Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 59
Filtrar
1.
Nature ; 597(7877): 516-521, 2021 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-34471291

RESUMEN

Biodiversity contributes to the ecological and climatic stability of the Amazon Basin1,2, but is increasingly threatened by deforestation and fire3,4. Here we quantify these impacts over the past two decades using remote-sensing estimates of fire and deforestation and comprehensive range estimates of 11,514 plant species and 3,079 vertebrate species in the Amazon. Deforestation has led to large amounts of habitat loss, and fires further exacerbate this already substantial impact on Amazonian biodiversity. Since 2001, 103,079-189,755 km2 of Amazon rainforest has been impacted by fires, potentially impacting the ranges of 77.3-85.2% of species that are listed as threatened in this region5. The impacts of fire on the ranges of species in Amazonia could be as high as 64%, and greater impacts are typically associated with species that have restricted ranges. We find close associations between forest policy, fire-impacted forest area and their potential impacts on biodiversity. In Brazil, forest policies that were initiated in the mid-2000s corresponded to reduced rates of burning. However, relaxed enforcement of these policies in 2019 has seemingly begun to reverse this trend: approximately 4,253-10,343 km2 of forest has been impacted by fire, leading to some of the most severe potential impacts on biodiversity since 2009. These results highlight the critical role of policy enforcement in the preservation of biodiversity in the Amazon.

2.
BMJ Open ; 11(9): e051836, 2021 09 21.
Artículo en Inglés | MEDLINE | ID: mdl-34548362

RESUMEN

OBJECTIVE: This study aimed to capture key epidemiological data on SARS-CoV-2 infection in Nicaraguan children (≤18 years) seeking medical care, between 6 October and 16 November 2020. DESIGN: In this cross-sectional study, 418 children were recruited: 319 with symptoms characteristic of COVID-19 and 99 with no symptoms of illness. Children were tested for SARS-CoV-2 RNA using loop-mediated isothermal amplification. A questionnaire was employed to identify symptoms, risk factors, comorbidities and COVID-19 prevention measures. SETTING: Research was carried out in four hospitals and two clinics in Managua, Nicaragua, where schools and businesses remained open throughout the COVID-19 pandemic. PARTICIPANTS: Children were enrolled into a possible COVID-19 group if presenting with clinical symptoms. A comparison group included children lacking any COVID-19 symptoms attending routine check-ups or seeking care for issues unrelated to COVID-19. RESULTS: A high prevalence (43%) of SARS-CoV-2 infection was found, which was relatively equivalent in symptomatic and non-symptomatic children. Age distribution was similar between symptomatic and non-symptomatic children testing positive for SARS-CoV-2. Symptomatic children who tested positive for SARS-CoV-2 were 2.7 times more likely to have diarrhoea (26.7% in positive vs 12.0% in negative; OR=2.7 (95% CI 1.5 to 4.8), p=0.001) and were 2.0 times more likely to have myalgia (17.8% in positive vs 9.8% in negative; OR=2.0 (95% CI 1.0 to 3.8), p=0.04). Children with COVID-19 symptoms, who tested positive for SARS-CoV-2, were more likely to be under age 5 years and to have a pre-existing comorbid condition than children who tested positive but did not have symptoms. CONCLUSIONS: This is the first paediatric study to provide laboratory-confirmed data on SARS-CoV-2 infection in Nicaragua, crucial for paediatric health services planning and a successful COVID-19 response. The high prevalence of the virus suggests widespread and sustained community transmission, underscoring the urgent need for robust data on the true extent of SARS-CoV-2 infection throughout Nicaragua.


