, co-creation to develop a health information campaign, ongoing community listening and evaluation. Qualitative data were collected during workshops, project meetings and focus groups. Questionnaire-based surveys were conducted to assess COVID-19-related attitudes, knowledge and practices. RESULTS: The collected data highlighted the value of working closely with well-established community health committees and involving community members with social media skills in the design of COVID-19-related messages to address on- and offline misinformation. Co-creation sessions enabled the adjustment of the information campaign in terms of content and approach based on the needs and preferences of community members and health staff. The continuous listening with community and health personnel facilitated the ongoing adaptation of project activities. CONCLUSION: Through a stepped and multi-pronged approach, incorporating co-creation and community listening, the engagement could respond to emerging local challenges during the pandemic. The project created spaces for dialogue and opportunities for collaboration that strengthened links between the community and the health services.
Main findings Key elements of community engagement to improve COVID-19 diagnosis and treatment in Cochabamba, Bolivia, included working closely with well-established community health committees, involving community members with social media skills in the co-design of COVID-19-related messages, and continuous listening with community and health personnel facilitated the ongoing adaptation of project activities.Added knowledge With little research on community engagement for COVID-19 diagnosis and treatment in Latin America, this study reports the results of mixed methods research on the impact of a comprehensive approach to engagement that highlights lessons for future health emergencies.Global health impact for policy and action Lessons for engagement in health emergencies include the need for a multi-pronged approach, incorporating co-creation and community listening, to respond to emerging local challenges.
Subject(s)
COVID-19 , Community Participation , Humans , Bolivia , COVID-19/epidemiology , COVID-19/diagnosis , COVID-19/therapy , Community Participation/methods , SARS-CoV-2 , Health Knowledge, Attitudes, Practice , Surveys and Questionnaires , MaleABSTRACT
The Tropical Andes, one of the world's most biodiverse regions, is vital for ecological research and conservation. However, while researchers in Bolivia, Ecuador, and Peru contribute significantly to scientific knowledge, their publication rates in academic journals have historically lagged behind neighboring nations. A multifaceted strategy was employed to understand and address the publication divide in the Tropical Andes region. This approach focused on regional researchers and consisted of a three-day workshop to improve scientific writing skills, offer publication insights, and equip researchers with tools to overcome obstacles. A series of surveys were also conducted to explore the challenges faced by local researchers and their proposed solutions, covering topics such as participant demographics, factors contributing to lower publication rates, personal barriers, proposed strategies for improving publications, specific topics of interest, participant satisfaction, most valuable workshop topics, and future recommendations. The workshop had an overwhelming response, with over 500 interested participants registering in just a few days, mostly experienced professionals, highlighting the need for such initiatives in the region. About two-thirds had ready-to-publish materials, highlighting the potential impact of targeted interventions on unlocking untapped knowledge. The surveys revealed the challenges contributing to the publication divide, including insufficient training, cultural emphasis on economic development, language barriers, limited resource access, lack of institutional support, high publishing costs, and time and financial constraints. The most common personal barriers were insufficient knowledge and experience in the publication process, lack of self-confidence, and fears of rejection. Proposed solutions include conducting training workshops, fostering collaborative networks, improving resource accessibility, and an institutional and cultural shift that encourages publishing. Addressing challenges faced by experienced professionals in the Tropical Andes by understanding individual needs, fostering support, and demystifying the publication process offers a promising path to closing the publication divide and unlocking the region's valuable scientific contributions.
