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1.
San Salvador; OPS; 2021-09-09. (OPS/SLV/21-0002).
No convencional en Español | PAHO-IRIS | ID: phr2-54810

RESUMEN

Establecida en 1902 como el organismo independiente especializado en salud del sistema interamericano, la Organización Panamericana de la Salud (OPS) ha desarrollado competencias y experiencia ampliamente reconocidas al brindar cooperación técnica a sus Estados Miembros para combatir las enfermedades transmisibles y no transmisibles y sus causas, fortalecer los sistemas de salud y responder a situaciones de emergencia y desastres en toda la Región de las Américas. Asimismo, en su calidad de oficina regional de la Organización Mundial de la Salud, la OPS participa activamente en los equipos de las Naciones Unidas en los países, colaborando con otros organismos, fondos y programas del sistema de las Naciones Unidas para contribuir al logro de los Objetivos de Desarrollo Sostenible (ODS) a nivel de país. En este informe anual se presenta la cooperación técnica de la OPS a nivel de país en el 2020, mediante la aplicación de la estrategia de cooperación con el país, la respuesta a las necesidades y prioridades nacionales, y el desarrollo de las actividades en el marco de los mandatos regionales y mundiales de la Organización y los ODS. En consonancia con el tema general de "la salud universal y la pandemia: sistemas de salud resilientes", se pone de relieve la respuesta de la OPS a la pandemia de COVID-19, así como sus esfuerzos continuos en esferas prioritarias como las enfermedades transmisibles, las enfermedades no transmisibles, la salud mental, la salud a lo largo del curso de vida y las emergencias de salud. También se presenta un resumen financiero del ejercicio examinado.


Asunto(s)
Cooperación Técnica , Sistemas de Salud , Programas Nacionales de Salud , Políticas, Planificación y Administración en Salud , Cobertura de los Servicios de Salud , Cobertura Universal de Salud , Enfermedades no Transmisibles , Enfermedades Transmisibles , Factores de Riesgo , Factores Socioeconómicos , Salud Mental , Administración en Salud Pública , Administración Financiera , Sistemas de Información en Salud , América Central , El Salvador
2.
Vaccine ; 39(34): 4849-4855, 2021 08 09.
Artículo en Inglés | MEDLINE | ID: mdl-34275672

RESUMEN

Detection and surveillance of vaccine safety hazards is a public health staple. In the post-marketing phase, when vaccines are used in mass, it is crucial to monitor potential signals of adverse reactions that may have been missed in the pre-marketing phase. We analysed spontaneous reports of drug adverse events in El Salvador to assess a potential safety signal related to an increase in febrile seizures following the pentavalent (diphtheria, tetanus, pertussis, hepatitis B, and Haemophilus influenzae Type B) vaccine in 2019. This was a retrospective observational study of adverse event notifications in the national electronic drug safety database from 2011 to 2019. We performed standard disproportionality analysis computing Proportional Reporting Risk (PRR), Reporting Odds Ratio (ROR), Relative Reporting Ratio (RRR), Chi-squared, and Information Component (IC), comparing the pairing of febrile seizures and pentavalent vaccine to all other drugs and adverse events recorded in 2019. The occurrence of febrile seizures following pentavalent vaccination exceeded the WHO expected rate of six cases × 100 000 doses administered from April 2019, with a maximum of 9.2 in September. IC was 4.3, ORR 421.9 (95% Confidence Interval, CI: 123.8-1437.7), PRR 223.5 (95 %CI: 70.2-710.9), RRR was 19.5. The first booster presented the highest rate (14.6 per 100,000 doses) of febrile seizures, more than double than expected. Rates for 2018 remained below expected. Reports of febrile seizures following pentavalent vaccine were also on the increase globally since 2014, with highest rates in 2018 and 2019. There was a disproportion of febrile seizures notifications following pentavalent in El Salvador in 2019, suggesting the existence of a safety signal. This may be due to the change in provider. Further studies should assess the causes of the increase and compute costs and benefits of this vaccination to determine if switching to a less reactogenic vaccine formulation is indicated.