Asunto(s)
COVID-19 , SARS-CoV-2 , Niño , Preescolar , Estudios Transversales , Humanos , Técnicas de Diagnóstico Molecular , Nicaragua/epidemiología , Técnicas de Amplificación de Ácido Nucleico , Pandemias , Prevalencia , ARN Viral , Factores de Riesgo
3.
Environ Health Perspect ; 129(9): 96002, 2021 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-34582261

RESUMEN

BACKGROUND: Climate change is expected to increase the frequency of flooding events. Although rainfall is highly correlated with mosquito-borne diseases (MBD) in humans, less research focuses on understanding the impact of flooding events on disease incidence. This lack of research presents a significant gap in climate change-driven disease forecasting. OBJECTIVES: We conducted a scoping review to assess the strength of evidence regarding the potential relationship between flooding and MBD and to determine knowledge gaps. METHODS: PubMed, Embase, and Web of Science were searched through 31 December 2020 and supplemented with review of citations in relevant publications. Studies on rainfall were included only if the operationalization allowed for distinction of unusually heavy rainfall events. Data were abstracted by disease (dengue, malaria, or other) and stratified by post-event timing of disease assessment. Studies that conducted statistical testing were summarized in detail. RESULTS: From 3,008 initial results, we included 131 relevant studies (dengue n=45, malaria n=61, other MBD n=49). Dengue studies indicated short-term (<1 month) decreases and subsequent (1-4 month) increases in incidence. Malaria studies indicated post-event incidence increases, but the results were mixed, and the temporal pattern was less clear. Statistical evidence was limited for other MBD, though findings suggest that human outbreaks of Murray Valley encephalitis, Ross River virus, Barmah Forest virus, Rift Valley fever, and Japanese encephalitis may follow flooding. DISCUSSION: Flooding is generally associated with increased incidence of MBD, potentially following a brief decrease in incidence for some diseases. Methodological inconsistencies significantly limit direct comparison and generalizability of study results. Regions with established MBD and weather surveillance should be leveraged to conduct multisite research to a) standardize the quantification of relevant flooding, b) study nonlinear relationships between rainfall and disease, c) report outcomes at multiple lag periods, and d) investigate interacting factors that modify the likelihood and severity of outbreaks across different settings. https://doi.org/10.1289/EHP8887.

4.
PLoS One ; 16(8): e0254347, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34347785

RESUMEN

Clinical presentation, outcomes, and duration of COVID-19 has ranged dramatically. While some individuals recover quickly, others suffer from persistent symptoms, collectively known as long COVID, or post-acute sequelae of SARS-CoV-2 (PASC). Most PASC research has focused on hospitalized COVID-19 patients with moderate to severe disease. We used data from a diverse population-based cohort of Arizonans to estimate prevalence of PASC, defined as experiencing at least one symptom 30 days or longer, and prevalence of individual symptoms. There were 303 non-hospitalized individuals with a positive lab-confirmed COVID-19 test who were followed for a median of 61 days (range 30-250). COVID-19 positive participants were mostly female (70%), non-Hispanic white (68%), and on average 44 years old. Prevalence of PASC at 30 days post-infection was 68.7% (95% confidence interval: 63.4, 73.9). The most common symptoms were fatigue (37.5%), shortness-of-breath (37.5%), brain fog (30.8%), and stress/anxiety (30.8%). The median number of symptoms was 3 (range 1-20). Amongst 157 participants with longer follow-up (≥60 days), PASC prevalence was 77.1%.


Asunto(s)
COVID-19/complicaciones , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Arizona/epidemiología , COVID-19/diagnóstico , COVID-19/epidemiología , COVID-19/patología , COVID-19/rehabilitación , Niño , Estudios de Cohortes , Progresión de la Enfermedad , Femenino , Servicios de Atención de Salud a Domicilio/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Pronóstico , SARS-CoV-2/fisiología , Adulto Joven
5.
Risk Anal ; 2021 Jun 21.
Artículo en Inglés | MEDLINE | ID: mdl-34155669