Subject(s)
Research Personnel , Humans , Research Personnel/psychology , Peru , Bolivia , Ecuador , Publications/statistics & numerical data , PublishingABSTRACT
OBJECTIVE: The current pediatric neurosurgery capacity in lower-middle-income countries (LMICs) in South America is poorly understood. Correspondingly, the authors sought to interrogate the neurosurgical inpatient experience of the sole publicly funded pediatric hospital in one of the largest regional departments of Bolivia to better understand this capacity. METHODS: A retrospective review of all neurosurgical procedures performed at the Children's Hospital of La Paz, Bolivia (Hospital del Niño "Dr. Ovidio Aliaga Uria") between 2019 and 2023 was conducted after institutional approval using a recently implemented national electronic medical record system. RESULTS: A total of 475 neurosurgical admissions satisfied inclusion for analysis over the 5-year span. The majority of admissions were from within the La Paz Department (87%) via the emergency department (77%), without private insurance (83%). The most common indications for neurosurgical intervention were trauma (35%), followed by hydrocephalus (28%), congenital disease (12%), infection (5%), and craniosynostosis (3%). Overall, the median age at time of surgery was 2.0 years, and the median operating time was 1.5 hours with a minority of intraoperative complications (2%). The most common inpatient complication was unplanned return to the operating room (19%), most commonly seen in congenital indications. At final discharge, the median postoperative length of stay was 10 days. Twenty-seven (6%) of the 475 patients died during hospitalization, most commonly seen in tumor indications. Of the 448 patients who were discharged, 299 (67%) returned for at least one follow-up appointment. CONCLUSIONS: There is restricted breadth in neurosurgical indications and outcomes achievable at the Children's Hospital of La Paz, Bolivia. As such, the capacity of pediatric neurosurgery at institutions in LMICs in South America such as this one is very limited. Identifying and prioritizing actionable interventions to improve this capacity is institution- and LMIC-dependent, and as such, future efforts will need to be tailored appropriately.
Subject(s)
Neurosurgical Procedures , Humans , Bolivia , Child, Preschool , Retrospective Studies , Male , Female , Infant , Neurosurgical Procedures/statistics & numerical data , Child , Neurosurgery , Developing Countries , Adolescent , Postoperative Complications/epidemiology , Hospitals, Pediatric , Infant, NewbornABSTRACT
The conservation of animal genetic resources refers to measures taken to prevent the loss of genetic diversity in livestock populations, including the protection of breeds from extinction. Creole cattle populations have suffered a drastic reduction in recent decades owing to absorbent crosses or replacement with commercial breeds of European or Indian origin. Genetic characterization can serve as a source of information for conservation strategies to maintain genetic variation. The objective of this work was to evaluate the levels of inbreeding and kinship through the use of genomic information. A total of 903 DNAs from 13 cattle populations from Argentina, Bolivia and Uruguay were genotyped using an SNP panel of 48 K. Also, a dataset of 76 K SNPs from Peruvian Creole was included. Two inbreeding indices (FROH and Fhat2) and kinship relationships were calculated. In addition, effective population size (Ne), linkage disequilibrium, population composition and phylogenetic relationships were estimated. In Creole cattle, FROH ranged from 0.14 to 0.03, and Fhat2 was close to zero. The inferred Ne trends exhibited a decline toward the present for all populations, whereas Creole cattle presented a lower magnitude of Ne than foreign breeds. Cluster analysis clearly differentiated the taurine and Zebu components (K2) and showed that Bolivian Creole cattle presented Zebu gene introgression. Despite the population reduction, Creole populations did not present extreme values of consanguinity and kinship and maintain high levels of genetic diversity. The information obtained in this work may be useful for planning conservation programmes for these valuable local animal genetic resources.
Subject(s)
Inbreeding , Polymorphism, Single Nucleotide , Animals , Cattle/genetics , Uruguay , Bolivia , Breeding , Linkage Disequilibrium , Phylogeny , Genotype , Argentina , Pedigree , Genetic Variation , Genetics, Population , Population DensityABSTRACT
COVID-19 affects children less seriously than adults; however, severe cases and deaths are documented. This study objective is to determine socio-demographic, clinical and laboratory indicators associated with severe pediatric COVID-19 and mortality at hospital entrance. A multicenter, retrospective, cross-sectional study was performed in 13 tertiary hospitals in Bolivia. Clinical records were collected retrospectively from patients less than 18 years of age and positive for SARS-CoV-2 infection. All variables were measured at hospital entrance; outcomes of interest were ICU admission and death. A score for disease severity was developed using a logistic regression model. 209 patients were included in the analysis. By the end of the study, 43 (20.6%) of children were admitted to the Intensive care unit (ICU), and 17 (8.1%) died. Five indicators were independently predictive of COVID-19 severity: age below 10 years OR: 3.3 (CI95%: 1.1-10.4), days with symptoms to medical care OR: 2.8 (CI95%: 1.2-6.5), breathing difficulty OR: 3.4 (CI95%: 1.4-8.2), vomiting OR: 3.3 (CI95%: 1.4-7.4), cutaneous lesions OR: 5.6 (CI95%: 1.9-16.6). Presence of three or more of these risk factors at hospital entrance predicted severe disease in COVID-19 positive children. Age, presence of underlying illness, male sex, breathing difficulty, and dehydration were predictive of death in COVID-19 children. Our study identifies several predictors of severe pediatric COVID-19 and death. Incorporating these predictors, we developed a tool that clinicians can use to identify children at high risk of severe COVID-19 in limited-resource settings.
