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1.
Managua; OPS; 2021-09-21. (OPS/NIC/21-0001).
No convencional en Español | PAHO-IRIS | ID: phr2-54866

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 , Políticas, Planificación y Administración en Salud , Política de Salud , Prioridades en Salud , Programas Nacionales de Salud , Cobertura de los Servicios de Salud , Cobertura Universal de Salud , Enfermedades no Transmisibles , Enfermedades Transmisibles , Sistemas Nacionales de Salud , Sistemas de Información en Salud , Factores de Riesgo , Factores Socioeconómicos , Salud Mental , Administración en Salud Pública , América Central , Nicaragua
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
4.
BMC Womens Health ; 21(1): 310, 2021 08 23.
Artículo en Inglés | MEDLINE | ID: mdl-34425798

RESUMEN

BACKGROUND: Reproductive coercion (RC) is a common form of violence against women. It can take several expressions aiming at limiting women's reproductive autonomy. Thus, the frequency and how reproductive coercion can be resisted must be investigated. There is limited research regarding RC in Latin America. Therefore, this study aimed to measure RC prevalence and associated factors and to explore the women experiences and coping strategies for RC. METHODS: A convergent mixed-methods study with parallel sampling was conducted in Nicaragua. A quantitative phase was applied with 390 women 18-35 years old attending three main urban primary health care facilities. Lifetime and 12 months of exposure to RC behaviors including pregnancy promotion (PP) and contraceptive sabotage (CS) were assessed. Poisson regression with a robust variance estimator was used to obtain adjusted prevalence rate ratios and 95% Confidence Intervals (CIs). In addition, seven in-depth interviews were collected and analyzed using qualitative content analysis. RESULTS: Ever RC prevalence was 17.4% (95% CI, 13.8-21.6) with similar proportions reporting ever experiencing PP (12.6%, 95% CI 9.4-16.3) or ever experiencing CS (11.8%, 95% CI 8.7-15.4). The prevalence of last twelve months RC was slightly lower (12.3%, 95% CI, 9.2-16.0) than above. Twelve months PP (7.4%, 95% CI 5.0-10.5) and CS (8.7%, 95% CI 6.1-12.0) were also similar. Women's higher education was a protective factor against ever and 12 months of exposure to any RC behaviors by a current or former partner. Informants described a broad spectrum of coping strategies during and after exposure to RC. However, these rarely succeeded in preventing unintended pregnancies or regaining women's long-term fertility autonomy. CONCLUSIONS: Our facility-based study showed that men's RC is a continuous phenomenon that can be enacted through explicit or subtle behaviors. Women in our study used different strategies to cope with RC but rarely succeeded in preventing unintended pregnancies or regaining their long-term fertility autonomy. Population-based studies are needed assess this phenomenon in a larger sample. The Nicaraguan health system should screen for RC and develop policies to protect women's reproductive autonomy.


Asunto(s)
Coerción , Violencia de Pareja , Adaptación Psicológica , Adolescente , Adulto , Femenino , Instituciones de Salud , Humanos , Masculino , Nicaragua , Embarazo , Prevalencia , Adulto Joven
5.
Childs Nerv Syst ; 37(10): 3083-3087, 2021 10.
Artículo en Inglés | MEDLINE | ID: mdl-34427745

RESUMEN

With respect to the tremendous deficit in surgical care plaguing developing nations, it is critical that medical outreach models be organized in such a fashion that sustainable advancements can be durably imparted beyond the duration of targeted missions. Using a didactic framework focused on empowering host neurosurgeons with an enhanced surgical skillset, a mission was launched in Managua, Nicaragua, after previous success in Kiev, Ukraine, and Lima, Peru. Unfortunately, the failure to critically assess the internal and external state of affairs of the region's medical center compromised the outreach mission. Herein lies the visiting team's lessons from failure and insights on facilitating effective communication with host institutions, circumventing geopolitical instability, and utilizing digital collaboration and video-conferencing tools in the post-COVID-19 era to advance the surgical care of developing regions in a fashion that can be generationally felt.