RESUMEN

Most early Bluetooth-based exposure notification apps use three binary classifications to recommend quarantine following SARS-CoV-2 exposure: a window of infectiousness in the transmitter, ≥15 minutes duration, and Bluetooth attenuation below a threshold. However, Bluetooth attenuation is not a reliable measure of distance, and infection risk is not a binary function of distance, nor duration, nor timing. We model uncertainty in the shape and orientation of an exhaled virus-containing plume and in inhalation parameters, and measure uncertainty in distance as a function of Bluetooth attenuation. We calculate expected dose by combining this with estimated infectiousness based on timing relative to symptom onset. We calibrate an exponential dose-response curve based on infection probabilities of household contacts. The probability of current or future infectiousness, conditioned on how long postexposure an exposed individual has been symptom-free, decreases during quarantine, with shape determined by incubation periods, proportion of asymptomatic cases, and asymptomatic shedding durations. It can be adjusted for negative test results using Bayes' theorem. We capture a 10-fold range of risk using six infectiousness values, 11-fold range using three Bluetooth attenuation bins, ∼sixfold range from exposure duration given the 30 minute duration cap imposed by the Google/Apple v1.1, and ∼11-fold between the beginning and end of 14 day quarantine. Public health authorities can either set a threshold on initial infection risk to determine 14-day quarantine onset, or on the conditional probability of current and future infectiousness conditions to determine both quarantine and duration.

6.
Front Public Health ; 9: 620060, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33643990

RESUMEN

This study is a prospective, population-based cohort of individuals with a history of SARS-CoV-2 infection and those without past infection through multiple recruitment sources. The main study goal is to track health status over time, within the diverse populations of Arizona and to identify the long-term consequences of COVID-19 on health and well-being. A total of 2,881 study participants (16.2% with a confirmed SARS-CoV-2 infection) have been enrolled as of December 22, 2020, with a target enrollment of 10,000 participants and a planned follow-up of at least 2 years. This manuscript describes a scalable study design that utilizes a wide range of recruitment sources, leveraging electronic data collection to capture and link longitudinal participant data on the current and emerging issues associated with the COVID-19 pandemic. The cohort is built within a collaborative infrastructure that includes new and established partnerships with multiple stakeholders, including the state's public universities, local health departments, tribes, and tribal organizations. Challenges remain for ensuring recruitment of diverse participants and participant retention, although the electronic data management system and timing of participant contact can help to mitigate these problems.


Asunto(s)
COVID-19 , Estado de Salud , Salud Poblacional , Desarrollo de Programa , Adolescente , Adulto , Arizona , Enfermedad Crónica , Diversidad Cultural , Ejercicio Físico , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Estudios Prospectivos , SARS-CoV-2 , Sueño , Estrés Psicológico , Adulto Joven
7.
Am J Trop Med Hyg ; 104(1): 184-189, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-33219641

RESUMEN

Rocky Mountain spotted fever (RMSF) is a serious disease in northwest Mexico, particularly in low-income communities. This study aimed to evaluate RMSF-related knowledge, attitudes, and practices in an endemic urban area with a high burden of the disease. A cross-sectional study design using a non-probabilistic household survey was conducted with 400 residents in Hermosillo, Mexico. Primary themes assessed included dog and tick-related exposure, RMSF knowledge, healthcare-seeking behavior, sociodemographic data, and household information. The majority (59%) of those surveyed had heard about RMSF, although only 36% of RMSF-aware respondents knew any RMSF symptoms. Among RMSF-aware respondents, 26% did not know or were unsure of prevention strategies. Individuals in the low socioeconomic status (SES) stratum were less likely to have heard about RMSF (odds ratio [OR]: 0.39; 95% CI: 0.25-0.59), use dog collars or any other product to avoid ticks (OR: 0.40; 95% CI: 0.17-0.99), or check their dogs for ticks (OR: 0.25; 95% CI: 0.09-0.74). The likelihood of observing high numbers of free-roaming dogs in their neighborhood was four times higher in the low SES stratum (OR: 4.19; 95% CI: 2.10-8.38) than in the high SES stratum. These findings emphasize the need for an integrative community approach to improve early recognition of symptoms and knowledge of prevention strategies, particularly in low SES neighborhoods.


