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2.
BMJ Open ; 10(12): e035307, 2020 12 15.
Artículo en Inglés | MEDLINE | ID: mdl-33323426

RESUMEN

INTRODUCTION: Zika virus (ZIKV) infection in pregnancy has been associated with microcephaly and severe neurological damage to the fetus. Our aim is to document the risks of adverse pregnancy and birth outcomes and the prevalence of laboratory markers of congenital infection in deliveries to women experiencing ZIKV infection during pregnancy, using data from European Commission-funded prospective cohort studies in 20 centres in 11 countries across Latin America and the Caribbean. METHODS AND ANALYSIS: We will carry out a centre-by-centre analysis of the risks of adverse pregnancy and birth outcomes, comparing women with confirmed and suspected ZIKV infection in pregnancy to those with no evidence of infection in pregnancy. We will document the proportion of deliveries in which laboratory markers of congenital infection were present. Finally, we will investigate the associations of trimester of maternal infection in pregnancy, presence or absence of maternal symptoms of acute ZIKV infection and previous flavivirus infections with adverse outcomes and with markers of congenital infection. Centre-specific estimates will be pooled using a two-stage approach. ETHICS AND DISSEMINATION: Ethical approval was obtained at each centre. Findings will be presented at international conferences and published in peer-reviewed open access journals and discussed with local public health officials and representatives of the national Ministries of Health, Pan American Health Organization and WHO involved with ZIKV prevention and control activities.


Asunto(s)
Complicaciones Infecciosas del Embarazo , Infección por el Virus Zika , Virus Zika , Región del Caribe/epidemiología , Estudios de Cohortes , Femenino , Humanos , América Latina/epidemiología , Embarazo , Complicaciones Infecciosas del Embarazo/epidemiología , Estudios Prospectivos , Riesgo , Infección por el Virus Zika/epidemiología
3.
PLoS Med ; 17(12): e1003443, 2020 12.
Artículo en Inglés | MEDLINE | ID: mdl-33373361

RESUMEN

BACKGROUND: Adolescents and young people (10-24 years old) in the Latin America and the Caribbean (LAC) region represent approximately 25% of the region's population. Since the 2008 global economic crisis, the pace of reduction in poverty and income inequality in the LAC region has stalled. The region is characterised by high levels of inequities and is also vulnerable to many natural disasters. Food systems are changing with increased availability and marketing of packaged and fast foods and sugar-sweetened drinks. Adolescence is a formative phase of the life course with multiple physical, emotional and social changes which can make them vulnerable to health problems. We assess the potential impact of macro-determinants, human and economic development as well as income inequality, on 2 top-ranking regional priorities for adolescent nutrition and mental health, using measures of overweight and suicidal ideation and planning which some have shown to be associated. METHODS AND FINDINGS: The Global School-based Health Survey (GSHS) is a nationally representative self-administered, school-based survey. We examined overweight/obesity and suicidal ideation with planning by gross domestic product (GDP) per capita or human development index (HDI) in 10-19-year-old adolescents from 21 LAC countries between 2009 and 2013. Sample sizes varied from 943 in Anguilla to 27,988 in Argentina. A total of 55,295 adolescents had a measure of overweight/obesity status, and 59,061 adolescents reported about suicidal ideation with planning. There was equal representation by sex in the surveys (52% girls and 48% boys). A total of 28.8% of boys and 28.1% of girls had overweight/obesity, and 7.5% of boys and 17.5% of girls reported suicidal ideation with planning over the last 12 months. Adjusted for individual socioeconomic and risk behaviours, and relative to the highest GDP per capita tertile, the middle tertile was associated with 42% (95% confidence interval (CI) 59% to 17%, p = 0.003) and 32% (95% CI 60% to 5%, p = 0.023), and the lowest tertile with 40% (95% CI 55% to 19%, p = 0.001) and 46% (95% CI 59% to 29%, p < 0.001) lower chances of overweight/obesity for girls and boys, respectively. A similar positive effect was seen with HDI, with lowest chances of overweight in the lowest tertile compared with the highest tertile for both sexes. Overweight/obesity was positively related with suicidal ideation with planning for girls (odds ratio (OR) 1.12, 95% CI 1.02 to 1.22, p = 0.009) and weakly related for boys (OR 1.09, 95% CI 0.96 to 1.24, p = 0.182). In contrast to overweight/obesity status, suicidal ideation with planning was not related to macro-level indices despite both outcomes sharing common individual socioeconomic and risk behaviour correlates. Limitations include the dominance of Argentinians in the sample (40%), the exclusion of vulnerable adolescents who dropped out of school, and reporting bias due to stigma of mental health-related issues. CONCLUSIONS: This study shows that economic and human development were positively associated with adolescent overweight/obesity but not with suicidal ideation with planning. We also observed an interconnectedness between overweight/obesity and suicide ideation with planning among girls. These findings highlight the importance of strategies that engage with both upstream and downstream determinants to improve adolescent nutrition and mental health.


