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Am J Trop Med Hyg ; 102(6): 1172-1174, 2020 06.
Artículo en Inglés | MEDLINE | ID: mdl-32358952


The first case of novel coronavirus disease (COVID-19) in the Dominican Republic coincided with a period of political crisis. Distrust in governmental institutions shaped the critical phase of early response. Having a weak public health infrastructure and a lack of public trust, the Ministry of Health (MoH) began the fight against COVID-19 with a losing streak. Within 45 days of the first reported case, the political crisis and turmoil caused by "fake news" are limiting the capacity and success of the MoH response to the pandemic.

Antivirales/uso terapéutico , Betacoronavirus/patogenicidad , Infecciones por Coronavirus/epidemiología , Pandemias , Neumonía Viral/epidemiología , Medios de Comunicación Sociales/ética , Anticuerpos Monoclonales Humanizados/uso terapéutico , Antivirales/provisión & distribución , Azitromicina/provisión & distribución , Azitromicina/uso terapéutico , Betacoronavirus/efectos de los fármacos , Desórdenes Civiles , Infecciones por Coronavirus/tratamiento farmacológico , Infecciones por Coronavirus/economía , Disentimientos y Disputas , República Dominicana/epidemiología , Reposicionamiento de Medicamentos , Humanos , Hidroxicloroquina/provisión & distribución , Hidroxicloroquina/uso terapéutico , Ivermectina/provisión & distribución , Ivermectina/uso terapéutico , Pandemias/economía , Neumonía Viral/tratamiento farmacológico , Neumonía Viral/economía , Política , Salud Pública/economía , Salud Pública/tendencias , Confianza/psicología
Trans R Soc Trop Med Hyg ; 113(6): 293-297, 2019 06 01.
Artículo en Inglés | MEDLINE | ID: mdl-30892643


BACKGROUND: Human immunodeficiency virus (HIV) increases the risk of acquiring human T-cell lymphotropic virus (HTLV) and subsequently HTLV's progression to tropical spastic paraparesis/HTLV-1-associated myelopathy (TSP/HAM). Existing data have exclusively reported generalized rates of HIV and HTLV-1 chronic viral infections in the Dominican Republic. To our knowledge, no published studies have focused on the rates of HTLV-1/2 in transactional sex workers and drug users, both higher risk groups, in the Dominican Republic. METHODS: From December 2012 to April 2013 we conducted a study to estimate the seroprevalence of HTLV-1/2 immunoglobulin G (IgG) and HIV antibodies among transactional sex workers and intravenous drug users in Santo Domingo, Dominican Republic. Serological status was analysed with behaviour and demographic data. RESULTS: We collected and analysed plasma from 200 participants with a mean age of 27.4 y in men and 25.2 y in women. The overall weighted seroprevalence of HTLV-1/2 IgG antibodies was 13.91% (95% CI 7.59 to 20.23) in men and 10.59% (95% CI 4.05 to 17.13) in women. The overall weighted seroprevalence of HIV-1 was 13.91% (95% CI 7.59 to 20.23%) in men and 17.65% (95% CI 9.55 to 25.75) in women. Male intravenous drug users had an exceptionally high rate of HTLV-positive HIV co-infection, at 75% (95% CI 44.99 to 105.01). Although there an association has been found between HTLV/HIV co-infections and sex work, the adjusted odds revealed a confounding role of HIV infection. CONCLUSIONS: The results highlight the urgent need for enhanced public health preventive strategies among high-risk populations in the Dominican Republic and other resource-constrained Caribbean settings, as well as global adoption of routine screening for HTLV-associated infections, particularly in these high-risk, underserved populations.