Asunto(s)
Vacunas contra Haemophilus , Preparaciones Farmacéuticas , Vacuna contra Difteria, Tétanos y Tos Ferina/efectos adversos , El Salvador , Vacunas contra Haemophilus/efectos adversos , Vacunas contra Hepatitis B/efectos adversos , Humanos , Lactante , Vacuna Antipolio de Virus Inactivados , Vacunas Combinadas/efectos adversos
3.
Alerta (San Salvador) ; 4(3): 134-126, jul. 29, 2021. graf
Artículo en Español | LILACS, BISSAL | ID: biblio-1282983

RESUMEN

Introducción. El cáncer de mama para el año 2020 fue el número uno a nivel mundial, con una tendencia al alza constante. Puesto que afecta tanto a países desarrollados como en vía desarrollo, las consecuencias derivadas demandan al sistema de salud una respuesta oportuna. Objetivo. Caracterizar clínica y epidemiológicamente el cáncer de mama en las pacientes mayores de 20 años atendidas en el Instituto del Cáncer de El Salvador. Metodología. La investigación fue de tipo transversal descriptivo. Se recolectó información de 344 expedientes de pacientes con cáncer de mama de enero de 2017 a diciembre de 2018 con diagnóstico por biopsia de muestra patológica, mayores de 20 años. Luego se aplicó un análisis estadístico descriptivo. Resultados. Se identificó un mayor porcentaje, 59,9%, de pacientes de zona urbana; el 89,2% fue ama de casa, la edad promedio de diagnóstico de cáncer fue 54 años y el promedio de índice de masa corporal fue de 29,1. El signo clínico inicial fue tumoración, el 85,8%, con un tamaño promedio de 4,8 cm. El diagnóstico más frecuente, equivalente al 83,4%, fue carcinoma ductal invasivo y más del 50% fue ≥N1. Se observó una mayor positividad de receptores hormonales. El 84,1% de las pacientes recibieron tratamiento con radioterapia. Conclusiones. Las mujeres con cáncer de mama tienen las siguientes características: adulta de la sexta década de la vida, con sobrepeso, ama de casa, con signo inicial de tumoración, en estadio local avanzado, con diagnóstico de carcinoma ductal invasivo


Introduction. By the year 2020, breast cancer was ranked number one in the world, with a constant upward trend, it affects developed and developing countries, the resulting consequences demand a timely response from the health system. Objective. To characterize clinically and epidemiologically breast cancer in patients older than 20 years treated at the Cancer Institute of El Salvador. Methodology. A cross sectional descriptive study was carried out, Information was collected from 344 records of female patients older than 20, with breast cancer from January 2017 to December 2018, diagnosed by biopsy of a pathological sample. A descriptive statistical analysis was applied. Results. A higher percentage, 59,9%, of patients were identified in urban areas; 89,2% were housewives, the average age of cancer diagnosis was 54 years, the average Body Mass Index was 29,1. The initial clinical sign was a tumor, 85,8%, with an average size of 4,8 cm. The most frequent diagnosis, 83,4%, was invasive ductal carcinoma, and more than 50% was ≥N1. Higher hormone receptor positivity was observed. 84,1% of the patients received radiotherapy treatment. Conclusion. Women with breast cancer have the following characteristics: an adult in the sixth decade of life, overweight, a housewife, with an initial sign of a tumor, in an advanced local stage with a diagnosis of invasive ductal carcinoma


Asunto(s)
Mujeres , Neoplasias de la Mama , El Salvador , Neoplasias
4.
Malar J ; 20(1): 208, 2021 Apr 30.
Artículo en Inglés | MEDLINE | ID: mdl-33931091