Subject(s)
COVID-19 , SARS-CoV-2 , Severity of Illness Index , Humans , COVID-19/mortality , COVID-19/epidemiology , COVID-19/diagnosis , Child , Male , Female , Child, Preschool , Adolescent , Retrospective Studies , Cross-Sectional Studies , Infant , SARS-CoV-2/isolation & purification , Bolivia/epidemiology , Hospitalization , Intensive Care Units/statistics & numerical data , Risk Factors , Sociodemographic FactorsABSTRACT
Chagas disease is caused by the protozoan parasite Trypanosoma cruzi (Chagas, 1909). One of the primary vectors of T. cruzi in South America is Triatoma infestans (Klug, 1834). This triatomine species is distributed across a huge latitudinal gradient, inhabiting domiciliary , peridomiciliary , and wild environments. Its wide geographic distribution provides an excellent opportunity to study the relationships between environmental gradients and intraspecific morphological variation. In this study, we investigated variations in wing size and shape in T. infestans across six ecoregions. We aimed to address the following questions: How do wing size and shape vary on a regional scale, does morphological variation follow specific patterns along an environmental or latitudinal gradient, and what environmental factors might contribute to wing variation? Geometric morphometric methods were applied to the wings of 162 females belonging to 21 T. infestans populations, 13 from Argentina (n = 105), 5 from Bolivia (n = 42), and 3 from Paraguay (n = 15). A comparison of wing centroid size across the 21 populations showed significant differences. Canonical Variate Analysis (CVA) revealed significant differences in wing shape between the populations from Argentina, Bolivia, and Paraguay, although there was a considerable overlap, especially among the Argentinian populations. Well-structured populations were observed for the Bolivian and Paraguayan groups. Two analyses were performed to assess the association between wing size and shape, geographic and climatic variables: multiple linear regression analysis (MRA) for size and Partial Least Squares (PLS) regression for shape. The MRA showed a significant general model fit. Six temperature-related variables, one precipitation-related variable, and the latitude showed significant associations with wing size. The PLS analysis revealed a significant correlation between wing shape with latitude, longitude, temperature-related, and rainfall-related variables. Wing size and shape in T. infestans populations varied across geographic distribution. Our findings demonstrate that geographic and climatic variables significantly influence T. infestans wing morphology.
Subject(s)
Triatoma , Wings, Animal , Animals , Triatoma/anatomy & histology , Triatoma/physiology , Triatoma/growth & development , Triatoma/classification , Wings, Animal/anatomy & histology , Female , Argentina , Bolivia , Paraguay , Chagas Disease/transmissionABSTRACT
Exposure to particulate matter (PM) pollution is a significant health risk, driving the search for innovative metrics that more accurately reflect the potential harm to human health. Among these, oxidative potential (OP) has emerged as a promising health-based metric, yet its application and relevance across different environments remain to be further explored. This study, set in two high-altitude Bolivian cities, aims to identify the most significant sources of PM-induced oxidation in the lungs and assess the utility of OP in assessing PM health impacts. Utilizing two distinct assays, OPDTT and OPDCFH, we measured the OP of PM samples, while also examining the associations between PM mass, OP, and black carbon (BC) concentrations with hospital visits for acute respiratory infections (ARI) and pneumonia over a range of exposure lags (0-2 weeks) using a Poisson regression model adjusted for meteorological conditions. The analysis also leveraged Positive Matrix Factorization (PMF) to link these health outcomes to specific PM sources, building on a prior source apportionment study utilizing the same dataset. Our findings highlight anthropogenic combustion, particularly from traffic and biomass burning, as the primary contributors to OP in these urban sites. Significant correlations were observed between both OPDTT and PM2.5 concentration exposure and ARI hospital visits, alongside a notable association with pneumonia cases and OPDTT levels. Furthermore, PMF analysis demonstrated a clear link between traffic-related pollution and increased hospital admissions for respiratory issues, affirming the health impact of these sources. These results underscore the potential of OPDTT as a valuable metric for assessing the health risks associated with acute PM exposure, showcasing its broader application in environmental health studies.