Asunto(s)
Fiebre Maculosa de las Montañas Rocosas/epidemiología , Fiebre Maculosa de las Montañas Rocosas/prevención & control , Adolescente , Adulto , Niño , Preescolar , Brotes de Enfermedades , Composición Familiar , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Lactante , Masculino , México/epidemiología , Persona de Mediana Edad , Aceptación de la Atención de Salud , Fiebre Maculosa de las Montañas Rocosas/tratamiento farmacológico
9.
Malar J ; 19(1): 272, 2020 Jul 29.
Artículo en Inglés | MEDLINE | ID: mdl-32727452

RESUMEN

BACKGROUND: Alternative long-lasting insecticidal net (LLIN) use for purposes other than sleeping protection from mosquitoes is widely debated as a limitation to successful malaria control efforts, yet rarely rigorously studied. METHODS: A cross-sectional survey of 1217 households in an epidemic highland site and an endemic lowland site in western Kenya collected information on alternative use in three ways: direct observations, participant self-report, and participant reporting of community-level practices. LLIN misuse was defined as use of an intact net for alternative purposes and repurposing as alternatively using an old or damaged net. Associations between households with observed repurposed nets and universal access and household net use were examined. RESULTS: Households describe repurposing nets when they are torn and/or old. Repurposed nets were observed in 8.1% (52/643) highlands households and 33.0% (184/574) lowlands households. Repurposed nets served as chicken coops (33% highlands, 20% lowlands), fences (37% highlands, 25% lowlands), tree covers (22% lowlands), curtains (3% highlands), covering bathrooms (1.5% highlands, 9% lowlands), and washing sponges (13% lowlands). No association was found between repurposing and universal access or household net use. Misuse was rare. Of 379 repurposed nets, 4 (1.06%) were in good condition with no holes. Of 1,758 active nets, 13 (0.74%) were misused. CONCLUSIONS: Alternative net use in this study involved repurposing rather than misuse. Repurposing was not detrimental to malaria prevention efforts in these communities. Standardized measurement of alternative net use should be used to better understand the practice and its potential impact on the success of malaria interventions.


Asunto(s)
Mosquiteros Tratados con Insecticida/estadística & datos numéricos , Control de Mosquitos/estadística & datos numéricos , Propiedad , Estudios Transversales , Composición Familiar , Kenia , Malaria/prevención & control , Control de Mosquitos/organización & administración , Propiedad/estadística & datos numéricos
10.
Proc Natl Acad Sci U S A ; 117(20): 10904-10910, 2020 05 19.
Artículo en Inglés | MEDLINE | ID: mdl-32366659

RESUMEN

Darwin proposed two seemingly contradictory hypotheses regarding factors influencing the outcome of biological invasions. He initially posited that nonnative species closely related to native species would be more likely to successfully establish, because they might share adaptations to the local environment (preadaptation hypothesis). However, based on observations that the majority of naturalized plant species in the United States belonged to nonnative genera, he concluded that the lack of competitive exclusion would facilitate the establishment of alien invaders phylogenetically distinct from the native flora (competition-relatedness hypothesis). To date, no consensus has been reached regarding these opposing hypotheses. Here, following Darwin, we use the flora of the United States to examine patterns of taxonomic and phylogenetic relatedness between native and nonnative taxa across thousands of nested locations ranging in size and extent, from local to regional scales. We find that the probability of observing the signature of environmental filtering over that of competition increases with spatial scale. Further, native and nonnative species tended to be less related in warm, humid environments. Our work provides an empirical assessment of the role of observation scale and climate in biological invasions and demonstrates that Darwin's two opposing hypotheses need not be mutually exclusive.


Asunto(s)
Adaptación Fisiológica , Fenómenos Fisiológicos de las Plantas , Selección Genética , Evolución Biológica , Bosques , Modelos Biológicos , Filogenia , Desarrollo de la Planta , Plantas , Especificidad de la Especie , Estados Unidos
11.
J Med Entomol ; 57(4): 1228-1238, 2020 07 04.
Artículo en Inglés | MEDLINE | ID: mdl-32266939