Asunto(s)
COVID-19 , Neurocirugia , Humanos , Neurocirujanos , Nicaragua , SARS-CoV-2
6.
Washington, D.C.; PAHO; 2021-08-16.
en Inglés | PAHO-IRIS | ID: phr-54670

RESUMEN

The main purpose of this publication is to advocate for the need to understand the gendered nature of vulnerabilities to poor health. Gender equality in health is an integral dimension of sustainable development, and it is critical to apply a “gender lens” to all aspects of the health system, including financing mechanisms in health. The impact of health-related out-of-pocket expenditure (OPE) on household poverty has been a significant factor driving the move toward universal health coverage across much of Latin America and beyond. However, not only do health care users still face a broad range of health-related OPEs that can contribute to the impoverishment of households, but the gender dimensions of OPEs have received very little attention. Drawing primarily on data from Bolivia (Plurinational State of), Guatemala, Nicaragua, and Peru, this report offers an in-depth analysis of the gender dimensions of health-related OPEs in Latin America. It highlights the limitations of survey data in determining levels of household spending on health as well as the potential failure of indicators to capture the impacts of coping strategies that households adopt to pay for OPEs. This publication calls for the application of an intersectional analysis to ensure a more nuanced understanding of the ways in which other social identity markers, such as race and ethnicity, alongside gender shape the ability of individuals and households to respond to the different OPEs they may encounter. Until policymakers consider the issue through a gender lens, OPE will continue to limit the potential of universal health care coverage to effectively address health inequalities.


Asunto(s)
Género y Salud , Análisis de Género en Salud , Gastos en Salud , Cobertura Universal de Salud , Bolivia , Guatemala , Nicaragua , Perú
7.
Washington, D.C.; OPS; 2021-08-16.
en Español | PAHO-IRIS | ID: phr-54668

RESUMEN

El objetivo principal de esta publicación es defender la necesidad de comprender la naturaleza de género de las vulnerabilidades a la mala salud. La igualdad de género en la salud es una dimensión integral del desarrollo sostenible, por lo que es fundamental aplicar una perspectiva de género a todos los aspectos del sistema de salud, incluidos los mecanismos de financiamiento de la salud. El impacto de los gastos directos de bolsillo relacionados con la salud en la pobreza de los hogares ha sido un factor importante que ha impulsado el avance hacia la cobertura universal de salud en gran parte de América Latina y en otros países. Sin embargo, no solo los usuarios de la atención de salud siguen enfrentándose a una amplia gama de gastos directos de bolsillo relacionados con la salud que pueden contribuir al empobrecimiento de los hogares, sino que las dimensiones de género de estos gastos han recibido muy poca atención. Basándose principalmente en datos de Bolivia (Estado Plurinacional de), Guatemala, Nicaragua y Perú, en este informe se ofrece un análisis en profundidad de las dimensiones de género que tienen los gastos directos de bolsillo relacionados con la salud en América Latina. Se destacan las limitaciones de los datos de las encuestas a la hora de determinar los niveles de gasto de los hogares en salud, así como la posible imposibilidad de que los indicadores capten los efectos de las estrategias de afrontamiento que adoptan los hogares para pagar por los gastos directos de bolsillo. En esta publicación se hace un llamamiento a aplicar un análisis interseccional para comprender con más matices las formas en que otros marcadores de identidad social, como la raza y la etnia, junto con el género, determinan la capacidad de las personas y los hogares para responder a los diferentes gastos directos de bolsillo que puedan encontrar. Hasta que los responsables de las políticas no consideren la cuestión desde una perspectiva de género, los gastos directos de bolsillo seguirán limitando el potencial de la cobertura universal de salud para abordar eficazmente las desigualdades de salud.


Asunto(s)
Género y Salud , Análisis de Género en Salud , Gastos en Salud , Cobertura Universal de Salud , Bolivia , Guatemala , Nicaragua , Perú
8.
J Glob Health ; 11: 04024, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34326989

