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1.
Ann Plast Surg ; 88(3 Suppl 3): S194-S196, 2022 05 01.
Article in English | MEDLINE | ID: mdl-35513318

ABSTRACT

BACKGROUND: Keloid formation occurs with increased incidence in African Americans and Afro-Caribbeans when compared with other ethnic populations. Although surgical management and nonsurgical management of keloids are mainstays of treatment, there are significant variations within studies comparing the efficacy of intraoperative steroid injection, postoperative radiotherapy, or a combination of both modalities. The purpose of our study is to evaluate the efficacy of different treatment modalities used for treatment of keloids and to determine their recurrence in a select Afro-Caribbean population. METHODS: A retrospective review of the plastic surgery case list from January 2015 to October 2019 was conducted, with identification of 46 Afro-Caribbean and African American patients with 56 keloids. Each patient was contacted to determine whether they had experienced recurrence of their keloid(s). Eighteen patients were lost to follow-up, resulting in 28 patients with 35 keloids included in our study. The treatment protocol involved surgical excision for all keloids, with selective additional triamcinolone 40 mg/mL injection intraoperatively, immediate postoperative radiotherapy, or intraoperative triamcinolone injection with postoperative radiotherapy. Recurrence rates between the different treatment groups were calculated, and statistical analyses were performed using IBM SPSS Statistics, with a value of P < 0.05 deeming statistical significance. RESULTS: Our study demonstrates that postoperative recurrence rates of primary and secondary keloids were 43% and 58%, respectively. Results of recurrence rate varied by specific treatment modality; keloid excision yielded a rate of only 54%, keloid excision with postoperative radiation yielded a rate of 83%, keloid excision with intraoperative triamcinolone injection yielded a rate of 33%, and keloid excision with a combination of intraoperative triamcinolone injection and postoperative radiation yielded a rate of 33%. CONCLUSION: Patients of Afro-Caribbean and African American ethnicity are more heavily affected by the formation of keloids compared with other population groups. Results of varying modalities for keloid management demonstrate that patients who received a combination of excision with intraoperative triamcinolone injection, with or without postoperative radiation, had the lowest recurrence rates compared with other treatment protocols including excision alone and excision with postoperative radiation only.


Subject(s)
Keloid , African Americans , Caribbean Region , Humans , Keloid/pathology , Keloid/surgery , Recurrence , Treatment Outcome , Triamcinolone
2.
Sci Rep ; 12(1): 7106, 2022 May 02.
Article in English | MEDLINE | ID: mdl-35501329

ABSTRACT

Declines in abundance of scleractinian corals on shallow Caribbean reefs have left many reefs dominated by forests of arborescent octocorals. The ecological mechanisms favoring their persistence require exploration. We quantified octocoral communities from 2014 to 2019 at two sites in St. John, US Virgin Islands, and evaluated their dynamics to assess whether portfolio effects might contribute to their resilience. Octocorals were identified to species, or species complexes, and their abundances and heights were measured, with height2 serving as a biomass proxy. Annual variation in abundance was asynchronous among species, except when they responded in similar ways to hurricanes in September 2017. Multivariate changes in octocoral communities, viewed in 2-dimensional ordinations, were similar between sites, but analyses based on density differed from those based on the biomass proxy. On the density scale, variation in the community composed of all octocoral species was indistinguishable from that quantified with subsets of 6-10 of the octocoral species at one of the two sites, identifying structural redundancy in the response of the community. Conservation of the relative colony size-frequency structure, combined with temporal changes in the species represented by the tallest colonies, suggests that portfolio effects and functional redundancy stabilize the vertical structure and canopy in these tropical octocoral forests.


Subject(s)
Anthozoa , Cyclonic Storms , Animals , Anthozoa/physiology , Biomass , Caribbean Region , Forests
3.
Radiol Clin North Am ; 60(3): 429-443, 2022 May.
Article in English | MEDLINE | ID: mdl-35534129

ABSTRACT

Infectious diseases, including parasitic diseases, which are commonly associated with poverty and poor sanitation, continue to cause significant morbidity, disability, and mortality in Latin America and the Caribbean region. This article reviews the epidemiology, pathophysiology, and cardiothoracic imaging manifestation of several communicable diseases endemic to this region.


Subject(s)
Parasitic Diseases , Caribbean Region/epidemiology , Humans , Latin America/epidemiology
4.
Article in English | PAHO-IRIS | ID: phr-56017

ABSTRACT

[ABSTRACT]. Objectives. To estimate inequalities in demand for family planning satisfied with modern methods among women in Latin America and the Caribbean, with an emphasis on Brazil and Mexico, and to calculate the scenario for recovery of modern contraceptive coverage by expanding access to long-acting contraceptives (LARC) after the COVID-19 pandemic. Methods. National health surveys from 2006 to 2018 were used to estimate the demand for family planning satisfied with modern methods and how it was affected by the COVID-19 pandemic. The scenario included three variables: coverage, health outcomes, and costs. Considering coverage, United Nations Population Fund data were used to estimate the impact of COVID-19 on access to contraception in Latin America and the Caribbean. Health outcomes were assessed with the Impact 2 tool. Direct investment was used to evaluate cost-effectiveness. Results. Substantial inequalities were found in the use of modern contraceptive methods before the pandemic. We showed the potential cost-effectiveness of avoiding maternal deaths by introducing LARCs. Conclusions. In the scenario predicted for Brazil and Mexico, the costs of modern family planning and averted disability-adjusted life years are modest. Governments in Latin America and the Caribbean should consider promoting LARCs as a highly efficient and cost-effective intervention.


[RESUMEN]. Objetivos. Estimar las desigualdades en la demanda de planificación familiar satisfecha con métodos anticonceptivos modernos entre las mujeres de América Latina y el Caribe, especialmente en Brasil y México, y analizar el escenario de recuperación de la cobertura de los anticonceptivos modernos mediante la ampliación del acceso a los anticonceptivos de acción prolongada tras la pandemia de COVID-19. Métodos. Se emplearon encuestas nacionales de salud desde el año 2006 hasta el año 2018 para estimar la demanda de planificación familiar satisfecha con métodos modernos y el impacto de la pandemia de COVID-19. El escenario comprendía tres variables: cobertura, resultados en materia de salud y costos. En lo respectivo a la cobertura, se emplearon datos del Fondo de Población de las Naciones Unidas para evaluar la repercusión de la COVID-19 en el acceso a los anticonceptivos en América Latina y el Caribe. Los resultados en materia de salud se examinaron con la herramienta Impact 2. Se empleó la inversión directa para evaluar la costo-efectividad. Resultados. Se encontraron desigualdades sustanciales en el uso de métodos anticonceptivos modernos antes de la pandemia. Se demostró la posible costo-efectividad de evitar muertes maternas mediante la introducción de anticonceptivos de acción prolongada. Conclusiones. De acuerdo con el escenario previsto para Brasil y México, los costos de la planificación familiar moderna y los años de vida ajustados en función de la discapacidad evitados son moderados. Los gobiernos de América Latina y el Caribe deberían considerar la posibilidad de p


[RESUMO]. Objetivos. Estimar as desigualdades na demanda por planejamento familiar atendida por métodos contraceptivos modernos em mulheres da América Latina e do Caribe, com ênfase no Brasil e no México, e calcular o cenário de recuperação da cobertura por métodos contraceptivos modernos por meio da ampliação do acesso a métodos contraceptivos reversíveis de longa duração (LARC) após a pandemia de COVID-19. Métodos. Foram usadas pesquisas nacionais de saúde de 2006 a 2018 para estimar a demanda por planejamento familiar atendida por métodos contraceptivos modernos e como ela foi afetada pela pandemia de COVID-19. O cenário incluiu três variáveis: cobertura, desfechos de saúde e custos. Para cobertura, os dados do Fundo de População das Nações Unidas foram usados para estimar o impacto da COVID-19 no acesso à contracepção na América Latina e no Caribe. Desfechos de saúde foram avaliados com a ferramenta Impact 2. O investimento direto foi usado para avaliar a relação custo-benefício. Resultados. Foram constatadas desigualdades importantes no uso de métodos contraceptivos modernos antes da pandemia. Demonstramos a potencial relação custo-benefício de evitar mortes maternas mediante a introdução de LARC. Conclusões. No cenário previsto para o Brasil e o México, os custos do planejamento familiar moderno e dos anos de vida ajustados por incapacidade por ele evitados são modestos. Os governos da América Latina e do Caribe devem considerar a promoção dos LARC como uma intervenção altamente eficiente e custo-efetiva.