RESUMEN

BACKGROUND: In malaria elimination settings, available metrics for malaria surveillance have been insufficient to measure the performance of passive case detection adequately. An indicator for malaria suspected cases with malaria test (MSCT) is proposed to measure the rate of testing on persons presenting to health facilities who satisfy the definition of a suspected malaria case. This metric does not rely on prior knowledge of fever prevalence, seasonality, or external denominators, and can be used to compare detection rates in suspected cases within and between countries, including across settings with different levels of transmission. METHODS: To compute the MSCT, an operational definition for suspected malaria cases was established, including clinical and epidemiological criteria. In general, suspected cases included: (1) persons with fever detected in areas with active malaria transmission; (2) persons with fever identified in areas with no active transmission and travel history to, or residence in areas with active transmission (either national or international); and (3) persons presenting with fever, chills and sweating from any area. Data was collected from 9 countries: Belize, Colombia (in areas with active transmission), Costa Rica, Dominican Republic, El Salvador, Guatemala, Honduras, Nicaragua, and Panama (September-March 2020). A sample of eligible medical records for 2018 was selected from a sample of health facilities in each country. An algorithm was constructed to assess if a malaria test was ordered or performed for cases that met the suspected case definition. RESULTS: A sample of 5873 suspected malaria cases was obtained from 239 health facilities. Except for Nicaragua and Colombia, malaria tests were requested in less than 10% of all cases. More cases were tested in areas with active transmission than areas without cases. Travel history was not systematically recorded in any country. CONCLUSIONS: A statistically comparable, replicable, and standardized metric was proposed to measure suspected malaria cases with a test (microscopy or rapid diagnostic test) that enables assessing the performance of passive case detection. Cross-country findings have important implications for malaria and infectious disease surveillance, which should be promptly addressed as countries progress towards malaria elimination. Local and easy-to-implement tools could be implemented to assess and improve passive case detection.


Asunto(s)
Monitoreo Epidemiológico , Malaria/epidemiología , Malaria/transmisión , Vigilancia de la Población/métodos , Belice/epidemiología , Colombia/epidemiología , Costa Rica/epidemiología , República Dominicana/epidemiología , El Salvador/epidemiología , Guatemala/epidemiología , Honduras/epidemiología , Nicaragua/epidemiología , Panamá/epidemiología , Prevalencia
5.
BMC Public Health ; 21(1): 840, 2021 05 01.
Artículo en Inglés | MEDLINE | ID: mdl-33933045

RESUMEN

BACKGROUND: Mesoamerica is severely affected by an epidemic of Chronic Kidney Disease of non-traditional origin (CKDnt), an epidemic with a marked variation within countries. We sought to describe the spatial distribution of CKDnt in Mesoamerica and examine area-level crop and climate risk factors. METHODS: CKD mortality or hospital admissions data was available for five countries: Mexico, Guatemala, El Salvador, Nicaragua and Costa Rica and linked to demographic, crop and climate data. Maps were developed using Bayesian spatial regression models. Regression models were used to analyze the association between area-level CKD burden and heat and cultivation of four crops: sugarcane, banana, rice and coffee. RESULTS: There are regions within each of the five countries with elevated CKD burden. Municipalities in hot areas and much sugarcane cultivation had higher CKD burden, both compared to equally hot municipalities with lower intensity of sugarcane cultivation and to less hot areas with equally intense sugarcane cultivation, but associations with other crops at different intensity and heat levels were not consistent across countries. CONCLUSION: Mapping routinely collected, already available data could be a first step to identify areas with high CKD burden. The finding of higher CKD burden in hot regions with intense sugarcane cultivation which was repeated in all five countries agree with individual-level studies identifying heavy physical labor in heat as a key CKDnt risk factor. In contrast, no associations between CKD burden and other crops were observed.