RESUMEN

Background: Short-term surgical missions facilitated by non-governmental organizations (NGOs) may be a possible platform for cost-effective international global surgical efforts. The objective of this study is to determine if short-term surgical mission trips provided by the non-governmental organization (NGO) Esperança to Nicaragua from 2016 to 2020 are cost-effective. Methods: Using a provider perspective, the costs of implementing the surgical trips were collected via Esperança's previous trip reports. The reports and patient data were analyzed to determine disability-adjusted life years averted from each surgical procedure provided in Nicaragua from 2016-2020. Average cost-effectiveness ratios for each surgical trip specialty were calculated to determine the average cost of averting one disability-adjusted life year. Results: Esperança's surgical missions' program in Nicaragua from 2016 to 2020 was found to be cost-effective, with pediatric and gynecology surgical specialties being highly cost-effective and general and orthopedic surgical specialties being moderately cost-effective. These results were echoed in both scenarios of the sensitivity analysis, except for the orthopedic specialty which was found to not be cost-effective when testing an increased discount rate. Conclusions: The cost-effectiveness of short-term surgical missions provided by NGOs can be cost-effective, but limitations include inconsistent data from a societal perspective and lack of an appropriate counterfactual. Future studies should examine the capacity for NGOs to collect adequate data and conduct rigorous economic evaluations.


Asunto(s)
Misiones Médicas , Procedimientos Quirúrgicos Operativos , Adulto , Niño , Análisis Costo-Beneficio , Femenino , Cirugía General/economía , Procedimientos Quirúrgicos Ginecológicos/economía , Humanos , Masculino , Misiones Médicas/economía , Persona de Mediana Edad , Nicaragua , Procedimientos Ortopédicos/economía , Pediatría/economía , Procedimientos Quirúrgicos Operativos/economía
9.
Artículo en Inglés | MEDLINE | ID: mdl-34071535

RESUMEN

(1) Background: The COVID-19 pandemic has created a great impact on mental health in society. Considering the little attention paid by scientific studies to either students or university staff during lockdown, the current study has two aims: (a) to analyze the evolution of mental health and (b) to identify predictors of educational/professional experience and online learning/teaching experience. (2) Methods: 1084 university students and 554 staff in total from four different countries (Spain, Colombia, Chile and Nicaragua) participated in the study, affiliated with nine different universities, four of them Spanish and one of which was online. We used an online survey known as LockedDown, which consists of 82 items, analyzed with classical multiple regression analyses and machine learning techniques. (3) Results: Stress level and feelings of anxiety and depression of students and staff either increased or remained over the weeks. A better online learning experience for university students was associated with the age, perception of the experience as beneficial and support of the university. (4) Conclusions: The study has shown evidence of the emotional impact and quality of life for both students and staff. For students, the evolution of feelings of anxiety and depression, as well as the support offered by the university affected the educational experience and online learning. For staff who experienced a positive professional experience, with access to services and products, the quality-of-life levels were maintained.


Asunto(s)
COVID-19 , Educación a Distancia , Chile , Colombia , Control de Enfermedades Transmisibles , Humanos , Nicaragua , Pandemias , Calidad de Vida , SARS-CoV-2 , España , Estudiantes , Universidades
10.
Artículo en Inglés | MEDLINE | ID: mdl-34069421

RESUMEN

An ongoing epidemic of chronic kidney disease of uncertain etiology (CKDu) afflicts large parts of Central America and is hypothesized to be linked to heat stress at work. Mortality rates from CKDu appear to have increased dramatically since the 1970s. To explore this relationship, we assessed trends in maximum and minimum temperatures during harvest months between 1973 and 2014 as well as in the number of days during the harvest season for which the maximum temperature surpassed 35 °C. Data were collected at a weather station at a Nicaraguan sugar company where large numbers of workers have been affected by CKDu. Monthly averages of the daily maximum temperatures between 1996 and 2014 were also compared to concurrent weather data from eight Automated Surface Observing System Network weather stations across Nicaragua. Our objectives were to assess changes in temperature across harvest seasons, estimate the number of days that workers were at risk of heat-related illness and compare daily maximum temperatures across various sites in Nicaragua. The monthly average daily maximum temperature during the harvest season increased by 0.7 °C per decade between 1973 and 1990. The number of days per harvest season with a maximum temperature over 35 °C increased by approximately five days per year between 1974 and 1990, from 32 days to 114 days. Between 1991 and 2013, the number of harvest days with a maximum temperature over 35 °C decreased by two days per year, and the monthly average daily maximum temperature decreased by 0.3 °C per decade. Comparisons with weather stations across Nicaragua demonstrate that this company is located in one of the consistently hottest regions of the country.