Asunto(s)
Conducta del Adolescente , Conducta Infantil , Obesidad Pediátrica/psicología , Ideación Suicida , Adolescente , Factores de Edad , Región del Caribe/epidemiología , Niño , Estudios Transversales , Femenino , Encuestas Epidemiológicas , Humanos , América Latina/epidemiología , Masculino , Salud Mental , Obesidad Pediátrica/diagnóstico , Obesidad Pediátrica/epidemiología , Medición de Riesgo , Factores de Riesgo , Factores Sexuales , Adulto Joven
4.
Rev. bioét. derecho ; (50): 221-237, nov. 2020.
Artículo en Español | IBECS | ID: ibc-191355

RESUMEN

Los avances de las Tecnologías de la Información y la Comunicación (TIC) permiten acceder en tiempo real a una cantidad ingente de datos, a través de los cuales es posible conocer el comportamiento de hechos sociales. En este escenario, la actual pandemia por SARS-CoV-2 ha permitido, bajo cuestionables criterios de inmediatez y urgencia, circular información que genera realidad e impacta en la toma de decisiones; y, además, ha favorecido la apropiación del dato, exponiendo a las personas a violaciones de sus derechos fundamentales. Ambos asuntos son sensibles para América Latina y el Caribe, región que hoy se presenta no sólo como el epicentro de la pandemia sino también de las desigualdades. La contribución que desde la reflexión y deliberación bioética puede realizarse en esta materia, adquiere especial relevancia con vistas a generar un nuevo pacto para el tratamiento de los datos


Advances in Information and Communication Technologies (ICT) provide real-time access to a vast amount of data, through which it is possible to know the behavior of social facts. In this scenario, the current SARS-CoV-2 pandemic has allowed, under questionable criteria of immediacy and urgency, to circulate information that generates reality and impacts on decision-making; and has also favored the appropriation of the data, exposing people to violations of their fundamental rights. Both issues are sensitive to Latin America and the Caribbean, a region that today is presented itself not only as the epicenter of the pandemic but also of inequalities. The contribution that bioethical reflection and deliberation can make in this matter, acquires special relevance with a view to generating a new covenant for the treatment of data


Els avenços de les Tecnologies de la Informació I la Comunicació (TIC) permeten accedir en temps real a una quantitat ingent de dades, a través dels quals és possible conèixer el comportament de fets socials. En aquest escenari, l'actual pandèmia per SARS-CoV-2 ha permès, sota qüestionables criteris d'immediatesa I urgència, circular informació que genera realitat I impacta en la presa de decisions; i, a més, ha afavorit l'apropiació de la dada, exposant a les persones a violacions dels seus drets fonamentals. Tots dos assumptes són sensibles per a Amèrica Llatina I el Carib, regió que avui es presenta no només com l'epicentre de la pandèmia sinó també de les desigualtats. La contribució que des de la reflexió I deliberació bioètica pot realitzarse en aquesta matèria, adquireix especial rellevància amb vistes a generar un nou pacte per al tractament de les dades


Asunto(s)
Humanos , Infecciones por Coronavirus/epidemiología , Neumonía Viral/epidemiología , Pandemias , Acceso a Internet , Tecnología de la Información , América Latina/epidemiología , Región del Caribe/epidemiología
5.
PLoS One ; 15(10): e0239797, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33027272