Subject(s)
Air Pollutants , Altitude , Cities , Particulate Matter , Particulate Matter/analysis , Bolivia/epidemiology , Humans , Air Pollutants/analysis , Adult , Respiratory Tract Infections/epidemiology , Oxidation-Reduction , Male , Middle Aged , Female , Pneumonia/epidemiology , Pneumonia/chemically induced , Young Adult , Adolescent , Air Pollution/analysis , Air Pollution/adverse effects , Child , Environmental Monitoring/methods , Child, PreschoolABSTRACT
OBJECTIVES: The aim of this study was to estimate the prevalence and sociodemographic factors associated with tobacco use and heavy episodic drinking (TUHED), current tobacco use only (TU), and current heavy episodic drinking only (HED) among people 18-69 years in Bolivia in 2019. STUDY DESIGN: Cross-sectional study. METHODS: The analysis used cross-sectional data from Bolivia's STEPS 2019 survey; 4472 individuals answered questions about substance use and socio-demographic information. RESULTS: The sample included 50.2% women and 49.8% men, 52.1% had secondary or higher education, 48.6% were Mestizo and 28.0% Quechua. The prevalence of TUHD was 6.0% (10.5% for men, 1.6% for women), TU 12.2% (20.0% for men, 4.4% for women), and HED 11.2% (13.4% for men and 9.1% for women). Male sex increased the risk of TU, HED and TUHED and belonging to the Amara ethnic group decreased the risk of TU and TUHED. Higher education was increased the odds of HED and among women of TUHED. Urban residence increased the risk of TUHED and among women of HED. For women, unemployment was associated with TU and marriage or cohabitation was inversely associated with TU, and for men, belonging to another ethnic group (such as Castellano or Tacana) increased the risk of TU and TUHED. CONCLUSION: More than 10% of the general adult population in Bolivia participated in TU and HED, and among men in TUHED. Various factors associated with the different categories of substance use were identified.
Subject(s)
Tobacco Use , Humans , Bolivia/epidemiology , Male , Female , Adolescent , Middle Aged , Adult , Cross-Sectional Studies , Young Adult , Aged , Tobacco Use/epidemiology , Prevalence , Binge Drinking/epidemiology , Risk Factors , Sociodemographic Factors , Socioeconomic FactorsABSTRACT
BACKGROUND: How pediatric medulloblastoma patients fare in Lower Middle-Income Country (LMICs) in South America is not well understood. Correspondingly, the aim of this study was to summarize the pediatric neurosurgical experience of an institution in La Paz, and compare outcomes to that of a generalized High Income Country (HIC) United States (US) experience. METHODS: A retrospective review of all pediatric neurosurgical medulloblastoma patients at the Children's Hospital of La Paz, Bolivia (Hospital del Niño "Dr. Ovidio Aliaga Uria") between 2014 and 2023 was conducted and compared to a generalized US experience abstracted from the US National Cancer Database (NCDB) and National Inpatient Sample (NIS) databases. Categorical, continuous and survival data were statistically summarized and compared. RESULTS: A total of 24 pediatric medulloblastoma patients underwent neurosurgical treatment at the Hospital del Niño. In this La Paz cohort, there were 15 (63%) males and 9 (38%) females, with a mean age of 5.6 years old at diagnosis. The majority of patients underwent subtotal resection (STR, 79%), while the remaining patients underwent biopsy only. Ten (42%) patients expired during their hospitalization, and mean length of stay overall was 39 days. Only 8 (33%) patients received adjuvant treatment after surgery. Median overall survival from diagnosis in the La Paz cohort was 1.9 months. Compared to the US databases, the La Paz cohort experienced significantly more emergency room admissions for surgery, less gross total resection, more STR, more return to operating room for ventriculoperitoneal shunting, more bacteremia, more tracheostomy procedures, more percutaneous gastrostomy placements, longer lengths of stay, less adjuvant chemotherapy, less radiation therapy, shorter follow-up, and ultimately, significantly shorter overall survival (all P < 0.050). CONCLUSIONS: Pediatric neurosurgical medulloblastoma outcomes at the Children's Hospital of La Paz, Bolivia are significantly inferior to that of a generalized US experience. Future research is required to identify institution- and country-specific initiatives to improve discrepancies between institutions in LMICs in South America compared to HICs.