RESUMEN

The Aedes aegypti mosquito is the primary vector of dengue, yellow fever, chikungunya, and Zika viruses. Infection with the dengue virus alone occurs in an estimated 400 million people each year. Likelihood of infection with a virus transmitted by Ae. aegypti is most commonly attributed to abundance of the mosquito. However, the Arizona-Sonora desert region has abundant Ae. aegypti in most urban areas, yet local transmission of these arboviruses has not been reported in many of these cities. Previous work examined the role of differential Ae. aegypti longevity as a potential explanation for these discrepancies in transmission. To determine factors that were associated with Ae. aegypti longevity in the region, we collected eggs from ovitraps in Tucson, AZ and reared them under multiple experimental conditions in the laboratory to examine the relative impact of temperature and crowding during development, body size, fecundity, and relative humidity during the adult stage. Of the variables studied, we found that the combination of temperature during development, relative humidity, and body size produced the best model to explain variation in age at death. El mosquito Aedes aegypti es el vector primario de los virus de dengue, fiebre amarilla, chikungunya y Zika. Solamente las infecciones con los virus de dengue ocurren en aproximadamente 400 millones de personas cada año. La probabilidad de infección con un virus transmitido por Ae. aegypti es frecuentemente atribuido a la abundancia del mosquito. No obstante, la región del desierto de Arizona-Sonora tiene una abundancia de Ae. aegypti en la mayoría de las áreas urbanas, pero la transmisión local de estos arbovirus no ha sido reportada en muchas de estas ciudades. Trabajos previos han examinado el rol de las diferencias de longevidad en Ae. aegypti como explicación potencial por estas discrepancias en la transmisión. Para determinar que factores fueron asociados con longevidad en Ae. aegypti en la región, colectamos huevos de ovitrampas en Tucson, Arizona y los criamos debajo de múltiples condiciones experimentales en el laboratorio para examinar el impacto relativo de temperatura y competencia para nutrición durante desarrollo, tamaño del cuerpo, capacidad reproductiva, y humedad relativa durante adultez. De las variables estudiados, encontramos que la combinación de temperatura durante desarrollo, humedad relativa, y tamaño del cuerpo produjo el mejor modelo para explicar variación en edad al tiempo de la muerte.


Asunto(s)
Aedes/fisiología , Tamaño Corporal , Longevidad , Mosquitos Vectores/fisiología , Animales , Arizona , Femenino
12.
Am J Trop Med Hyg ; 102(6): 1328-1342, 2020 06.
Artículo en Inglés | MEDLINE | ID: mdl-32314696

RESUMEN

Universal "coverage" with long-lasting insecticidal nets (LLINs) is recommended for malaria control in endemic areas, but ownership does not ensure usage. We evaluated relationships between household-level ownership and individual-level usage in western Kenya in 2015. Low-prevalence highland (> 1,500 m) and highly endemic lowland (< 1,200 m) sites were surveyed from July to August 2015. Household members reported long-lasting insecticidal net ownership, use, and barriers to use. Net ownership was categorized as sufficient (≤ 2 people/net), insufficient (> 2 people/net), or none. Each LLIN was assumed to provide access to two people. We surveyed 574 lowland and 643 highland households, with 1,677 and 2,742 members, respectively. More than 98% of lowland households owned LLIN(s); 72.1% owned a sufficient number. Only 37.5% of highland households had sufficient nets. More people used LLINs than were estimated to have access in the lowlands (94.2% versus 85.3%), but proportions were similar in the highlands (54.3% versus 53.3%). Insufficient ownership was most common for larger households in both areas and strongly predicted LLIN usage. In households with insufficient nets, men, school-age children (aged 5-15 years), and nonnuclear family members were less likely to use LLINs; only relationship to the head of the household significantly predicted use in households with sufficient nets. Long-lasting insecticidal nets were widespread in western Kenya in 2015, but insufficient household ownership remained common in the epidemic highlands and in large households. Access seemed to be the primary driver of individual use. To interrupt transmission, LLIN campaigns should improve distribution to large households and promote use among men, school-age children, and nonnuclear family members.


Asunto(s)
Composición Familiar , Mosquiteros Tratados con Insecticida , Control de Mosquitos/métodos , Adolescente , Adulto , Niño , Preescolar , Estudios Transversales , Femenino , Humanos , Insecticidas , Kenia/epidemiología , Malaria/epidemiología , Malaria/prevención & control , Masculino , Persona de Mediana Edad , Adulto Joven
13.
Pathog Glob Health ; 114(1): 2-15, 2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-32000614