Asunto(s)
Clima , Insuficiencia Renal Crónica , América Central , Calor , Humanos , Nicaragua/epidemiología , Insuficiencia Renal Crónica/epidemiología , Estaciones del Año , Temperatura , Tiempo (Meteorología)
11.
Braz Oral Res ; 35(suppl 01): e054, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34076078

RESUMEN

Dental caries remains highly prevalent in Latin American and Caribbean countries (LACC). However, this disease can be controlled through interventions that implement evidence-based strategies in an affordable manner and that target all population groups instead of the most affluent only. Therefore, the aim of this report was to summarize the main scientifically documented community interventions and strategies based on restriction of sugars consumption, use of fluoride, and the use of occlusal sealants for caries control in LACC. A critical literature review was carried out in a systematic manner that included defined search strategies, independent review of the identified publications, and compilation of results in this report. Three systematic searches were conducted using the PubMed, LILACS, and SciELO databases to identify studies related to community interventions and strategies for caries control in LACC. Of the 37 publications identified, twenty-six focused on fluoride use, eight on occlusal sealant use, and three on the restriction of sugar consumption. Documented community interventions for sugars restriction were scarce in the region and were based on food supplementation, sugar replacement, and education. Thus, local and/or national policies should prioritize investment in upstream, coherent, and integrated population-wide policies such as taxes on sugary drinks and stronger regulation of advertising and promotion of sugary foods and drinks mainly targeting children. The main fluoride-based strategies used drinking water, refined domestic salt, cow milk, toothpaste and, to a lesser extent, mouth-rinses, acidulated phosphate fluoride (APF) gels, and varnishes to deliver fluoride to the population. Evidence of fluoride use was seen in Argentina, Belize, Bolivia, Brazil, Chile, Colombia, Costa Rica, Cuba, Dominican Republic, Ecuador, El Salvador, Guatemala, Haiti, Honduras, Mexico, Nicaragua, Panama, Paraguay, Peru, Uruguay, and Venezuela. Studies reporting the use of occlusal sealants were mainly located in Brazil, Chile, Colombia, Costa Rica, Peru, Mexico, and Venezuela. Community interventions restricting sugar consumption should be implemented at the individual level and through public policies. The use of fluoride must be monitored at the local, regional, and national levels so as to achieve maximum anti-caries effect while also minimizing the risk of dental fluorosis. Moreover, fluoridated water and salt programs, used as a mutually exclusive community level strategy for caries control, should expand their benefits to reach non-covered areas of the LACC while also simultaneously providing adequate surveillance of the fluoride concentration delivered to the population. Regulating the concentration of soluble fluoride (for anti-caries effect) in dentifrice formulations is also necessary in order to provide the population with an effective strategy for disease control. Targeting culturally appropriate, economically sustainable caries control interventions to rural populations and native ethnic groups such as indigenous people, quilombolas (African-origin), and riverside Amazonian people remains a crucial challenge.


Asunto(s)
Cariostáticos , Caries Dental , Argentina , Brasil , Región del Caribe , Cariostáticos/uso terapéutico , Niño , Chile , Colombia , Caries Dental/epidemiología , Caries Dental/prevención & control , Susceptibilidad a Caries Dentarias , Guatemala , Humanos , América Latina/epidemiología , México , Nicaragua , Panamá , Perú , Uruguay
12.
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
13.
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
14.
PLoS One ; 16(4): e0249345, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33819284

RESUMEN

Researchers often use moral dilemmas to investigate the specific factors that influence participants' judgments of the appropriateness of different actions. A common construction of such a dilemma is the Trolley Problem, which pits an obvious utilitarian solution against a common deontological dictum to not do harm to others. Cross-cultural studies have validated the robustness of numerous contextual biases, such as judging utilitarian decisions more negatively if they require contact with other individuals (contact bias), they force others to serve as a means to an end (means bias), and if they require direct action rather than inaction (omission bias). However, such cross-cultural research is largely limited to studies of industrialized, nation-state populations. Previous research has suggested that the more intimate community relationships that characterize small-scale populations might lead to important differences, such as an absence of an omission bias. Here we contribute to this literature by investigating perceptions of Trolley Problem solutions among a Mayangna/Miskito community, a small-scale indigenous population in Nicaragua. Compared to previously sampled populations, the Mayangna/Miskito participants report higher levels of acceptance of utilitarian solutions and do not exhibit an omission bias. We also examine the justifications participants offered to explore how Mayangna/Miskito culture might influence moral judgments.