Subject(s)
Cerebellar Neoplasms , Medulloblastoma , Neurosurgical Procedures , Humans , Male , Medulloblastoma/surgery , Medulloblastoma/mortality , Female , United States/epidemiology , Retrospective Studies , Child, Preschool , Bolivia/epidemiology , Child , Cerebellar Neoplasms/surgery , Cerebellar Neoplasms/mortality , Cerebellar Neoplasms/pathology , Infant , Developing Countries , Adolescent , Treatment Outcome , Survival RateABSTRACT
Quinoa (Chenopodium quinoa Willd.), an Andean crop, is a facultative halophyte food crop recognized globally for its high nutritional value and plasticity to adapt to harsh conditions. We conducted a genome-wide association study on a diverse set of quinoa germplasm accessions. These accessions were evaluated for the following agronomic and biochemical traits: days to 50% flowering (DTF), plant height (PH), panicle length (PL), stem diameter (SD), seed yield (SY), grain diameter (GD), and thousand-grain weight (TGW). These accessions underwent genotyping-by-sequencing using the DNBSeq-G400R platform. Among all evaluated traits, TGW represented maximum broad-sense heritability. Our study revealed average SNP density of ≈ 3.11 SNPs/10 kb for the whole genome, with the lowest and highest on chromosomes Cq1B and Cq9A, respectively. Principal component analysis clustered the quinoa population in three main clusters, one clearly representing lowland Chilean accessions, whereas the other two groups corresponded to germplasm from the highlands of Peru and Bolivia. In our germplasm set, we estimated linkage disequilibrium decay to be ≈ 118.5 kb. Marker-trait analyses revealed major and consistent effect associations for DTF on chromosomes 3A, 4B, 5B, 6A, 7A, 7B and 8B, with phenotypic variance explained (PVE) as high as 19.15%. Nine associations across eight chromosomes were also found for saponin content with 20% PVE by qSPN5A.1. More QTLs were identified for PL and TGW on multiple chromosomal locations. We identified putative candidate genes in the genomic regions associated with DTF and saponin content. The consistent and major-effect genomic associations can be used in fast-tracking quinoa breeding for wider adaptation across marginal environments.
Subject(s)
Chenopodium quinoa , Genome, Plant , Genome-Wide Association Study , Polymorphism, Single Nucleotide , Quantitative Trait Loci , Chenopodium quinoa/genetics , Chenopodium quinoa/metabolism , Phenotype , Peru , Genotype , Bolivia , Chromosomes, Plant/genetics , Quantitative Trait, HeritableABSTRACT
Chitinozoans recovered from one section of the Middle Devonian Los Monos Formation in the TCB X-1001-Tacobo borehole, sub-Andean basin of Bolivia, have been analysed. Eleven from the eighteen processed cutting samples yielded specimens that allowed taxonomic study. Eleven genera and thirty-five chitinozoan species were identified from the Los Monos Formation with four of them recorded for the first time in Western Gondwana. Ancyrochitina biconstricta, Ancyrochitina parisi, Angochitina galarzae and Ramochitina boliviensis are among the most relevant taxa restricted to Western Gondwana that support the affinity with this paleocontinent. One new species, Lagenochitina tacobensis sp. nov. is described, and Ramochitina candelariaensis sp. nov. (n. n.) is formally erected. The chitinozoan assemblage reinforces the late Eifelian-middle Givetian age previously proposed by organic-walled phytoplankton and miospores for this section of the TCB X-1001-Tacobo borehole. A new local chitinozoan biozonation based on the chitinozoan assemblages is proposed and a revision of the current chitinozoan biozonation for Western Gondwana and Bolivia is recommended.