Subject(s)
Long-Acting Reversible Contraception , Health Services Accessibility , COVID-19 , Latin America , Caribbean Region , Brazil , Mexico , Long-Acting Reversible Contraception , Health Services Accessibility , Latin America , Caribbean Region , Brazil , Mexico , Long-Acting Reversible Contraception , Health Services Accessibility , Caribbean Region
5.
Washington, D.C.; PAHO; 2022-05-19.
in English, Spanish | PAHO-IRIS | ID: phr-56011

ABSTRACT

[WEEKLY SUMMARY]. North America: Overall, influenza and SARS-CoV-2 activity remained at low levels. In Canada, influenza activity increased above the average of previous seasons for this period at low intensity levels, and SARS-CoV-2 activity decreased and remained at low levels. In Mexico, influenza activity increased above the epidemic threshold and was at the average of previous seasons, and SARS-CoV-2 activity decreased. In the United States, influenza activity varied within regions and continued to increase in some states with influenza A(H3N2) viruses predominating. Caribbean: Influenza activity remained at low levels, with predominating influenza A(H3N2), and overall, SARS-CoV-2 activity declined in most countries. In Belize and Dominica, influenza and SARS-CoV-2 activity and percent positivity increased. Central America: Overall, influenza activity remained low and SARS-CoV-2 activity decreased in most countries. In El Salvador, influenza activity remained above-average levels at low-intensity levels. In Costa Rica and Panama, SARS-CoV-2 activity and percent positivity increased compared to previous seasons. Andean: Overall, influenza activity remained low with A(H3N2) predominance. SARS-CoV-2 activity continued to decline in most countries, except in Peru, where the influenza activity with the predominance of A(H3N2) continued elevated above the average seasonal levels. In Ecuador, RSV activity continued elevated. Brazil and Southern Cone: Overall, influenza with the predominance of A(H3N2) and SARS-CoV-2 activity decreased. In Brazil, SARS-CoV-2 activity increased slightly compared to the previous week. In Chile and Uruguay, influenza A(H3N2) activity and SARS-CoV-2 positivity increased slightly at low intensity levels. RSV activity continued elevated in Chile and Uruguay. Global: Influenza activity continued to decrease, following a peak in March 2022. In the temperate zones of the northern hemisphere, influenza activity decreased or remained stable. Detections were mainly influenza A(H3N2) viruses and B/Victoria lineage viruses, with some detections of A(H1N1)pdm09 viruses. In Central Asia, a single influenza B detection was reported in Kazakhstan. In East Asia, influenza activity with mainly influenza B/Victoria lineage. Overall, in Europe, influenza continues to decline, with influenza A(H3N2) predominant. Very little RSV activity was observed. Detections continued to decrease in China while A(H3N2) became the predominantly detected virus across the southern provinces in China. Elsewhere, influenza illness indicators and activity remained low. In Northern Africa, Tunisia continued to report few detections of mainly influenza A(H3N2) and one influenza A(H1N1)pdm09 detection, while Egypt reported increasing detections of influenza B followed by A(H3N2). In Western Asia, influenza activity was low across reporting countries, except Georgia, where detections of influenza A(H3N2) continued to be reported although decreasing. In Southern Asia, influenza virus detections were at low levels, with a few detections of A(H3N2) and A(H1N1)pdm09 viruses. In South-East Asia, low A(H3N2) detections were reported in Singapore and Timor-Leste. In the temperate zones of the southern hemisphere, influenza activity was low overall, as expected at this time of year. Overall, COVID positivity from sentinel surveillance increased and was just above 10% during the reporting period. Activity from non-sentinel sites was varied.


[RESUMEN SEMANAL]. América del Norte: en general, la actividad de la influenza y de SARS-CoV-2 se mantuvo en niveles bajos. En Canadá, la actividad de la influenza aumentó por encima del promedio de temporadas anteriores para esta época del año en nivel de intensidad bajo y la actividad de SARS-CoV-2 disminuyó y se mantuvo en niveles bajos. En México, la actividad de la influenza aumentó por encima del umbral epidémico y estuvo en el promedio de las temporadas anteriores y la actividad y el porcentaje de positividad del SARS-CoV-2 aumentó. En los Estados Unidos, la actividad de la influenza varía según la región y siguió aumentando en algunas zonas del país con predominio de los virus influenza A(H3N2). Caribe: la actividad de la influenza se mantuvo en niveles bajos, con predominio de influenza A(H3N2) y, en general, la actividad del SARS-CoV-2 disminuyó en la mayoría de los países. En Belice y Dominica, aumentó la actividad y el porcentaje de positividad de influenza y SARS-CoV-2. América Central: en general, la actividad de la influenza se mantuvo baja y la actividad del SARS-CoV-2 disminuyó en la mayoría de los países. En El Salvador, la actividad de influenza se mantuvo por encima del promedio en niveles de baja intensidad. En Costa Rica y Panamá, la actividad del SARS-CoV-2 y el porcentaje de positividad aumentaron en comparación con temporadas anteriores. Andina: en general, la actividad de influenza se mantuvo baja con predominio de A(H3N2). La actividad de SARS-CoV-2 continuó disminuyendo en la mayoría de los países, excepto en Perú, donde la actividad de influenza con predominio de A(H3N2) continuó elevada por encima de los niveles promedio estacionales. En Ecuador, la actividad del VRS continuó elevada. Brasil y Cono Sur: en general, disminuyó la actividad de influenza con predominio de A(H3N2) y SARS-CoV-2. En Brasil, la actividad del SARS-CoV-2 aumentó levemente con respecto a la semana anterior. En Chile y Uruguay, la actividad de influenza A(H3N2) y la positividad de SARS-CoV-2 aumentaron levemente en niveles de baja intensidad. La actividad del VRS continuó elevada en Chile y Uruguay. Global: la actividad de la influenza siguió disminuyendo, luego de un pico en marzo de 2022. En las zonas templadas del hemisferio norte, la actividad de la influenza disminuyó o se mantuvo estable. Las detecciones fueron principalmente virus de la influenza A(H3N2) e influenza B linaje Victoria, con algunas detecciones de los virus A(H1N1)pdm09. En Asia Central, se notificó una sola detección de influenza B en Kazajstán. En el este de Asia, la actividad de la influenza fue principalmente de influenza B linaje Victoria. En general, en Europa, la influenza sigue disminuyendo con predominio de influenza A(H3N2). Se observó muy poca actividad de VRS. Las detecciones continuaron disminuyendo en China, mientras que el A(H3N2) se convirtió en el virus predominantemente detectado en las provincias del sur de China. En otros lugares, los indicadores y la actividad de la enfermedad por influenza permanecieron bajos. En el norte de África, Túnez continuó informando pocas detecciones principalmente de influenza A(H3N2) y una detección de influenza A(H1N1)pdm09, mientras que Egipto reportó un aumento en las detecciones de influenza B seguida de A(H3N2). En Asia occidental, la actividad de la influenza fue baja en todos los países que notificaron, excepto en Georgia, donde continuaron las notificaciones de detecciones de influenza A(H3N2), aunque en disminución. En el sur de Asia, las detecciones del virus de la influenza estuvieron en niveles bajos, con algunas detecciones de los virus A(H3N2) y A(H1N1)pdm09. En el Sudeste Asiático, se informaron detecciones bajas de A(H3N2) en Singapur y Timor-Leste. En las zonas templadas del hemisferio sur, en general, la actividad de la influenza fue baja como se esperaba en esta época del año. En general, la positividad de la COVID de la vigilancia centinela aumentó y estuvo justo por encima del 10 % durante el período del informe. La actividad de los sitios no centinela fue variada.