Asunto(s)
Teoría Ética , Toma de Decisiones , Humanos , Relaciones Interpersonales , Principios Morales , Nicaragua , Solución de Problemas
15.
Parasitol Res ; 120(6): 1965-1977, 2021 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-33851247

RESUMEN

Procamallanus is a species-rich genus of parasitic nematodes of marine, brackish, and freshwater fishes, occurring also occasionally in amphibians and reptiles. In the Neotropical region, this genus is highly diverse, with species described from a wide range of fish families. In this study, we reassess the taxonomic status of Procamallanus rebecae with molecular and morphological data and describe a new species endemic to Nicaragua and Costa Rica. We analyzed all Procamallanus isolated from fish from the Nicaraguan lakes and some rivers in Costa Rica after an exhaustive analysis of their freshwater fish endoparasite fauna. Procamallanus rebecae is a host-specific parasite of Middle American cichlids, previously reported in southern Mexico, Nicaragua, and Costa Rica. We therefore compared these Central American specimens with individuals of P. rebecae collected in cichlids from southeastern Mexico using two genomic regions (28S rDNA and mitochondrial cytochrome oxidase subunit 1, COI). We found high levels of sequence divergence between Procamallanus from the two geographical regions, with up to 9.8 and 10.5% for both genetic markers, respectively. We also analyzed their morphology and found conspicuous differences in the shape of the mouth and the structure of the female cauda. We therefore describe the specimens of Procamallanus from Central American cichlids as a new species. Both Procamallanus species occur in different cichlid species and are allopatrically distributed. The host specificity and ancient association patterns between cichlids and Procamallanus and the jointly colonization of both hosts and parasites during their northern dispersal from South America are briefly discussed.


Asunto(s)
Cíclidos/parasitología , Infecciones por Spirurida/veterinaria , Espirúridos/clasificación , Animales , Costa Rica/epidemiología , ADN Ribosómico/genética , Femenino , Nematodos/clasificación , Nicaragua/epidemiología , Filogenia , Especificidad de la Especie , Espirúridos/genética , Infecciones por Spirurida/epidemiología , Infecciones por Spirurida/parasitología , Estados Unidos
16.
Exp Appl Acarol ; 83(4): 527-544, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33687585

RESUMEN

The ectoparasite Varroa (Acari: Varroidae) is considered to be the main pest of honey bees (Apis mellifera L.) in Nicaragua. The aim of this study was to determine morphotypes and mitochondrial haplotypes of the Varroa mites, related to infestation levels in A. mellifera hives in Nicaragua in a cross-sectional study (2013-2016). Samples were taken from 34 sentinel apiaries in five geographical zones; from 713 Varroa females collected during the study, 153 were selected for measurement of various morphometric characters for further classification into morphotypes. The mitochondrial haplotype was assigned to one of the two (Korean or Japanese), using the restriction by SacI of the PCR product of a fragment of the gene CO-I. Morphometric measurement and sequencing revealed the affiliation to the species Varroa destructor with a mean (± SD) body width of 1699.1 ± 60.2 µm and a body length of 1161.1 ± 34.9 µm. Body characters were significantly different among the 34 apiaries. Varroa destructor samples were classified into four morphotypes, with no significant differences in the geographical zones. As GAGCTC SacI enzyme cleavage sequences were not observed, all PCR products were identified as V. destructor Korean haplotype. The CO-I gene nucleotide sequences from two samples V. destructor showed both 100% similarity with the Korean haplotype and 99.8% similarity to the Japanese haplotype. Although the V. destructor mite was identified as a Korean haplotype, host-parasite association in 2 decades has led into a balance without entering into severe losses in the Nicaraguan apiculture.