RESUMEN

Education intervention effectiveness to improve bed net care and repair knowledge or practices is unclear. To assess intervention effectiveness, we systematically reviewed eight peer-reviewed literature databases and 16 malaria organizations (PROSPERO protocol CRD42019123932) using pre-specified combinations of 'education intervention', 'mosquito net', and 'malaria' search terms. Data were abstracted for 29 of 43 studies meeting inclusion criteria, of which 16 studies included education as amain focus. Of these 16, there was evidence of intervention effectiveness among half of the studies, which reported improvements in knowledge or practices, while four had mixed results, and four had unclear results. Overall there is no clear conclusion regarding the effectiveness of education interventions to improve net care and repair, though some instructional methods suggest more success than others. Interventions used combinations of instructional methods; passive mass education (6), active mass education (12), and interpersonal methods (8). Interventions combining mass and interpersonal methods resulted in positive improvements (four positive, one mixed). We found no evidence that interventions grounded in health behavior theory achieved more positive results than those not grounded in theory, potentially because net care education was typically asecondary objective. Of 289 gray literature results, 286 (99%) were net distribution reports from Against Malaria Foundation describing 136 distributions; eighty of which (58.8%) mentioned no education related to net care and repair. We found lack of involvement of experts in education among included interventions. Involving trained instructors with expertise in education theory and instructional strategies may improve instruction quality to yield more effective interventions.


Asunto(s)
Educación en Salud , Malaria/prevención & control , Mosquiteros , Animales , Humanos , Conocimiento , Malaria/epidemiología , Control de Mosquitos/instrumentación
14.
Am J Trop Med Hyg ; 102(3): 629-633, 2020 03.
Artículo en Inglés | MEDLINE | ID: mdl-31933455

RESUMEN

During the 2016 Zika pandemic in Brazil, women's perceptions of infection risk, ability to adhere to Zika prevention strategies, or access to services following exposure were not emphasized in the public health response. Women in Fortaleza, Brazil, responded to a questionnaire on social factors related to perceived Zika risk and access to health care in June 2016. Data were coded using prespecified categories, and response frequency was reported. Of 37 respondents, most reported a lack of public services to support mosquito control (n = 19) or delayed access to reproductive health care (n = 14). Only 22% described specific maternal risks or fetal outcomes as a consequence of Zika infection. Respondents indicated an overall disconnect between public health efforts and women's perceptions of their reproductive control, including limited support concerning microcephaly in infants. Interventions targeting Zika may require a greater emphasis on strengthening health systems and infrastructure to realistically prevent transmission.


Asunto(s)
Brotes de Enfermedades , Complicaciones Infecciosas del Embarazo/epidemiología , Complicaciones Infecciosas del Embarazo/virología , Infección por el Virus Zika/epidemiología , Adulto , Brasil/epidemiología , Cultura , Recolección de Datos , Femenino , Humanos , Percepción , Embarazo , Encuestas y Cuestionarios , Salud de la Mujer
15.
Malar J ; 18(1): 274, 2019 Aug 14.
Artículo en Inglés | MEDLINE | ID: mdl-31412865

RESUMEN

BACKGROUND: Insecticide-treated nets (ITNs) and long-lasting insecticidal nets (LLINs) are effective for malaria prevention and are designed to provide nearly 5 years of mosquito protection. However, many ITNs and LLINs become damaged and ineffective for mosquito bite prevention within 1 to 2 years in field conditions. Non-adherence to recommended bed net care and repair practices may partially explain this shortened net longevity. METHODS: Using data from a cross-sectional study, a net care adherence score was developed and adherence to net care practices described from two regions of western Kenya. Relationships between attitudes and environmental factors that influence net longevity were measured with adherence to bed net care practices. RESULTS: While overall care practices are highly adherent particularly in the highlands, practices related to daily storage, washing frequency, and drying location need improvement in the lowlands. Seventy-seven percent of nets in the lowlands were washed < 3 months prior to the survey compared to 23% of nets in the highlands. More nets were dried in the sun in the lowlands (32% of nets) compared to the highlands (4% of nets). Different elements of care are influenced by various malaria attitudes and environmental factors, highlighting the complexity of factors associated with net care. For example, households that learned about net care from community events, that share a sleeping structure with animals, and that have nets used by adult males tend to adhere to washing frequency recommendations. CONCLUSIONS: In western Kenya, many nets are cared for in accordance to recommended practices, particularly in the highlands sites. In the lowlands, demonstrating methods at community events to tie nets up during the day coupled with messaging to emphasize infrequent washing and drying nets in the shade may be an appropriate intervention. As illustrated by differences between the highlands and lowlands sites in the present study, should interventions to improve adherence to bed net care practices be necessary, they should be context-specific.