Subject(s)
COVID-19 , Influenza, Human , SARS-CoV-2 , Betacoronavirus , International Health Regulations , Americas , Caribbean Region , Influenza, Human , International Health Regulations , Americas , Caribbean Region
6.
Washington, D.C.; OPAS; 2022-05-11. (OPAS/IMS/EIH/COVID-19/22-0012).
in Portuguese | PAHO-IRIS | ID: phr-55977

ABSTRACT

Desde o início da pandemia de COVID-19, inúmeros ensaios clínicos foram planejados e realizados para avaliar a eficácia e a segurança de várias intervenções que poderiam evitar agravamento da doença e a hospitalização em pessoas infectadas pelo vírus SARS-CoV-2. Atualmente, a Organização Mundial da Saúde (OMS) e a Organização Pan-Americana da Saúde (OPAS) recomendam o uso de corticoides, tocilizumabe, baricitinibe e casirivimabe/ indevimabe (essa última associação em pacientes soronegativos para COVID-19) e propõem o uso de sotrovimabe, casirivimabe/indevimabe e molnupiravir em pacientes pertencentes aos grupos de risco para complicações, mas ainda na forma leve ou moderada da doença. Outras potenciais intervenções terapêuticas estão sob investigação ou avaliação da OMS e da OPAS. As intervenções atualmente recomendadas ou aquelas que serão recomendadas no futuro apresentam desafios relacionados à via de administração (por exemplo, oral ou intravenosa); à eficácia, que depende da variante do vírus; a quem deve ser considerado de alto risco (por exemplo, em relação ao status vacinal); ao seu custo; e aos recursos necessários para administrá-las, bem como a outros aspectos relacionados à sua implementação (por exemplo, distribuição, farmacovigilância, contraindicações, interações medicamentosas, etc.). A fim de apoiar a tomada de decisões para o manejo de pacientes, a OPAS apresenta neste documento recomendações sobre o uso racional de antivirais, anticorpos monoclonais e outras intervenções, considerando as evidências mais atualizadas, o status vacinal, o acesso e custos para os países da Região das Américas.


Subject(s)
COVID-19 , SARS-CoV-2 , Evidence-Based Medicine , Translational Medical Research , Access to Essential Medicines and Health Technologies , Patient Care Management , Americas , Caribbean Region
7.
Washington, D.C.; PAHO; 2022-05-11.
in English, Spanish | PAHO-IRIS | ID: phr-55976

ABSTRACT

[WEEKLY SUMMARY]. North America: Overall, influenza and SARS-CoV-2 activity remained at low levels. In Canada, influenza activity increased above the average of previous seasons for this period at low intensity levels, and SARS-CoV-2 activity decreased and remained at low levels. In Mexico, influenza activity remained stable below the average of previous seasons, and SARS-CoV-2 activity decreased. In the United States, influenza activity varied within regions and continued to increase in some states with influenza A(H3N2) viruses predominating. Caribbean: Influenza activity remained at low levels, with predominating influenza A(H3N2), and overall, SARS-CoV-2 activity continued to decline. In Belize, influenza activity and percent positivity increased. In Jamaica and Saint Lucia, SARS-CoV-2 percent positivity increased at low levels compared to the previous seasons. In Puerto Rico, the percentage of visits for influenza-like illness continued to increase to high levels for this time of year. Central America: Overall, influenza activity remained low and SARS-CoV-2 activity decreased in most countries. In El Salvador, influenza activity remained above-average levels at low-intensity levels. In Panama, SARS-CoV-2 activity and percent positivity increased compared to previous seasons. Andean: Overall, influenza activity remained low with A(H3N2) predominance. SARS-CoV-2 activity continued to decline in most countries. In Ecuador, influenza activity decreased to above-average baseline levels for previous years; and RSV activity was higher than in previous years, except in 2015 and 2016. In Peru, influenza activity increased but remained at low levels compared to previous weeks. Brazil and Southern Cone: Overall, influenza activity decreased with the predominance of A(H3N2). SARS-CoV-2 activity decreased. In Brazil, RSV percent positivity increased to high-intensity levels above the levels observed in 2021, but below the levels of 2016-17 and 2019; and SARS-CoV-2 activity remained above the levels observed in 2021. In Argentina, influenza activity increased at high intensity levels and SARS-CoV-2 activity slightly increased.


[RESUMEN SEMANAL]. América del Norte: en general, la actividad de la influenza y de SARS-CoV-2 se mantienen en niveles bajos. En Canadá, la actividad de la influenza aumentó por encima del promedio de temporadas anteriores para esta época del año en nivel de intensidad bajo y la actividad de SARS-CoV-2 disminuyó y se mantiene en niveles bajos. En México, la actividad de la influenza se mantiene estable por debajo del promedio de temporadas anteriores y la actividad del SARS-CoV-2 disminuyó. En los Estados Unidos, la actividad de la influenza varía según la región y sigue aumentando en algunas zonas del país con predominio de los virus influenza A(H3N2). Caribe: la actividad de la influenza se mantuvo en niveles bajos, con predominio de influenza A(H3N2) y la actividad del SARS-CoV-2 continuó en disminución. En Belice aumentó la actividad y porcentaje de positividad de influenza. En Jamaica y Santa Lucía el porcentaje de positividad del SARS-CoV-2 aumentó en nivel de intensidad bajo con respecto a los registrados previamente. En Puerto Rico, el porcentaje de visitas por enfermedad tipo influenza continúa en aumento a niveles altos para esta época del año. América Central: en general, la actividad de la influenza se mantuvo baja y la actividad del SARS-CoV-2 disminuyó en la mayoría de los países. En El Salvador la actividad de la influenza permaneció por encima de los niveles promedio en niveles de intensidad bajos. En Panamá la actividad y porcentaje de positividad para el SARS-CoV-2 aumentaron en comparación con periodos previos. Andina: en general, la actividad de la influenza continuó baja con predominio de A(H3N2). La actividad del SARS-CoV-2 continuó disminuyendo en la mayoría de los países. En Ecuador, la actividad de la influenza disminuyó a los niveles de referencia por encima del promedio de los años anteriores. La actividad del VRS fue mayor que en años anteriores, excepto en 2015 y 2016. En Perú, la actividad de influenza aumentó en las últimas semanas, pero se mantiene en niveles de baja intensidad Brasil y Cono Sur: en general, la actividad de la influenza con predominio de A(H3N2) y SARS-CoV-2 tienden a la disminución. En Brasil el porcentaje de positividad de virus respiratorio sincitial se mantuvo en niveles altos por encima de los niveles observados a finales de 2021, pero por debajo de los niveles de las temporadas 2016-17 y 2019 y la actividad y porcentaje de positividad de SARS-CoV2 se mantuvo en niveles altos por encima de lo observado a fines de 2021. En Argentina la actividad y porcentaje de positividad para influenza aumentaron a niveles de intensidad alta y la actividad de SARS-CoV-2 aumentó levemente.


Subject(s)
COVID-19 , Influenza, Human , SARS-CoV-2 , Betacoronavirus , International Health Regulations , Americas , Caribbean Region , Influenza, Human , International Health Regulations , Americas , Caribbean Region
8.
Washington, D.C.; PAHO; 2022-05-09. (PAHO/IMS/EIH/COVID-19/22-0012).
in English | PAHO-IRIS | ID: phr-55968

ABSTRACT

Since the onset of the COVID-19 pandemic, a large number of clinical trials have been planned and developed to assess the effectiveness and safety of various interventions that could prevent hospitalizations and progression to severe disease in people infected with SARS-CoV-2. Currently, the World Health Organization (WHO) and the Pan American Health Organization (PAHO) recommend the use of corticosteroids, tocilizumab, baricitinib, and casirivimab e imdevimab (the latter in seronegative COVID-19 patients) and propose the use of sotrovimab, casirivimab/imdevimab, and molnupiravir in patients with non-severe illness who are at high risk for complications. Other potential therapeutic interventions are currently undergoing study or evaluation by WHO and PAHO. The interventions recommended at present and those that will be recommended at a later date pose challenges in terms of route of administration (e.g., oral or intravenous); efficacy, which depends on the viral variant; establishment of high-risk status (e.g., relative to vaccination status); cost; resources required to administer them; and other implementation-related aspects (e.g., distribution, drug safety monitoring, contraindications, interactions, etc.). To support decision-making for patient management, in this document PAHO presents considerations on the rational use of antivirals, monoclonal antibodies, and other interventions in light of the most current evidence, vaccination status, access, and the costs to countries of the Region.