Asunto(s)
Calor , Insuficiencia Renal Crónica , Teorema de Bayes , Costa Rica , El Salvador/epidemiología , Guatemala , Humanos , México/epidemiología , Nicaragua/epidemiología , Insuficiencia Renal Crónica/epidemiología
6.
Infant Ment Health J ; 42(3): 400-412, 2021 05.
Artículo en Inglés | MEDLINE | ID: mdl-33843073

RESUMEN

A pilot randomized controlled trial (RCT) was conducted in El Salvador of an intervention ('Thula Sana') previously shown to enhance maternal sensitivity and infant security of attachment in a South African sample. In El Salvador, trained community workers delivered the intervention from late pregnancy to 6 months postpartum as part of a home-visiting programme. The sample comprised 64 pregnant adolescent women, aged 14-19 years, living in predominantly rural settings. They were randomised to receive either the intervention or normal care. Demographic information was collected at baseline and, immediately post-intervention, blind assessments were made of parental sensitivity and infant emotion regulation. The intervention was found to have a substantial positive impact on maternal sensitivity. Further, compared to control group, infants in the intervention group showed more regulated behaviour: in a social challenge task they showed more attempts to restore communication, and in a non-social challenge task they showed more social and goal-directed behaviour. This replication and extension of the South African findings in a small El Salvador sample shows promise and justifies the conduct of a large-scale RCT in a Central or South American context.


Asunto(s)
Madres , Responsabilidad Parental , Adolescente , El Salvador , Femenino , Humanos , Lactante , Relaciones Madre-Hijo , Proyectos Piloto , Embarazo
7.
Medicina (B Aires) ; 81(2): 154-158, 2021.
Artículo en Español | MEDLINE | ID: mdl-33906132

RESUMEN

Chagas disease is endemic in Latin America and remains a regional problem despite improvements in environmental health conditions that have helped to control its transmission. To know more about its prevalence in heart disease patients, we carried out a survey in our national (El Salvador) reference hospital. We reviewed the Chagas Lab's records 2013-2015 to find out how many of the patients admitted to the Hospital's Heart Unit were serologically positives for Trypanosoma cruzi infection and which the associated diagnoses were. A total of 1472 patients were tested along the 36-month study period. Out of 557 (37.8%) patients with positive serology for Chagas infection, 97 (17.4%) were eventually admitted to the Heart Unit. Among these 97 Chagas infected patients with heart disease, 40 (41.2%) met the criteria for permanent pacemaker placement, while only 13 of 191 (6.8%) patients with non-chagasic heart disease met these criteria. The frequency of heart atrioventricular block associated with Trypanosoma cruzi infection was higher than frequencies reported in South American studies.


Asunto(s)
Bloqueo Atrioventricular , Enfermedad de Chagas , Trypanosoma cruzi , Bloqueo Atrioventricular/epidemiología , Bloqueo Atrioventricular/etiología , Enfermedad de Chagas/diagnóstico , Enfermedad de Chagas/epidemiología , El Salvador , Humanos , América Latina
8.
BMJ Open ; 11(4): e048287, 2021 04 01.
Artículo en Inglés | MEDLINE | ID: mdl-33795312

RESUMEN

OBJECTIVES: To translate a symptom screening tool developed for paediatric patients receiving cancer therapies called Symptom Screening in Pediatrics Tool (SSPedi) into Argentinian Spanish and to evaluate the understandability and cultural relevance of the translated version of SSPedi among children with cancer and paediatric haematopoietic stem cell transplant (HSCT) recipients. METHODS: We conducted a multiphase, descriptive study to translate SSPedi into Argentinian Spanish. Using two translators, forward and backward translations were performed. The translated version was evaluated by Spanish-speaking paediatric patients 8-18 years of age receiving cancer treatments in two centres in Argentina and El Salvador. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome was patient self-reported difficulty with understanding of the SSPedi instructions and each symptom using a 5-point Likert scale. Secondary outcomes were incorrect understanding of the SSPedi instructions, symptoms and response scale determined by cognitive interviews with the patients and rated using a 4-point Likert scale. Cultural relevance was assessed qualitatively. RESULTS: There were 30 children enrolled and included in cognitive interviews; 16 lived in Argentina and 14 lived in El Salvador. The most common types of Spanish spoken were Central American (17, 57%) followed by South American (10, 33%) and Castilian (3, 10%). No changes to Argentinian Spanish SSPedi were required based on the outcomes or qualitative comments. No issues with cultural relevance were identified by any of the respondents. CONCLUSIONS: We translated and finalised Argentinian Spanish SSPedi. Future research will focus on its use to describe bothersome symptoms by Argentinian Spanish-speaking children.