Asunto(s)
Varroidae , Animales , Apicultura , Abejas , Estudios Transversales , Femenino , Haplotipos , Nicaragua
17.
J Infect Dis ; 223(2): 278-286, 2021 02 03.
Artículo en Inglés | MEDLINE | ID: mdl-33535235

RESUMEN

BACKGROUND: Chikungunya infections range from subclinical infection to debilitating arthralgia and to chronic inflammatory rheumatism. Tumor necrosis factor (TNF) α, DC-SIGN (dendritic cell-specific intercellular adhesion molecule 3-grabbing nonintegrin), Toll-like receptor (TLR) 3, and blood groups have been directly or indirectly implicated in the susceptibility and pathogenesis of chikungunya. METHODS: To test the hypothesis that polymorphisms in genes coding for these molecules determine clinical outcomes of chikungunya infection, a retrospective case-control study was performed in León, Nicaragua. The study included 132 case patients and 132 controls, matched for age, sex and neighborhood. Case patients had clinical symptoms of chikungunya, which was diagnosed by means of polymerase chain reaction. Controls were individuals not reporting abrupt presentation of clinical chikungunya-like symptoms. Polymorphisms were identified by TaqMan single-nucleotide polymorphism genotyping assays. RESULTS: After adjustment for sociodemographic risk factors, chikungunya disease was associated with polymorphism in DC-SIGN and TLR3 genes (odds ratios, 5.2 and 3.3, respectively), and TNF-α with reduced persistent joint pain (0.24). Persistent joint pain was also associated with age, female sex and other comorbid conditions. Most interestingly, the Lewis-negative phenotype was strongly associated with both symptomatic chikungunya and immunoglobulin G seropositivity (odds ratios, 2.7, and 3.3, respectively). CONCLUSION: This study identified polymorphisms in DC-SIGN, TLR3, and TNF-α genes as well as Lewis-negative phenotype as risk factors for chikungunya infection and disease progression.


Asunto(s)
Moléculas de Adhesión Celular/genética , Fiebre Chikungunya/epidemiología , Fiebre Chikungunya/etiología , Predisposición Genética a la Enfermedad , Lectinas Tipo C/genética , Polimorfismo de Nucleótido Simple , Receptores de Superficie Celular/genética , Receptor Toll-Like 3/genética , Factor de Necrosis Tumoral alfa/genética , Estudios de Casos y Controles , Fiebre Chikungunya/diagnóstico , Estudios de Asociación Genética , Genotipo , Humanos , Nicaragua/epidemiología , Fenotipo , Medición de Riesgo , Factores de Riesgo
18.
Malar J ; 20(1): 106, 2021 Feb 19.
Artículo en Inglés | MEDLINE | ID: mdl-33608024

RESUMEN

BACKGROUND: Vector control for malaria prevention relies most often on the use of insecticide-treated bed net (ITNs) and indoor residual spraying. Little is known about the longevity of long-lasting insecticidal nets (LLINs) in the Americas. The physical integrity and insecticide retention of LLINs over time were monitored after a bed net distribution campaign to assess community practices around LLIN care and use in Waspam, northeastern Nicaragua. METHODS: At least 30 nets were collected at 6, 12, 24, and 36 months post distribution. Physical integrity was measured by counting holes and classifying nets into categories (good, damaged, and too torn) depending on a proportionate hole index (pHI). Insecticide bioefficacy was assessed using cone bioassays, and insecticide content measured using a cyanopyrethroid field test (CFT). RESULTS: At 6 months, 87.3 % of LLINs were in good physical condition, while by 36 months this decreased to 20.6 %, with 38.2 % considered 'too torn.' The median pHI increased from 7 at the 6-month time point to 480.5 by 36 months. After 36 months of use, median mortality in cone bioassays was 2 % (range: 0-6 %) compared to 16 % (range: 2-70 %) at 6 months. There was a decrease in the level of deltamethrin detected on the surface of the LLINs with 100 % of tested LLINs tested at 12 months and 24 months crossing the threshold for being considered a failed net by CFT. CONCLUSIONS: This first comprehensive analysis of LLIN durability in Central America revealed rapid loss of chemical bioefficacy and progressive physical damage over a 36-month period. Use of these findings to guide future LLIN interventions in malaria elimination settings in Nicaragua, and potentially elsewhere in the Americas, could help optimize the successful implementation of vector control strategies.