Subject(s)
COVID-19 , SARS-CoV-2 , Evidence-Based Medicine , Translational Medical Research , Access to Essential Medicines and Health Technologies , Patient Care Management , Americas , Caribbean Region
9.
Washington, D.C.; PAHO; 2022-05-05.
in English, Spanish | PAHO-IRIS | ID: phr-55958

ABSTRACT

[WEEKLY SUMMARY]. North America: Overall, influenza activity remained at low levels, SARS-CoV-2 activity continued to decline, and percent positivity for SARS-Cov2 remained at low levels. In Canada, influenza activity and SARS-CoV-2 activity remained at low levels. In Mexico, influenza activity has increased but remained below the average of previous seasons, and SARS-CoV-2 activity decreased. In the United States, influenza activity varied within regions and continued to increase in some states with influenza A(H3N2) viruses predominating. SARS-CoV-2 activity continued to decline. Caribbean: Influenza activity remained at low levels, with predominating influenza A(H3N2), and overall, SARS-CoV-2 activity continued to decline. In Dominica, SARI activity increased and remains below baseline levels. In Puerto Rico, the percentage of visits for influenza-like illness continued to increase to high levels for this time of year. Central America: Overall, influenza activity remained low and SARS-CoV-2 activity decreased in most countries. In El Salvador, influenza activity remained above-average levels at low-intensity levels. Andean: Overall, influenza activity remained low with A(H3N2) predominance. SARS-CoV-2 activity continued to decline in most countries. In Ecuador, influenza activity decreased to above-average baseline levels for previous years; and RSV activity was higher than in previous years, except in 2015 and 2016. In Peru, influenza activity increased with A(H3N2) predominance. Brazil and Southern Cone: Overall, influenza activity tends to decrease with the predominance of A(H3N2). SARS-CoV-2 activity decreased, except in Brazil, where SARS-CoV-2 percent positivity increased to high-intensity levels above the levels observed in 2021. Global: Influenza activity remained low, with a further decrease in some areas. In the temperate zones of the northern hemisphere, influenza activity seems to decrease. In Europe, overall influenza activity appeared to decline, with influenza A(H3N2) predominant. In Central Asia, sporadic influenza B detections were reported in Kazakhstan. In East Asia, influenza activity with mainly influenza B/Victoria lineage detections continued to decrease in China. ILI rate and pneumonia hospitalizations remained elevated in Mongolia. Elsewhere, influenza illness indicators and activity remained low. In Northern Africa, decreased detections of influenza A(H3N2) were reported in Tunisia. In Western Asia, Georgia reported increased detections of influenza A(H3N2). In tropical Africa, influenza activity was informed mainly from Eastern Africa, with influenza A(H3N2) predominating, followed by influenza B viruses. In Southern Asia, influenza virus detections were at low levels overall. Only Malaysia reported influenza detections of influenza A(H3N2) and B viruses in South-East Asia. In the temperate zones of the southern hemisphere, influenza activity remained low overall. However, detections of influenza A viruses (with A(H3N2) predominant among the subtyped viruses) continued to be reported in South Africa. SARS-CoV-2 percent positivity from sentinel surveillance decreased below 10% in all WHO regions during this reporting period. Overall positivity from non-sentinel sites also showed a decreasing trend.


[RESUMEN SEMANAL]. América del Norte: en general, la actividad de la influenza se mantuvo en niveles bajos La actividad del SARS-CoV-2 continuó disminuyendo y el porcentaje de positividad de SARS-Cov2 se mantiene en niveles bajos. En Canadá, la actividad de la influenza y la actividad de SARS-CoV-2 se mantiene en niveles bajos En México, la actividad de la influenza ha aumentado pero se mantiene por debajo del promedio de temporadas anteriores y la actividad del SARS-CoV-2 disminuyó. En los Estados Unidos, la actividad de la influenza varía según la región y sigue aumentando en algunas zonas del país con predominio de los virus influenza A(H3N2). La actividad del SARS-CoV-2 siguió en disminución. Caribe: la actividad de la influenza se mantuvo en niveles bajos, con predominio de influenza A(H3N2) y la actividad del SARS-CoV-2 continuó en disminución. En Dominica, la actividad de las IRAG aumentó y se mantiene por debajo de los niveles de referencia. En Puerto Rico, el porcentaje de visitas por enfermedad tipo influenza continúa en aumento a niveles altos para esta época del año. América Central: en general, la actividad de la influenza se mantuvo baja y la actividad del SARS-CoV-2 disminuyó en la mayoría de los países. En El Salvador la actividad de la influenza permaneció por encima de los niveles promedio en niveles de intensidad bajos. Andina: en general, la actividad de la influenza continuó baja con predominio de A(H3N2). La actividad del SARS-CoV-2 continuó disminuyendo en la mayoría de los países. En Ecuador, la actividad de la influenza disminuyó a los niveles de referencia por encima del promedio de los años anteriores. La actividad del VRS fue mayor que en años anteriores, excepto en 2015 y 2016. En Perú, la actividad de influenza aumentó con predominio de A(H3N2). Brasil y Cono Sur: en general, la actividad de la influenza con predominio de A(H3N2) y SARS-CoV-2 tienden a la disminución, excepto en Brasil en donde el porcentaje de positividad de SARS-CoV2 aumentó a niveles altos por encima de los niveles observados a fines de 2021. Global: la actividad de la influenza se mantuvo baja, con una disminución adicional en algunas áreas. En las zonas templadas del hemisferio norte, la actividad de la influenza parece disminuir. En Europa, la actividad general de la influenza pareció disminuir, predominando la influenza A(H3N2). En Asia Central, se informaron detecciones esporádicas de influenza B en Kazajstán. En el este de Asia, la actividad de la influenza principalmente con detecciones de influenza B linaje Victoria continuó disminuyendo en China. La tasa de ETI y las hospitalizaciones por neumonía permanecieron elevadas en Mongolia. En otros lugares, los indicadores y la actividad de la enfermedad por influenza permanecieron bajos. En el norte de África, se informó una disminución de las detecciones de influenza A(H3N2) en Túnez. En Asia Occidental, Georgia informó un aumento en las detecciones de influenza A(H3N2). En África tropical, se notificó la actividad de la influenza principalmente en África oriental, predominando la influenza A(H3N2), seguida por los virus de la influenza B. En el sur de Asia, las detecciones del virus de la influenza estuvieron en niveles bajos en general. Solo Malasia notificó detecciones de virus de la influenza A(H3N2) y B en el sudeste asiático. En las zonas templadas del hemisferio sur, la actividad de la influenza se mantuvo baja en general. Sin embargo, continuó la notificación de detecciones de virus influenza A(H3N2) (predominante entre los virus a los que se les determinó el subtipo) en Sudáfrica. El porcentaje de positividad de SARS-CoV-2 en la vigilancia centinela disminuyó por debajo del 10% en todas las regiones durante este período de informe. La positividad general de los sitios no centinela también mostró una tendencia a la baja.