Subject(s)
Fossils , Bolivia , AnimalsABSTRACT
Our research occurred in the Andean region, one of the eight global centers of domestication of plant species grown for agriculture. The shores of Lake Titicaca (located between Peru and Bolivia), at 3800 meters above sea level, are recognized as the center of origin of quinoa (Chenopodium quinoa Willd.). In this region, complex societies have emerged, thanks to the development of water and soil management technologies. They have managed to overcome high mountain territories' extreme and variable climatic conditions. These societies have traditionally protected and preserved quinoa as food for present and future generations through their long-standing knowledge and cultivation practices. The fieldwork occurred in the context of Andean family farming, and our study analyzes nature-society dynamics with a chorematic approach and interviews with local communities. The interest of this work is the transformation of the landscape at the scale of the mountain agroecosystem to understand better the impacts of rural development policies. Chorematic modeling was applied to two periods, before and after 1970, a pivotal year in Peru for agriculture, to show how socio-spatial dynamics in the Andean environment are changing, particularly concerning the evolution of quinoa cultivation. The results show that wild quinoa relatives' distribution is strongly linked to the socio-spatial organization of the agroecosystem. Different species of wild quinoa relatives are maintained by villagers for their multiple foods, medicinal and cultural uses in natural areas, grazed areas, on edge, and also within cultivated fields. However, this management is changing under the pressure of global issues related to the international quinoa market, whose requirements imply reducing the presence of wild relatives in cultivated fields.
Subject(s)
Chenopodium quinoa , Peru , Bolivia , Domestication , AgricultureABSTRACT
Bolivia has one of the highest burdens of Chagas disease in the world. Vertical transmission from mother to infant accounts for a growing number of cases. We performed a systematic review of articles assessing the prevalence of Chagas disease in pregnant women and rates of vertical transmission to infants in Bolivia. Studies were not excluded based on year of publication or language. Random-effects analyses were performed to estimate a pooled prevalence of maternal Chagas disease and pooled vertical transmission rate. Our search yielded 21 articles describing over 400,000 cases of Chagas disease among pregnant women in Bolivia. The reported prevalence of maternal Chagas disease ranged from 17.3% to 64.5%, with a pooled prevalence of 33.0% (95% CI, 27.4-38.7%). The prevalence of maternal Chagas disease trended down over time (P = 0.006), decreasing by approximately 25% to 30% over the last 40 years. Vertical transmission rates ranged from 2.0% to 13% with a pooled average of 6.2% (95% CI, 4.4-7.5%); rates did not significantly change over time. Our study is the first systematic review and meta-analysis of Chagas disease maternal prevalence and vertical transmission in Bolivia. Our findings indicate that maternal Chagas disease has fallen in prevalence but still affects 20% to 30% of pregnant women and poses a considerable risk of vertical transmission. Pregnant women and infants are an important target for public health interventions to limit the mortality and morbidity of Chagas disease and to reduce intergenerational spread.