Asunto(s)
Neoplasias , Pediatría , Argentina , Niño , Detección Precoz del Cáncer , El Salvador , Humanos , Neoplasias/terapia , Psicometría , Encuestas y Cuestionarios , Evaluación de Síntomas , Traducción
9.
Zootaxa ; 4951(1): zootaxa.4951.1.3, 2021 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-33903414

RESUMEN

This paper is primarily a compilation of published data on the staphylinid beetle species reported for El Salvador. It is based on taxonomic and ecological literature, with inclusion of some new records from different entomological collections. Thirty eight genera and 96 species are reported in the list, including a first country record: Eulissus chalybaeus. Country-level distribution outside of El Salvador, locality references and topographic zones are included for each species. In the list, three endemic species are recorded: Seeversiella badia, S. minima and Stenus salvadorensis. It is remarkable that 14 genera (37%) and 52 species (54%) have only been reported at a country level in the literature, without a specific locality of collection, indicating the need for local inventories of this coleopteran family in the salvadoran territory.


Asunto(s)
Escarabajos , Animales , Escarabajos/clasificación , El Salvador
10.
Parasit Vectors ; 14(1): 167, 2021 Mar 19.
Artículo en Inglés | MEDLINE | ID: mdl-33741050

RESUMEN

BACKGROUND: In 2015, an outbreak of Zika virus spread across Latin America and the Caribbean (LAC). Public health programs promoted vector control behaviors, including covering water storage containers with lids. Such approaches disrupt Zika transmission by eliminating the habitats of the Aedes aegypti mosquito, which breeds in stagnant water. METHODS: A quantitative household survey and observation checklist with trained enumerators were undertaken between August and October 2018 in selected urban/peri-urban USAID implementation communities in El Salvador, Guatemala, and Honduras. The survey included questions regarding knowledge, attitudes, and practices related to Zika virus. An accompanying checklist was implemented to observe water storage containers, including for short-term and long-term water use. The characteristics of these containers were tabulated, including the presence of a lid. The lids were examined for key features to determine their potential effectiveness to prevent mosquito breeding: fully covering and sealing the container, not having holes, and not having water on them (potentially creating a secondary breeding site). Multivariate logistic regression was used to estimate the effectiveness of lid types and characteristics on the presence of larvae. RESULTS: Overall, in adjusted models, using an effective lid versus no lid was associated with a 94% decrease in odds of larval presence in long-term water storage containers (odds ratio = 0.06; 95% confidence interval [0.029, 0.152]); however, similar impacts were not observed for washbasins in the adjusted models. Models adjusted for household wealth, receiving a visit from a vector control technician, scrubbing the container in the last 7 days, and perception of more mosquitoes around. CONCLUSIONS: Effective lids, if made available and coupled with complementary behavioral messaging, may reduce transmission of Zika and other Aedes mosquito-borne diseases in the LAC region.


Asunto(s)
Ecosistema , Larva/fisiología , Control de Mosquitos/métodos , Mosquitos Vectores/fisiología , Abastecimiento de Agua , Infección por el Virus Zika/prevención & control , Animales , Brotes de Enfermedades/prevención & control , El Salvador , Composición Familiar , Guatemala , Honduras , Humanos , Mosquitos Vectores/virología , Infección por el Virus Zika/transmisión
11.
Exp Appl Acarol ; 83(4): 545-554, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33778915