Subject(s)
COVID-19 , Influenza, Human , SARS-CoV-2 , Betacoronavirus , International Health Regulations , Americas , Caribbean Region , Influenza, Human , International Health Regulations , Americas , Caribbean Region
10.
Article in English | PAHO-IRIS | ID: phr-55935

ABSTRACT

[ABSTRACT]. Objective. To estimate the point prevalence and likely ranges of pregnancy-induced hypertension, preeclampsia, gestational diabetes, low birth weight and preterm delivery in Latin America and the Caribbean, and evaluate the heterogeneity of the estimates. Methods. We conducted a systematic review and meta-analysis of observational studies reporting the prevalence of maternal and perinatal adverse outcomes in populations in Latin American and the Caribbean published between 2000 and 2019 in English, Spanish, or Portuguese. We searched PubMed, Embase, and LILACS. We estimated the point prevalence and evaluated overall heterogeneity and, in sub-group analyses, heterogeneity by study design and level of bias. Results. Of 1087 records retrieved, 50 articles were included in the review: two on hypertensive disorders of pregnancy, 14 on pre-eclampsia, six on gestational diabetes, nine on low birth weight and 19 on preterm birth. No meta-analysis for hypertensive disorders of pregnancy could be done because of the small number of studies. Point prevalence estimates and 95% confidence intervals (CIs) for pre-eclampsia, gestational diabetes, low birth weight, and preterm birth were: 6.6% (95% CI: 4.9%, 8.6%), 8.5% (95% CI: 3.9%, 14.7%), 8.5% (95% CI: 7.2%, 9.8%), and 10.0% (95% CI: 8.0%, 12.0%), respectively. We observed substantial heterogeneity overall and by study design. No major differences in estimates were observed by level of bias. Conclusions. The results of this study provide updated estimates of some of the most prevalent adverse pregnancy and perinatal outcomes in Latin America and the Caribbean. They highlight that important heterogeneity exists in prevalence estimates, which may reflect the diversity of populations in the region.


[RESUMEN]. Objetivo. Estimar la prevalencia puntual y los rangos probables de hipertensión provocada por embarazo, preeclampsia, diabetes gestacional, peso bajo al nacer y parto prematuro en América Latina y el Caribe, y evaluar la heterogeneidad de las estimaciones. Métodos. Se llevó a cabo una revisión sistemática y metanálisis de los estudios de observación que notificaron la prevalencia de resultados adversos perinatales y maternos en poblaciones de América Latina y el Caribe, publicados entre los años 2000 y 2019 en inglés, español o portugués. Se realizaron búsquedas en PubMed, Embase y LILACS. Se estimó la prevalencia puntual y se evaluó la heterogeneidad general y, en los análisis de subgrupos, la heterogeneidad según el diseño del estudio y nivel de sesgo. Resultados. De 1 087 registros recuperados, se incluyeron 50 artículos en la revisión: 2 sobre los trastornos hipertensivos en el embarazo, 14 sobre preeclampsia, 6 sobre la diabetes gestacional, 9 sobre peso bajo al nacer y 19 sobre parto prematuro. No se pudo realizar ningún metanálisis de los trastornos hipertensivos del embarazo debido al número reducido de estudios. Las estimaciones de prevalencia puntual y los intervalos de confianza (IC) del 95% para la preeclampsia, la diabetes gestacional, el peso bajo al nacer y el parto prematuro fueron: 6,6% (IC de 95%: 4,9%, 8,6%), 8,5% (IC de 95%: 3,9%, 14,7%), 8,5% (IC de 95%: 7,2%, 9,8%) y 10,0% (IC de 95%: 8,0%, 12,0%), respectivamente. Se observó una heterogeneidad significativa en general, así como según el diseño del estudio. No se advirtieron grandes diferencias en las estimaciones según el nivel del sesgo. Conclusiones. Los resultados de este estudio ofrecen cálculos actualizados de algunos de los resultados adversos perinatales y del embarazo con mayor prevalencia en América Latina y el Caribe. Estos resultados ponen de manifiesto que existe una gran heterogeneidad en las estimaciones de prevalencia, que podría reflejar la diversidad de la población de la región.


Subject(s)
Hypertension , Pre-Eclampsia , Diabetes, Gestational , Infant, Low Birth Weight , Premature Birth , Latin America , Caribbean Region , Hypertension, Pregnancy-Induced , Pre-Eclampsia , Diabetes, Gestational , Infant, Low Birth Weight , Premature Birth , Latin America , Caribbean Region , Hypertension, Pregnancy-Induced , Pre-Eclampsia , Infant, Low Birth Weight , Premature Birth , Caribbean Region
11.
Article in Spanish | PAHO-IRIS | ID: phr-55934

ABSTRACT

[RESUMEN]. Objetivo. Mapear protocolos de investigación, publicaciones y colaboraciones sobre la enfermedad por el coronavirus 2019 (COVID-19, por su sigla en inglés) desarrollados en América Latina y el Caribe (ALC). Métodos. Se incluyeron protocolos registrados en plataformas internacionales y publicaciones de investigaciones que consideraron población, datos y autores de ALC. La fuente de información para los protocolos fue principalmente la Plataforma Internacional de Registro de Ensayos Clínicos (ICTRP, por su sigla en inglés) de la Organización Mundial de la Salud; para las publicaciones se utilizaron bases electrónicas y repositorios específicos sobre la COVID-19. Se realizaron búsquedas de las publicaciones hasta el 11 de noviembre y de los protocolos hasta el día 30 de noviembre de 2020, inclusive. La información de los protocolos se extrajo según variables estandarizadas de la plataforma ICTRP y la de las publicaciones, según criterios preestablecidos. Resultados. De los protocolos, 63,0% fueron estudios sobre terapias, 10% de prevención y 45% fueron colaborativos. Con respecto al financiamiento, 64% de los protocolos no provino de la industria. En cuanto a las publicaciones, 23% fueron sin revisión de pares y 23% fueron colaborativas. Los diseños más frecuentes fueron las revisiones sistemáticas y estudios de corte transversal; 47,1% fueron realizados en servicios de salud y 22% en el ámbito comunitario; 38,0% se enfocaron en el diagnóstico y 27,9% en el pronóstico. Se realizó una síntesis cualitativa según la línea de cuidado y las estrategias de abordaje. Conclusiones. Se observó un aumento del número de investigaciones colaborativas en comparación con estudios anteriores y de protocolos no financiados por la industria. La agenda de investigación propuesta se cubrió en gran parte conforme al avance de la pandemia.


[ABSTRACT]. Objective. To map research protocols, publications, and collaborations on coronavirus disease 2019 (COVID- 19) developed in Latin America and the Caribbean (LAC). Methods. Included were research protocols registered in international platforms and research publications containing populations, data, or authors from LAC. The source of information for protocols was primarily the International Clinical Trial Registry Platform (ICTRP) of the World Health Organization; for publications, specific electronic databases and repositories pertaining to COVID-19 were used. The search for publications was conducted up to 11 November; the search for protocols, up to 30 November 2020 (both dates inclusive). Data was extracted from protocols using standardized variables from the ICTRP, and from publications following pre-established criteria. Results. Among the protocols, 63.0% were therapeutic studies, 10% focused on prevention, and 45% were collaborative; 64% of the protocols received no funding from industry; 23% of the publications were not peerreviewed and 23% were collaborative in nature. The most frequent study designs were systematic reviews and cross-sectional studies; 47.1% of studies were conducted in health facilities and 22% in community settings; 38.0% focused on diagnosis and 27.9% on prognosis. A qualitative synthesis was performed by line of care and approach strategies. Conclusions. There was an increase in the number of collaborative research studies relative to earlier studies and in protocols not funded by industry. The proposed research agenda was covered in large part as the pandemic unfolded.


[RESUMO]. Objetivo. Mapear protocolos de pesquisa, publicações e colaborações sobre a doença causada pelo coronavírus 2019 (COVID-19, na sigla em inglês) desenvolvidos na América Latina e no Caribe (ALC). Métodos. Foram incluídos protocolos registrados em plataformas internacionais e publicações de pesquisas que consideraram população, dados e autores da ALC. A fonte de informação para os protocolos foi principalmente a Plataforma Internacional de Registros de Ensaios Clínicos (ICTRP, na sigla em inglês) da Organização Mundial da Saúde. Para as publicações, foram utilizadas bases de dados eletrônicas e repositórios específicos sobre COVID-19. As publicações foram pesquisadas até 11 de novembro, e os protocolos, até 30 de novembro de 2020 (inclusive). As informações dos protocolos foram extraídas de acordo com variáveis padronizadas da plataforma ICTRP e das publicações, segundo critérios pré-estabelecidos. Resultados. Dos protocolos, 63% eram estudos sobre terapias, 10% sobre prevenção e 45% eram colaborativos. Em relação ao financiamento, 64% dos protocolos não vieram da indústria. Em relação às publicações, 23% eram sem revisão por pares e 23% eram colaborativas. Os delineamentos mais frequentes foram revisões sistemáticas e estudos transversais; 47,1% foram realizados em serviços de saúde e 22% no âmbito comunitário; 38,0% focaram no diagnóstico e 27,9% no prognóstico. Realizou-se uma síntese qualitativa segundo a linha de cuidado e as estratégias de abordagem. Conclusões. Observou-se um aumento no número de pesquisas colaborativas (em comparação com estudos anteriores) e de protocolos não financiados pela indústria. A agenda de pesquisa proposta foi coberta, em grande parte, à medida que a pandemia progredia.