Subject(s)
Chagas Disease , Infectious Disease Transmission, Vertical , Humans , Chagas Disease/transmission , Chagas Disease/epidemiology , Bolivia/epidemiology , Female , Infectious Disease Transmission, Vertical/statistics & numerical data , Pregnancy , Prevalence , Pregnancy Complications, Parasitic/epidemiology , Infant, NewbornABSTRACT
Bolivia has the highest incidence of Chagas disease (CD) worldwide. Caused by the parasite Trypanasoma cruzi, CD is generally a chronic condition. Diagnosis is logistically and financially challenging, requiring at least two different laboratory-based serological tests. Many CD cases are missed; in Bolivia it is estimated just 6% of individuals chronically infected with T. cruzi get diagnosed. Achieving control on the way to elimination of CD requires a radical simplification of the current CD testing pathways, to overcome the barriers to accessing CD treatment. We aimed to generate unbiased performance data of lateral flow assays (LFAs) for T. cruzi infection in Bolivia, to evaluate their usefulness for improving T. cruzi diagnosis rates in a precise and efficient manner. This retrospective, laboratory-based, diagnostic evaluation study sought to estimate the sensitivity/specificity of 10 commercially available LFAs for T. cruzi, using the current CD diagnostic algorithm employed in Bolivia as the reference test method. All tests were blinded at the study site and performed by three operators. In total, 470 serum samples were tested, including 221 and 249 characterized as CD-positive/-negative, respectively. The LFAs were scored according to their relative importance using a decision-tree-based algorithm, with the mean decrease in Gini index as the scoring metric. The estimates of sensitivities ranged from 62.2-97.7% (95% confidence interval (CI) lower bound 55.0-94.7%); for specificities the range was 78.6-100% (95% CI lower bound 72.0-97.5%); 5/10 and 6/10 tests had sensitivity >90% and specificity >95%, respectively. Four LFAs showed high values of both sensitivity (93-95%) and specificity (97-99%). The agreement between 6 LFAs and the reference tests was almost perfect (Kappa 0.83-0.94). Most LFAs evaluated thus showed performances comparable with current laboratory-based diagnostic methods.
Subject(s)
Chagas Disease , Trypanosoma cruzi , Humans , Bolivia , Retrospective Studies , Chagas Disease/parasitology , Sensitivity and SpecificityABSTRACT
BACKGROUND: Cervical cancer is a major health problem in Latin America. In 2019, the Italian Agency for Development Cooperation (La Paz regional site) conducted a pilot study to estimate the prevalence of high-risk human papillomavirus (HPV) and the feasibility of HPV screening in Bolivia through self-sampling and portable and transportable laboratory instruments for HPV testing in urban and rural areas. METHODS: Women aged 20-65 years from La Paz (urban area), Toro Toro (rural area), and Acasio (rural area) were enrolled in local public health centers between Dec 1, 2019, and June 30, 2021. Self-sampling was carried out with the Viba-Brush system (Rovers, Oss, Netherlands) and samples were preserved in ThinPrep containers (Hologic Corporation, San Diego, CA, USA). The GeneXpert system (Cepheid, Sunnyvale, CA, USA) for high-risk HPV testing detects HPV E6 and E7 DNA via real-time PCR in a mobile system of easy execution requiring minimal manual intervention. The system provides results in about 1 h. The hr- HPV prevalence data, overall and partial genotyping, were analyzed considering the following age groups: 20-34, 35-44, and 45-65 years old. FINDINGS: 2168 women were enrolled: 614 (28.3%) in La Paz, 743 (34.3%) in Toro Toro, and 811 (37.4%) in Acasio. Only one sample was collected from each participant. 2043 (94.2%) of 2168 samples were adequate for HPV testing. 255 (12.5%) samples were positive for high-risk HPV. Comparing the urban area (La Paz) versus rural combined areas (Acasio+Toro Toro), using a logistic model, the HPV total rate was statistically significantly higher in the city of La Paz (15.0% vs 11.4%; OR:1.37;95% CI: 1.04-1.80). Furthermore, the HPV prevalence was declining by age, and the urban/rural odds ratio was 1.50; (95% IC 1.13-19). The overall HPV 16 positivity was 2.7% (55/2043) and for HPV 18/45 was 1.8% (37/2043) without any statistically significant differences between the three BHU enrolling centers. Only the prevalence of HPV group '39/56/66/68' was significantly higher in La Paz (p<0,001) in comparison to Acasio and Toro Toro. INTERPRETATION: The total and age-adjusted prevalence of high-risk HPV infection in rural and urban areas in Bolivia, as measured with a validated test for screening, is similar to that observed in Europe and the USA. Our study shows that a screening protocol for HPV testing with self-sampling would be feasible in urban and rural areas in Bolivia, and that the reported high occurrence of cervical cancer in Bolivia is not related to a higher rate of high-risk HPV infections. Carrying out HPV tests locally avoids the issues associated with transportation and storage of the collected material and allows the participant to wait in the clinic for the test result, overcoming the very long response time for screening test in Bolivia.