RESUMEN

From May to November 2013, ticks were collected from wild and domestic hosts that were sampled by convenience in different localities of El Salvador. Among 48 localities, in total 1181 ticks were collected from 200 vertebrate animals, comprising 13 species of wild hosts (amphibian, reptiles, mammals) and five species of domestic mammals, plus four samples from humans and four samples from the environment. Through morphological analysis (corroborated by molecular analyses in a few cases), the following ten tick species were identified: Amblyomma dissimile, Amblyomma mixtum, Amblyomma ovale, Amblyomma cf. parvum, Amblyomma sabanerae, Amblyomma scutatum, Dermacentor dissimilis, Dermacentor nitens, Rhipicephalus microplus, and Rhipicephalus sanguineus sensu lato. Among a sample of 211 tick specimens tested for rickettsial infection by molecular methods, we identified: 'Candidatus Rickettsia colombianensi' in 10% of the A. dissimile ticks and 11% of the A. scutatum ticks; Rickettsia amblyommatis in 77% of the A. mixtum ticks, 50% of the A. cf. parvum ticks, 8% of the D. nitens ticks, and 11% of the Amblyomma spp. nymphs; and Rickettsia bellii in 3% of the A. dissimile ticks and 17% of the A. ovale ticks. The tick fauna of El Salvador is currently represented by 12 reported species.


Asunto(s)
Ixodidae , Rickettsia , Garrapatas , Animales , El Salvador , Rickettsia/genética
14.
AIDS Behav ; 25(7): 2316-2323, 2021 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-33515335

RESUMEN

The present study evaluates a combination prevention intervention for crack users in San Salvador, El Salvador that included social network HIV testing, community events and small group interventions. We examined the cumulative effects of the social network HIV testing and small group interventions on rates of HIV testing, beyond the increase that we saw with the introduction of the social network HIV testing intervention alone. HIV test data was converted into the number of daily tests and analyzed the immediate and overtime impact of small group interventions during and in the twelve weeks after the small group intervention. The addition of the small group interventions to the baseline of monthly HIV tests resulted in increased rates of testing lasting 7 days after the small group interventions suggesting a reinforcing effect of small group interventions on testing rates.


Asunto(s)
Cocaína Crack , Infecciones por VIH , El Salvador/epidemiología , Infecciones por VIH/diagnóstico , Infecciones por VIH/epidemiología , Infecciones por VIH/prevención & control , Prueba de VIH , Humanos , Red Social
15.
Soc Sci Med ; 270: 113671, 2021 02.
Artículo en Inglés | MEDLINE | ID: mdl-33486425

RESUMEN

The Zika outbreak of 2015-7 is a lens to analyse the positioning of abortion within in global health security. The sequelae of the virus almost exclusively affected newborn children, manifested through Congenital Zika Syndrome (CZS), and a focus on women at risk of, planning or being pregnant. At the global level, debate considered whether Zika would provide impetus for regulatory change for reproductive rights in Latin America, a region with some of the most restrictive abortion regulation in the world. However, regulatory change for abortion did not occur. We analyse why the Zika health emergency did not lead to any changes in abortion regulation through multi-method analysis of the intersection between Zika, health emergencies and abortion in Brazil, Colombia and El Salvador. These case study countries were purposefully selected; each had Zika infected women (albeit with differing incidence) yet represent diverse regulatory environments for abortion. Our comparative research is multi-method: framework analysis of key informant interviews (n = 49); content analysis of women's enquiries to a medical abortion telemedicine provider; and, policy analysis of (inter)national-level Zika response and abortion policies. We consider this within literature on global health security, and the prioritisation of a particular approach to epidemic control. Within this securitized landscape, despite increased public debate about abortion regulatory change, no meaningful change occurred, due to a dominant epidemiological approach to the Zika health emergency in all three countries and prominent conservative forces in government and within anti-abortion rights movements. Simultaneously, we demonstrate that regulation did not deter all women from seeking such service clandestinely.