Subject(s)
COVID-19 , Health Research Agenda , Latin America , Caribbean Region , Health Research Agenda , Latin America , Caribbean Region , Health Research Agenda , Latin America , Caribbean Region
12.
BMC Public Health ; 22(1): 913, 2022 05 07.
Article in English | MEDLINE | ID: mdl-35525946

ABSTRACT

BACKGROUND: The African, Caribbean, and Black (ACB) population of Ontario, Canada is comprised of individuals with diverse ethnic, cultural and linguistic backgrounds and experiences; some of whom have resided in Canada for many generations, and others who have migrated in recent decades. Even though the ACB population represents less than 3.5% of the Canadian population, this group accounts for 21.7% of all new HIV infections. It is well-documented that ACB populations, compared to the general population, experience multi-level barriers to accessing appropriate and responsive HIV services. In this paper, we present qualitative findings on the ACB population's experiences with HIV-testing, pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) and obtain their perspectives on how to improve access. METHODS: We conducted twelve Focus Group Discussions (FGDs), within a two-day World Café event and used socio-ecological framework and community-based participatory research (CBPR) approaches to guide this work. We meaningfully engaged ACB community members in discussions to identify barriers and facilitators to HIV testing, PEP and PrEP and how these may be addressed. The FGDs were transcribed verbatim and thematic analysis guided data interpretation. Credibility of data was established through data validation strategies such as external audit and peer-debriefing. RESULTS: Our analyses revealed multi-level barriers that explain why ACB community members do not access HIV testing, PEP and PrEP. Fear, health beliefs, stigma and lack of information, were among the most frequently cited individual- and community-level barriers to care. Health system barriers included lack of provider awareness, issues related to cultural sensitivity and confidentiality, cost, and racism in the health care system. Participants identified multi-level strategies to address the HIV needs including community-based educational, health system and innovative inter-sectoral strategies. CONCLUSION: CBPR, co-led by community members, is an important strategy for identifying the multi-level individual, interpersonal, community, institutional and structural factors that increase HIV vulnerability in ACB communities, notably anti-Black systemic racism. Study findings suggest the need for targeted community-based strategies and strategies aimed at reducing health system barriers to testing and care.


Subject(s)
Anti-HIV Agents , HIV Infections , Pre-Exposure Prophylaxis , Anti-HIV Agents/therapeutic use , Caribbean Region , HIV Infections/diagnosis , HIV Infections/drug therapy , HIV Infections/prevention & control , HIV Testing , Humans , Ontario , Post-Exposure Prophylaxis
13.
Brasilia, D.F.; OPAS; 2022-04-25. (OPAS/BRA/NMH/21-0077).
in Portuguese | PAHO-IRIS | ID: phr2-55920

ABSTRACT

Em 2016, por meio da Resolução 70/259, a Organização das Nações Unidas (ONU) endossou os resultados da II Conferência Internacional de Nutrição, proclamou a Década de Ação das Nações Unidas para Nutrição (2016-2025) e solicitou que a Organização Mundial da Saúde (OMS) e a Organização das Nações Unidas para a Alimentação e Agricultura (FAO) liderassem a implementação da Década1. O objetivo da Década é coordenar esforços de diversos setores para o efetivo enfrentamento a todas as formas de má nutrição, partindo de uma perspectiva ampliada que reconhece as principais causas e fatores que contribuem para os diferentes desfechos. O Brasil foi o primeiro país a formalizar compromissos no âmbito da Década de Ação das Nações Unidas para Nutrição. Em 2017, o Ministério da Saúde se comprometeu a deter o crescimento da obesidade e a melhorar o perfl alimentar por meio do aumento do consumo de frutas e hortaliças e da redução do consumo de bebidas adoçadas na população adulta. Nesse mesmo ano, durante a 44ª Sessão do Comitê de Segurança Alimentar da FAO, o Brasil divulgou o documento intitulado “Compromissos do Brasil para a Década de Ação das Nações Unidas para a Nutrição (2016-2025)”, que consolidou todos os compromissos do país para a Década de Ação.


Subject(s)
Food Guide , Nutritional Sciences , Diet, Healthy , Food-Processing Industry , Food Security , Latin America , Caribbean Region
14.
J Aging Health ; 34(3): 460-471, 2022 Jun.
Article in English | MEDLINE | ID: mdl-35420508

ABSTRACT

OBJECTIVES: This study examined differences in major and everyday discrimination between African Americans, Black Caribbeans, and non-Latino White older adults. METHODS: Data are taken from the National Survey of American Life. Measures of major (e.g., unfairly fired and harassed by police) and everyday (e.g., treated with less courtesy, insulted, and followed in stores) discrimination were examined. RESULTS: Both African Americans and Black Caribbeans reported more major and everyday discrimination than non-Latino Whites. However, there were no significant differences between African Americans and Whites with regards to being fired, neighbors making life difficult and receiving poor service. There were no significant differences between African Americans and Black Caribbeans in major or everyday discrimination. DISCUSSION: The discussion notes the importance of examining racial as well as within group ethnic differences within the Black American population in the types of discrimination. It also notes the importance of examining indicators of both major and everyday discrimination.


Subject(s)
African Americans , Aged , Caribbean Region , Humans , United States
15.
J Aging Health ; 34(3): 390-400, 2022 Jun.
Article in English | MEDLINE | ID: mdl-35438578

ABSTRACT

Objectives: This study examined the frequency and impact of traumatic events on the mental health of older African American and Black Caribbean adults. Methods: The current study used data from the National Survey of American Life of 1,135 African American and 426 Black Caribbean adults aged 50 and older. Analysis examined the impact of traumatic events on both positive (i.e., happiness and life satisfaction) and negative (i.e., depressive symptoms, psychological distress, and 12-month anti-depressant use) domains of mental health. Results: Findings indicate that approximately 80% of older African Americans and Black Caribbeans reported experiencing a traumatic event at some point in their lifetime. Among African Americans assaultive violence was associated with more depressive symptoms, lower levels of life satisfaction, and lower levels of happiness. This was not the case among Black Caribbeans. Conclusions: These findings provide preliminary insight in mental health outcomes for older African American and Black Caribbean adults.


Subject(s)
African Americans , Mental Health , African Americans/psychology , Aged , Caribbean Region , Humans , Middle Aged , United States
16.
J Aging Health ; 34(3): 435-447, 2022 Jun.
Article in English | MEDLINE | ID: mdl-35440226

ABSTRACT

ObjectiveThe purpose of this study was to examine race, ethnicity, and age differences in the association between social relationships and body weight in a nationally representative sample of African American, Caribbean Black, and non-Hispanic White adults. Methods: Data were drawn from the 2001-2003 National Survey of American Life (N = 5684). Multiple linear regressions were conducted to examine the links between race, ethnicity, and age with social relationships and weight. Results: Although African American respondents had higher BMI than non-Hispanic White respondents, Caribbean Black respondents did not differ from White respondents in BMI. Emotional support from family members was both positively and negatively associated with weight depending on age, race, and ethnicity. Discussion: Social relationships are an important contributing factor to obesity and obesity-related risks in adults. Study findings demonstrate the intersection of race, ethnicity, and age and how these complex relationships influence the association between social relationships and body weight.