Asunto(s)
Anopheles/efectos de los fármacos , Mosquiteros Tratados con Insecticida/estadística & datos numéricos , Insecticidas/farmacología , Malaria/prevención & control , Control de Mosquitos/estadística & datos numéricos , Mosquitos Vectores/efectos de los fármacos , Permetrina/farmacología , Animales , Bioensayo , Femenino , Nicaragua , Estaciones del Año
19.
Cognition ; 211: 104608, 2021 06.
Artículo en Inglés | MEDLINE | ID: mdl-33581667

RESUMEN

Linguistic input has an immediate effect on child language, making it difficult to discern whatever biases children may bring to language-learning. To discover these biases, we turn to deaf children who cannot acquire spoken language and are not exposed to sign language. These children nevertheless produce gestures, called homesigns, which have structural properties found in natural language. We ask whether these properties can be traced to gestures produced by hearing speakers in Nicaragua, a gesture-rich culture, and in the USA, a culture where speakers rarely gesture without speech. We studied 7 homesigning children and hearing family members in Nicaragua, and 4 in the USA. As expected, family members produced more gestures without speech, and longer gesture strings, in Nicaragua than in the USA. However, in both cultures, homesigners displayed more structural complexity than family members, and there was no correlation between individual homesigners and family members with respect to structural complexity. The findings replicate previous work showing that the gestures hearing speakers produce do not offer a model for the structural aspects of homesign, thus suggesting that children bring biases to construct, or learn, these properties to language-learning. The study also goes beyond the current literature in three ways. First, it extends homesign findings to Nicaragua, where homesigners received a richer gestural model than USA homesigners. Moreover, the relatively large numbers of gestures in Nicaragua made it possible to take advantage of more sophisticated statistical techniques than were used in the original homesign studies. Second, the study extends the discovery of complex noun phrases to Nicaraguan homesign. The almost complete absence of complex noun phrases in the hearing family members of both cultures provides the most convincing evidence to date that homesigners, and not their hearing family members, are the ones who introduce structural properties into homesign. Finally, by extending the homesign phenomenon to Nicaragua, the study offers insight into the gestural precursors of an emerging sign language. The findings shed light on the types of structures that an individual can introduce into communication before that communication is shared within a community of users, and thus sheds light on the roots of linguistic structure.


Asunto(s)
Comparación Transcultural , Gestos , Sesgo , Niño , Humanos , Desarrollo del Lenguaje , Nicaragua , Lengua de Signos
20.
Pediatr Infect Dis J ; 40(3): 220-226, 2021 03 01.
Artículo en Inglés | MEDLINE | ID: mdl-33464013

RESUMEN

BACKGROUND: Sapovirus is increasingly recognized as an important cause of acute gastroenteritis (AGE) in children. We identified risk factors and characterized the clinical profile of sapovirus AGE in a birth cohort in León, Nicaragua. METHODS: We conducted a case-control study nested within a birth cohort (n = 444). Fieldworkers conducted weekly household AGE surveillance. AGE stools were tested for sapovirus by reverse transcriptase quantitative polymerase chain reaction. For each first sapovirus episode, we selected 2 healthy age-matched controls and estimated independent risk factors of sapovirus AGE using conditional logistic regression. We compared clinical characteristics of sapovirus AGE episodes with episodes associated with other etiologies and identified co-infections with other enteric pathogens. RESULTS: From June 2017 to July 2019, we identified 63 first sapovirus AGE episodes and selected 126 controls. Having contact with an individual with AGE symptoms and vaginal delivery were independent risk factors for sapovirus AGE. All cases experienced diarrhea, lasting a median 6 days; 23% experienced vomiting. Compared with children with AGE due to another etiology, sapovirus AGE was similar in severity, with less reported fever. Most cases experienced co-infections and were more likely than controls to be infected with diarrheagenic Escherichia coli or astrovirus. CONCLUSIONS: Sapovirus was a commonly identified AGE etiology in this Central American setting, and symptoms were similar to AGE associated with other etiologies. The association between vaginal delivery and sapovirus is a novel finding. Gut microbiome composition might mediate this relationship, or vaginal delivery might be a proxy for other risk factors. Further investigation into more specific biological mechanisms is warranted.


Asunto(s)
Infecciones por Caliciviridae/epidemiología , Infecciones por Caliciviridae/virología , Gastroenteritis/epidemiología , Gastroenteritis/virología , Sapovirus , Estudios de Casos y Controles , Estudios de Cohortes , Femenino , Humanos , Lactante , Modelos Logísticos , Masculino , Nicaragua/epidemiología , Factores de Riesgo
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