Asunto(s)
Aborto Inducido , Infección por el Virus Zika , Virus Zika , Brasil/epidemiología , Colombia/epidemiología , El Salvador , Urgencias Médicas , Femenino , Humanos , Recién Nacido , América Latina , Embarazo , Infección por el Virus Zika/epidemiología
16.
J Antimicrob Chemother ; 76(5): 1155-1159, 2021 04 13.
Artículo en Inglés | MEDLINE | ID: mdl-33517418

RESUMEN

BACKGROUND: Invasive meningococcal disease (IMD) is an acute, highly transmissible and potentially fatal disease caused by Neisseria meningitidis. Prompt antimicrobial therapy and prophylaxis are recommended, where penicillin or ciprofloxacin are the available choices. However, the emergence of resistant isolates of N. meningitidis poses a challenge for antimicrobial therapy. OBJECTIVES: To describe the clinical, epidemiological and biological characteristics of six penicillin- and ciprofloxacin-resistant, culture-confirmed IMD cases reported in El Salvador, Central America, between 2017 and 2019. METHODS: Following the detection of six patients presenting with IMD in El Salvador, clinical data were collected and epidemiological action plans conducted. Isolates were subjected to antimicrobial susceptibility testing by broth microdilution and WGS for genotyping and molecular characterization analysis, including phylogeny comparison with global sequences available from public databases. RESULTS: A total of six IMD cases caused by N. meningitidis serogroup Y, resistant to both penicillin (MIC >8.0 mg/L) and ciprofloxacin (MIC 0.125 mg/L), were detected from 2017 to 2019. Genomic analysis showed that penicillin resistance was mediated by the production of ß-lactamase ROB-1. Ciprofloxacin resistance was attributed to an amino acid substitution in DNA gyrase (T91I). All isolates were classified as ST3587, clonal complex 23, and were genetically highly similar, based on core-genome SNP analysis. CONCLUSIONS: To the best of our knowledge, we report the first cases of MDR N. meningitidis causing IMD in Latin America. Our findings highlight the emergence of this potential public health threat, with a profound impact on the efficacy of IMD treatment and prophylaxis protocols.


Asunto(s)
Infecciones Meningocócicas , Neisseria meningitidis , Antibacterianos/farmacología , Antibacterianos/uso terapéutico , Ciprofloxacina/farmacología , El Salvador , Humanos , Infecciones Meningocócicas/tratamiento farmacológico , Infecciones Meningocócicas/epidemiología , Neisseria meningitidis/genética , Serogrupo
19.
Neurology ; 95(19): e2605-e2609, 2020 11 10.
Artículo en Inglés | MEDLINE | ID: mdl-33004606

RESUMEN

OBJECTIVE: Asylum seekers experience a high burden of physical and psychological trauma, yet there is a scarcity of literature regarding the epidemiology and sequelae of head injury (HI) in asylum seekers. We examined HI prevalence and association with neuropsychiatric comorbidities in asylum seekers. METHODS: A retrospective cross-sectional study was performed through review of 139 medical affidavits from an affidavit database. Affidavits written from 2010 to 2018 were included. Demographic and case-related data were collected and classified based on the presence of HI. For neuropsychiatric sequelae, the primary study outcome was headache and the secondary outcomes were depression, posttraumatic stress disorder, and anxiety. Multivariable logistic regression was performed to examine the association between HI and neuropsychiatric sequelae, adjusted for demographic and clinical characteristics. RESULTS: A total of 139 medical affidavits of asylum seekers were included. The mean age was 27.4 ± 12.1 years, 56.8% were female, and 38.8% were <19 years. Almost half (42.5%) explicitly self-reported history of HI. Compared to clients who did not report HI, clients with HI were older and more likely to report a history of headache, physical abuse, physical trauma, concussion, and loss of consciousness. After adjustment for demographic and clinical characteristics, clients with HI had greater odds for neuropsychological sequelae such as headache (odds ratio [OR] 4.2, 95% confidence interval [CI] 2.0-8.7) and depression (OR 2.5, 95% CI 1.1-5.7). CONCLUSIONS: We observed a high prevalence of HI in asylum seekers. Comprehensive screening for HI and neuropsychiatric comorbidities is encouraged when evaluating asylum seekers.