Subject(s)
African Americans , African Americans/psychology , Caribbean Region , Humans , Interpersonal Relations , Obesity/epidemiology , United States/epidemiology
17.
Washington, D.C.; PAHO; 2022-04-27.
in English, Spanish | PAHO-IRIS | ID: phr-55937

ABSTRACT

[WEEKLY SUMMARY]. North America: Overall, influenza activity remained at low levels, SARS-CoV-2 activity declined, and percent positivity for SARS-Cov2 remained at low levels. In Canada, influenza activity remained low, and SARS-CoV-2 activity remained at low levels. In Mexico, influenza activity has decreased below the average of previous seasons, and SARS-CoV-2 activity decreased. In the United States, influenza activity is highest in the northeastern, south-central, and mountain regions, with influenza A(H3N2) viruses predominating. SARS-CoV-2 activity continued to decline. Caribbean: Influenza activity remained at low levels, with predominating influenza A(H3N2). Overall, SARS-CoV-2 activity continued to decline. In Dominica, SARI activity increased and remains below baseline levels. In Puerto Rico, the percentage of visits for influenza-like illness increased to high levels for this time of year. Central America: Overall, influenza activity remained low and SARS-CoV-2 activity decreased in most countries. In El Salvador, influenza activity remained above-average levels at low-intensity levels. Andean: Overall, influenza activity remained low with some A(H3N2) detections. SARS-CoV-2 activity continued to decline in most countries. In Ecuador, influenza activity decreased to above-average baseline levels for previous years. Brazil and Southern Cone: Overall, the activity of influenza with the predominance of A(H3N2) and SARS-CoV-2 tends to decrease, except in Argentina, where the percentage of influenza positivity was at levels of extraordinary intensity compared to the average of influenza in previous seasons.


[RESUMEN SEMANAL]. América del Norte: en general, la actividad de la influenza se mantuvo en niveles bajos La actividad del SARS-CoV-2 continuó disminuyendo y el porcentaje de positividad de SARS-Cov2 se mantiene en niveles bajos. En Canadá, la actividad de la influenza continuó baja y la actividad de SARS-CoV-2 se mantiene en niveles bajos En México, la actividad de la influenza ha disminuido por debajo del promedio de temporadas anteriores y la actividad del SARS-CoV-2 disminuyó. En los Estados Unidos, la actividad de la influenza es mayor en las regiones nororiental, centro-sur y montañosa del país con predominio de los virus influenza A(H3N2). La actividad del SARS-CoV-2 siguió en disminución. Caribe: en general, la actividad de la influenza se mantuvo en niveles bajos, con predominio de influenza A(H3N2). En general, la actividad del SARS-CoV-2 continuó en disminución. En Dominica, la actividad de infecciones respiratorias agudas graves (IRAG) aumentó y se mantiene por debajo de los niveles de referencia. En Puerto Rico , el porcentaje de visitas por enfermedad tipo influenza aumentó a niveles altos para esta época del año. América Central: en general, la actividad de la influenza se mantuvo baja y la actividad del SARS-CoV-2 disminuyó en la mayoría de los países. En El Salvador la actividad de la influenza permaneció por encima de los niveles promedio en niveles de intensidad bajos. Andina: en general, la actividad de la influenza siguió baja con algunas detecciones de A(H3N2). La actividad del SARS-CoV-2 continuó disminuyendo en la mayoría de los países. En Ecuador, la actividad de la influenza disminuyó a los niveles de referencia por encima del promedio de los años anteriores. Brasil y Cono Sur: en general, la actividad de la influenza con predominio de A(H3N2)y SARS-CoV-2 tienden a la disminución, excepto en Argentina, donde el porcentaje de positividad de influenza estuvo en niveles de intensidad extraordinaria en comparación con el promedio de las temporadas anteriores.


Subject(s)
COVID-19 , Influenza, Human , SARS-CoV-2 , Betacoronavirus , International Health Regulations , Americas , Caribbean Region , Influenza, Human , International Health Regulations , Americas , Caribbean Region
18.
Washington, D.C.; OPS; 2022-04-25.
in Spanish | PAHO-IRIS | ID: phr-55923

ABSTRACT

La prevención y control de infecciones (PCI) es una estrategia fundamental para reducir las infecciones asociadas a la atención de salud, hacer frente a la propagación de microorganismos resistentes a los antimicrobianos, y mitigar las epidemias y pandemias futuras. En esta publicación sobre el estado actual de la aplicación de los componentes básicos de PCI en la Región de las Américas, se muestra un panorama de la aplicación de programas de control de infecciones en los últimos años y, principalmente, su evolución como respuesta a la pandemia de COVID-19. Como parte del ejercicio de mapeo, se analizaron 299 iniciativas de PCI validadas de manera oficial por 30 países y territorios de las Américas. Entre ellas se incluyen programas de PCI, directrices de PCI, políticas o programas de formación y capacitación del personal de salud, y directrices para la vigilancia y contención de las infecciones asociadas a la atención de salud. La búsqueda se realizó hasta diciembre del 2020 a través de diferentes fuentes de información y en los sitios web oficiales de las autoridades normativas competentes, que validaron las iniciativas durante el primer cuatrimestre del 2021. La pandemia ha puesto de manifiesto las brechas presentes en este ámbito a nivel nacional y en los establecimientos de salud. Si se logra eliminarlas, la Región de las Américas garantizará no solo la seguridad de las personas usuarias de los servicios de salud sino también de quienes proveen su cuidado. Este informe forma parte del empeño continuo de la Organización Panamericana de la Salud para fortalecer la PCI en los países y facilitará la reflexión sobre las medidas requeridas para construir sistemas de salud más resilientes.  


Subject(s)
Surveillance , Emergencies , Infection Control , Disease Prevention , Americas , Caribbean Region
19.
Washington, D.C.; PAHO; 2022-04-21.
in English, Spanish | PAHO-IRIS | ID: phr-55917

ABSTRACT

[WEEKLY SUMMARY]. North America: Overall, influenza activity remained at low levels. SARS-CoV-2 activity continued to decline, and SARS-CoV-2 percent positivity remained at low levels. In Canada, influenza activity continued low, and SARS-CoV-2 activity slightly increased. In Mexico, influenza activity has decreased below the average of previous seasons, and the SARS-CoV-2 activity declined. In the United States, influenza activity increased at the national level, with Influenza A(H3N2) viruses predominating. SARS-CoV-2 activity, including mortality, continued to decline. Caribbean: Influenza activity remained at low levels overall, with influenza A(H3N2) predominant. SARS-CoV-2 activity continued to decline overall. Central America: Overall, influenza activity remained low and SARS-CoV-2 activity decreased in most countries. In Nicaragua, influenza percent positivity remained stable at low-intensity levels. In El Salvador, influenza activity remained above average at low-intensity levels. Andean: Overall, influenza activity continued low with a few A(H3N2) detections. SARS-CoV-2 activity continued to decrease in most countries. In Peru, influenza percent positivity increased at low-intensity levels. RSV activity increased in Ecuador. Brazil and Southern Cone: Overall, influenza activity with A(H3N2) predominance and SARS-CoV-2 activity continued to decrease in most countries. In Chile, influenza percent positivity was above the previous season’s average within the reference levels, and SARS-CoV-2 activity decreased. In Brazil, RSV activity increased. Global: Influenza activity remained low, but activity has increased since February 2022, after an initial decrease in January 2022. In the temperate zones of the northern hemisphere, influenza activity increased or remained stable, except in East Asia, where detections decreased. Detections were mainly influenza A(H3N2) viruses and B/Victoria lineage viruses. In Europe, overall influenza activity has stabilized with influenza A(H3N2) predominant. Very little RSV activity was observed. In Central Asia, a single influenza B detection was reported in Kyrgyzstan. In East Asia, influenza activity with mainly influenza B/Victoria lineage detections appeared to decrease in China. ILI rate and pneumonia hospitalizations remained elevated in Mongolia. Elsewhere, influenza illness indicators and activity remained low. In Northern Africa, increasing influenza A(H3N2) detections were reported in Tunisia. In Western Asia, influenza activity was low across reporting countries, except Georgia, where increased influenza A(H3N2) detections were reported. In tropical Africa, influenza activity was reported mainly from Eastern Africa, with influenza A(H3N2) predominating, followed by influenza B/Victoria lineage viruses. In Southern Asia, influenza virus detections were at low levels with influenza A(H1N1)pdm09 and A(H3N2) viruses. In South-East Asia, influenza detections were at low levels except in Timor-Leste, with influenza A(H3N2) predominant. In the temperate zones of the southern hemisphere, influenza activity remained low overall. However, detections of influenza A viruses (with A(H3N2) predominant among the subtyped viruses) continued to be reported in South Africa. SARS-CoV-2 percent positivity from sentinel surveillance was around 10.0% in all regions during this reporting period. Percent positivity decreased in all regions except in the South-East Asian region, where it increased, and in the Eastern Mediterranean Region, where there was a slight uptick. Overall positivity from non-sentinel sites also showed a decreasing trend.