Asunto(s)
Mordeduras y Picaduras de Insectos/prevención & control , Mosquiteros Tratados con Insecticida/estadística & datos numéricos , Malaria/prevención & control , Control de Mosquitos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Animales , Anopheles , Niño , Preescolar , Estudios Transversales , Composición Familiar , Femenino , Humanos , Lactante , Recién Nacido , Kenia , Masculino , Persona de Mediana Edad , Adulto Joven
16.
Am J Trop Med Hyg ; 100(2): 434-437, 2019 02.
Artículo en Inglés | MEDLINE | ID: mdl-30594264

RESUMEN

The mosquito Aedes (Stegomyia) aegypti (L.) is the primary vector of dengue, chikungunya, and Zika viruses in the United States. Surveillance for adult Ae. aegypti is limited, hindering understanding of the mosquito's seasonal patterns and predictions of areas at elevated risk for autochthonous virus transmission. We developed a simple, intuitive empirical model that uses readily available temperature and humidity variables to predict environmental suitability for low, medium, or high potential abundance of adult Ae. aegypti in a given city 1 month in advance. Potential abundance was correctly predicted in 73% of months in arid Phoenix, AZ (over a 10-year period), and 63% of months in humid Miami, FL (over a 2-year period). The monthly model predictions can be updated daily, weekly, or monthly and thus may be applied to forecast suitable conditions for Ae. aegypti to inform vector-control activities and guide household-level actions to reduce mosquito habitat and human exposure.


Asunto(s)
Aedes/fisiología , Fiebre Chikungunya/transmisión , Dengue/transmisión , Modelos Estadísticos , Mosquitos Vectores/fisiología , Infección por el Virus Zika/transmisión , Aedes/virología , Animales , Arizona , Fiebre Chikungunya/virología , Ciudades , Dengue/virología , Monitoreo Epidemiológico , Florida , Humanos , Humedad , Mosquitos Vectores/virología , Dinámica Poblacional , Temperatura , Infección por el Virus Zika/virología
17.
Artículo en Inglés | MEDLINE | ID: mdl-30388798

RESUMEN

Swimming pool water ingestion volumes are necessary for assessing infection risk from swimming. Pool water ingestion volumes can be estimated by questionnaire or measuring a chemical tracer in swimmer urine. Questionnaires are often preferred to the chemical tracer method because surveys are less time consuming, but no research exists validating questionnaires accurately quantify pool water ingestion volumes. The objective of this study was to explore if questionnaires are a reliable tool for collecting pool water ingestion volumes. A questionnaire was issued at four pool sites in Tucson, Arizona to 46 swimmers who also submitted a urine sample for analyzing cyanuric acid, a chemical tracer. Perceived ingestion volumes reported on the questionnaire were compared with pool water ingestion volumes, quantified by analyzing cyanuric acid in swimmer urine. Swimmers were asked if they swallowed (1) no water or only a few drops, (2) one to two mouthfuls, (3) three to five mouthfuls, or (4) six to eight mouthfuls. One mouthful is the equivalent of 27 mL of water. The majority (81%) of swimmers ingested <27 mL of pool water but reported ingesting >27 mL ("one mouthful") on the questionnaire. More than half (52%) of swimmers overestimated their ingestion volume. These findings suggest swimmers are over-estimating pool water ingestion because they perceive one mouthful is <27 mL. The questionnaire did not reliably collect pool water ingestion volumes and should be improved for future exposure assessment studies. Images of the ingestion volume categories should be included on the questionnaire to help swimmers visualize the response options.