Asunto(s)
Ansiedad/epidemiología , Traumatismos Craneocerebrales/epidemiología , Depresión/epidemiología , Cefalea/epidemiología , Refugiados/estadística & datos numéricos , Trastornos por Estrés Postraumático/epidemiología , Violencia/estadística & datos numéricos , Adolescente , Adulto , Ansiedad/psicología , Conmoción Encefálica/epidemiología , Conmoción Encefálica/psicología , Traumatismos Craneocerebrales/psicología , Estudios Transversales , Depresión/psicología , El Salvador/etnología , Femenino , Guatemala/etnología , Haití/etnología , Cefalea/psicología , Honduras/etnología , Humanos , Masculino , Trastornos de la Memoria/epidemiología , Trastornos de la Memoria/psicología , México/etnología , Nicaragua/etnología , Oportunidad Relativa , Cuestionario de Salud del Paciente , Prevalencia , Trauma Psicológico/epidemiología , Trauma Psicológico/psicología , Refugiados/psicología , Estudios Retrospectivos , Distribución por Sexo , Delitos Sexuales/psicología , Delitos Sexuales/estadística & datos numéricos , Trastornos del Inicio y del Mantenimiento del Sueño/epidemiología , Trastornos del Inicio y del Mantenimiento del Sueño/psicología , Trastornos por Estrés Postraumático/psicología , Inconsciencia/epidemiología , Inconsciencia/psicología , Estados Unidos/epidemiología , Heridas y Lesiones/epidemiología , Heridas y Lesiones/psicología , Adulto Joven
20.
BMJ Open ; 10(10): e037408, 2020 10 06.
Artículo en Inglés | MEDLINE | ID: mdl-33028551

RESUMEN

OBJECTIVES: To describe and quantify the dengue-related knowledge, attitudes and practices of residents in an urban shantytown in Lima, Peru. DESIGN/SETTING: A cross-sectional survey of adults between 18 and 80 years living in approximately 120 blocks in Oasis, an urban shantytown situated in the low-to-middle income district of Villa El Salvador in Southern Lima. The survey was adapted from an existing survey previously used in Iquitos, Peru, and included questions relating to knowledge of dengue symptoms, transmission, prevention and current mosquito control practices. PARTICIPANTS: A total of 240 surveys were completed with 80% of respondents being female and approximately 50% of all respondents describing themselves as housewives. RESULTS: Although 97.9% of respondents had heard of dengue, only 6.2% of people knew someone who had experienced the disease. Approximately half (54.2%) of the respondents knew dengue was transmitted by mosquitoes and 51.7% were able to identify fever and one other correct symptom of dengue. Female sex was significantly associated with greater symptom knowledge (OR 2.22, 95% CI 1.08 to 4.72) and prevention knowledge (OR 2.12, 95% CI 1.06 to 4.21). Past or current higher education attendance was significantly associated with symptom knowledge (OR 2.56, 95% CI 1.25 to 5.44) and transmission knowledge (OR 3.46, 95% CI 1.69 to 7.57). Knowledge of dengue was not significantly associated with carrying out practices to control mosquitoes (OR 1.76, 95% CI 0.87 to 3.54). CONCLUSIONS: This population demonstrated baseline dengue knowledge. However, this was incomplete and substantially less when compared with endemic areas. Given the sporadic nature of dengue transmission in Lima, it is not surprising that knowledge of the disease was not associated with carrying out practices to reduce mosquitoes. However, as dengue transmission in Lima is likely to increase, understanding how best to improve public knowledge of the disease and how to translate this into appropriate community action will be a key public health consideration.


Asunto(s)
Dengue , Conocimientos, Actitudes y Práctica en Salud , Adulto , Animales , Estudios Transversales , Dengue/epidemiología , Dengue/prevención & control , El Salvador , Femenino , Humanos , Perú/epidemiología , Encuestas y Cuestionarios
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