[RESUMEN SEMANAL]. América del Norte: en general, la actividad de la influenza se mantuvo en niveles bajos La actividad del SARS-CoV-2 continuó disminuyendo y el porcentaje de positividad de SARS-Cov2 se mantiene en niveles bajos. En Canadá, la actividad de la influenza continuó baja y la actividad de SARS-CoV-2 aumentó levemente. En México, la actividad de la influenza ha disminuido por debajo del promedio de temporadas anteriores y la actividad del SARS-CoV-2 disminuyó. En los Estados Unidos, la actividad de la influenza aumentó a nivel nacional con predominio de los virus influenza A(H3N2). La actividad del SARS-CoV-2, incluida la mortalidad, siguió en disminución Caribe: en general la actividad de la influenza se mantuvo en niveles bajos, con predominio de influenza A(H3N2). En general, la actividad del SARS-CoV-2 continuó en disminución. América Central: en general, la actividad de la influenza se mantuvo baja y la actividad del SARS-CoV-2 disminuyó en la mayoría de los países. En Nicaragua el porcentaje de positividad de influenza se mantuvo estable y en niveles de baja intensidad. En El Salvador la actividad de la influenza permaneció por encima de los niveles promedio en niveles de intensidad bajos. Andina: en general, la actividad de la influenza siguió baja con algunas detecciones de A(H3N2). La actividad del SARS-CoV-2 continuó disminuyendo en la mayoría de los países. En Perú el porcentaje de positividad de influenza aumentó en niveles de baja intensidad. La actividad de VSR aumentó en Ecuador. Brasil y Cono Sur: en general, la actividad de la influenza con predominio de A(H3N2)y SARS-CoV-2 tienden a la disminución. En Chile el porcentaje de positividad de influenza estuvo por encima del promedio de la temporada anterior en los niveles de referencia y la actividad del SARS-CoV-2 disminuyó. En Brasil la actividad de VRS aumentó. Global: la actividad de la influenza se mantuvo baja, pero ha aumentado desde febrero de 2022, luego de una disminución inicial en enero de 2022. En las zonas templadas del hemisferio norte, la actividad de la influenza aumentó o se mantuvo estable, excepto en el este de Asia, donde las detecciones disminuyeron. Se detectó principalmente virus de la influenza A(H3N2) e influenza B linaje Victoria. En Europa, en general, la actividad de la influenza se ha estabilizado con predominio de influenza A(H3N2). Se observó muy poca actividad de VRS. En Asia Central, se notificó una sola detección de influenza B en Kirguistán. En el este de Asia, la actividad de la influenza principalmente con detecciones de influenza B linaje Victoria, pareció disminuir en China. La tasa de ETI y las hospitalizaciones por neumonía permanecieron elevadas en Mongolia. En otros lugares, los indicadores y la actividad de la enfermedad por influenza permanecieron bajos. En el norte de África, en Túnez, se informó un aumento de las detecciones de influenza A(H3N2). En Asia occidental la actividad de la influenza fue baja en todos los países que informaron, excepto en Georgia, donde huno un aumento en las detecciones de influenza A(H3N2). En África tropical, se notificó actividad de la influenza principalmente en África oriental, con predominio de influenza A(H3N2), seguida por los virus influenza B linaje Victoria. En el sur de Asia, las detecciones del virus de la influenza fueron bajas con la circulación de los virus influenza A(H1N1)pdm09 y A(H3N2). En el sudeste asiático, las detecciones de influenza estuvieron en niveles bajos excepto en Timor-Leste, donde predomina la influenza A(H3N2). En las zonas templadas del hemisferio sur, en general, la actividad de la influenza se mantuvo baja. Sin embargo, continuaron las notificaciones de detecciones de los virus influenza A (con predominio de A(H3N2) en las muestras en que se determinó el subtipo) en Sudáfrica. El porcentaje de positividad de SARS-CoV-2 en la vigilancia centinela fue de alrededor del 10,0 % en todas las durante este período de informe. El porcentaje de positividad disminuyó en todas las regiones excepto en la región de Asia Sudoriental, donde aumentó, y en la Región del Mediterráneo Oriental, donde hubo un ligero repunte. La positividad general de los sitios no centinela también mostró una tendencia a la baja.


Subject(s)
COVID-19 , Influenza, Human , SARS-CoV-2 , Betacoronavirus , International Health Regulations , Americas , Caribbean Region , Influenza, Human , International Health Regulations , Americas , Caribbean Region
20.
Article in Spanish | PAHO-IRIS | ID: phr-55912

ABSTRACT

[RESUMEN]. Objetivo. Identificar los enfoques sobre la inocuidad y calidad del agua en los documentos que describen los programas de alimentación escolar en los países de América Latina y el Caribe (ALC). Métodos. Estudio descriptivo, transversal y exploratorio de los documentos sobre alimentación escolar en los países y territorios de ALC. Se realizó el análisis documental y se determinaron a priori cuatro categorías: “agua para el consumo”, “agua para la higiene”, “agua para la preparación”, y “agricultura local/familiar” según el uso del agua en la alimentación escolar. Los documentos fueron buscados durante 2018-2019 en los sitios web oficiales de los países y territorios de ALC, la Organización de las Naciones Unidas para la Alimentación y Agricultura y el Programa Mundial de Alimentos. Se obtuvieron las frecuencias absolutas y relativas de los datos cuantitativos y para los datos cualitativos se aplicó el análisis de contenido del tipo temático. Resultados. Se analizaron 114 documentos, de los cuales 29 eran elegibles. Los enfoques de las categorías “agua para el consumo”, “agua para la higiene” y “agua para la preparación” solo atribuían al agua la característica de ser potable. En la categoría “agricultura local/familiar” no se encontraron enfoques sobre el agua para el riego. Conclusión. Los documentos abordan el agua, pero no se centran en su inocuidad y calidad. Los gobiernos y autoridades locales deben revisar sus documentos y garantizar la unanimidad de los enfoques a partir del apoyo y diálogo intersectorial para alcanzar las metas de los Objetivos de Desarrollo Sostenible.


[ABSTRACT]. Objective. Identify approaches to water safety and quality in documents describing school feeding programs in Latin American and Caribbean (LAC) countries. Methods. Descriptive, cross-sectional, exploratory study of documents on school feeding in LAC countries and territories. A documentary analysis was carried out and four initial categories were determined: “water for consumption”, “water for hygiene”, “water for food preparation”, and “local/family agriculture”, according to the use of water in school feeding programs. Documents were identified in 2018 and 2019 on the official websites of LAC countries and territories, the United Nations Food and Agriculture Organization, and the World Food Programme. Absolute and relative frequencies were obtained for quantitative data; thematic content analysis was applied to qualitative data. Results. Of the 114 documents analyzed, 29 were eligible. In the categories “water for consumption”, “water for hygiene” and “water for food preparation”, the only characteristic attributed to water was that it be potable. In the category “local/family farming”, no approaches were found that addressed water for irrigation. Conclusion. The documents address water, but do not focus on its safety and quality. Governments and local authorities should review their documents and ensure that their approaches are mutually coherent and based on intersectoral support and dialogue to achieve the targets of the Sustainable Development Goals.


Subject(s)
School Feeding , Water , Food Safety , Latin America , Caribbean Region , School Feeding , Water , Food Safety , Water Security , Latin America , Caribbean Region , School Feeding , Water , Water Security , Caribbean Region
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