Asunto(s)
Ingestión de Alimentos/fisiología , Encuestas y Cuestionarios/normas , Piscinas/estadística & datos numéricos , Natación , Triazinas/orina , Agua/efectos adversos , Agua/análisis , Adolescente , Adulto , Arizona , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven
18.
Malar J ; 17(1): 326, 2018 Sep 10.
Artículo en Inglés | MEDLINE | ID: mdl-30200986

RESUMEN

Workshops with academic, national and local government, and community stakeholders were held in Kenya (2017) and Indonesia (2018) to understand the role and perceptions of women in vector control and to identify strategies for accelerating involvement of women in sustained support for vector control interventions at multiple levels/sectors.


Asunto(s)
Participación de la Comunidad , Control de Mosquitos , Mosquitos Vectores , Mujeres/educación , Femenino , Humanos , Indonesia , Kenia
19.
Front Psychol ; 9: 994, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-29971030

RESUMEN

Background: Women's status and empowerment influence health, nutrition, and socioeconomic status of women and their children. Despite its benefits, however, research on women's empowerment in Sub-Saharan Africa (SSA) is limited in scope and geography. Empowerment is variably defined and data for comparison across regions is often limited. The objective of the current study was to identify domains of empowerment from a widely available data source, Demographic and Health Surveys, across multiple regions in SSA. Methods: Demographic and Health Surveys from nineteen countries representing four African regions were used for the analysis. A total of 26 indicators across different dimensions (economic, socio-cultural, education, and health) were used to characterize women's empowerment. Pooled data from all countries were randomly divided into two datasets-one for exploratory factor analysis (EFA) and the other for Confirmatory Factor Analysis (CFA)-to verify the factor structure hypothesized during EFA. Results: Four factors including attitudes toward violence, labor force participation, education, and access to healthcare were found to define women's empowerment in Central, Southern, and West Africa. However, in East Africa, only three factors were relevant: attitudes toward violence, access to healthcare ranking, and labor force participation. There was limited evidence to support household decision-making, life course, or legal status domains as components of women's empowerment. Conclusion: This foremost study advances scholarship on women's empowerment by providing a validated measure of women's empowerment for researchers and other stakeholders in health and development.

20.
PLoS One ; 13(6): e0198655, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-29902199

RESUMEN

Previous work demonstrates that individuals who obtain exemptions from school immunization requirements are geographically clustered, making regional differences in vaccination coverage a significant concern. Even where exemption levels are high, there are still parents that vaccinate. School-level assessments have determined that exemptors are more likely to attend wealthier schools with fewer minorities. Few studies have assessed divergent opinions within the context of a higher-exemption community to examine subtle differences in opinion surrounding vaccinations. Therefore, the objective of this work was to assess attitudes and perceptions towards vaccinations and compare them for exemptors and non-exemptors. We administered surveys to parents in high-exemption (>10%) elementary schools in Arizona during the 2012-13 school year. A total of 404 surveys were completed by parents among schools in Maricopa (n = 7) and Yavapai (n = 2) counties. Of these, 35% (n = 141) were exemptors and 65% (n = 261) were non-exemptors. Exemptors were more likely than non-exemptors to be concerned about serious side-effects (p<0.001). They were more likely to report knowing someone who had been diagnosed with a vaccine-preventable disease (p<0.001) but less likely to report that this had been a serious illness in that person (p<0.001) and they believed it is better for a child to develop immunity through illness than vaccination (p<0.001). They were less likely to trust physicians (p<0.001) and information about vaccines (p<0.001) and were more likely to obtain their health care from a naturopath (p<0.001). In summary, exemptors in these Arizona schools do not appear to be exempting their children from vaccinations due to convenience, as has been hypothesized in other settings. Based on the divergent views within high-exemption schools and reported distrust of the medical establishment, target interventions for high-exemption schools are discussed. Additionally, given the lack of effective non-policy based interventions to-date, the negligible declines in personal belief exemption rates, and vaccine preventable disease rate increases in Arizona, especially in high-exemption areas, legislative action in Arizona may also warrant further investigation.


Asunto(s)
Conocimientos, Actitudes y Práctica en Salud , Padres/psicología , Vacunación/psicología , Adulto , Arizona , Femenino , Humanos , Masculino , Instituciones Académicas
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA
...