RESUMEN

The current coronavirus pandemic is an unprecedented public health challenge that is having a devastating economic impact on households. Using a sample of 230,540 respondents to an online survey from 17 countries in Latin America and the Caribbean, the study shows that the economic impacts are large and unequal: 45 percent of respondents report that a household member has lost their job and, among households owning small businesses, 59 percent of respondents report that a household member has closed their business. Among households with the lowest income prior to the pandemic, 71 percent report that a household member lost their job and 61 percent report that a household member has closed their business. Declines in food security and health are among the disproportionate impacts. The findings provide evidence that the current public health crisis will exacerbate economic inequality and provides some of the first estimates of the impact of the pandemic on the labor market and well-being in developing countries.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/economía , Infecciones por Coronavirus/epidemiología , Países en Desarrollo/economía , Pandemias/economía , Neumonía Viral/economía , Neumonía Viral/epidemiología , Factores Socioeconómicos , Adulto , Región del Caribe/epidemiología , Infecciones por Coronavirus/virología , Composición Familiar , Femenino , Abastecimiento de Alimentos , Humanos , Renta , América Latina/epidemiología , Masculino , Neumonía Viral/virología , Pobreza , Encuestas y Cuestionarios , Desempleo
6.
Medwave ; 20(8): e8025, 2020 Sep 16.
Artículo en Español | MEDLINE | ID: mdl-32956342

RESUMEN

Introduction: Coronavirus disease 2019 has been reported in the pediatric population; however, there is limited information in Latin American and the Caribbean countries. Objectives: To describe the frequency of cases, deaths, incidence, and case fatality rate attributed to COVID-19 in children and adolescents from Latin American and the Caribbean countries. Methods: An observational study was carried-out using COVID-19 case registries in children and adolescents published by the Ministries of Health of 19 countries in Latin American and the Caribbean countries until May 20, 2020. Cases and deaths were classified by sex and age group. Also, incidence and case fatality rates were calculated for each country. Results: A total of 20,757 (4.2% of all patients) cases of COVID-19 were reported in children from 0 to 19 years of age. 52.4% was in the group aged 10 to 19 years. 50.6% were male. 139 (0.26%) deaths were reported in children from 0 to 19 years. The accumulated incidence was higher in Chile, Panama, and Peru. The cumulative incidence per 100,000 inhabitants ranged from 1.26 to 77.55 in the population from 0 to 9 years old, 1.57 to 98.84 from 10 to 19 years old, and 0.91 to 88.34 from 0 to 19 years old. The case fatality rate in children from 0 to 19 years old ranged from 0 to 9.09%. Conclusion: In 19 Latin American and the Caribbean countries, the frequency of cases, cumulative incidence, case fatality rate in children and adolescents was heterogeneous. These results contribute to understanding the epidemiological behavior of this disease in children and adolescents of the countries included in the study.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/epidemiología , Neumonía Viral/epidemiología , Adolescente , Distribución por Edad , Región del Caribe/epidemiología , Niño , Preescolar , Infecciones por Coronavirus/mortalidad , Humanos , Incidencia , Lactante , Recién Nacido , América Latina/epidemiología , Pandemias , Neumonía Viral/mortalidad , Distribución por Sexo , Adulto Joven
7.
PLoS One ; 15(9): e0237542, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32886663

RESUMEN

BACKGROUND: Given that most evidence-based recommendations for managing type 2 diabetes mellitus (T2DM) are generated in high-income settings, significant challenges for their implementation exist in Latin America and the Caribbean region (LAC), where the rates of T2DM and related mortality are increasing. The aim of this study is to identify the facilitators and barriers to successful management of T2DM in LAC, from the perspectives of patients, their families or caregivers, healthcare professionals, and/or other stakeholders. METHODS: We conducted a systematic review in MEDLINE, Web of Science, SciELO, and LILACS. We included studies of disease management, prevention of complications and risk factor management. We qualitatively synthesized the verbatim text referring to barriers and/or facilitators of diabetes management according to the Theoretical Domain Framework and described their relative frequencies. FINDINGS: We included 60 studies from 1,595 records identified. 54 studies (90%) identified factors related to the environmental context and resources, highlighting the importance of questions related to health care access or lack of resources in the health system, and the environmental context and living conditions of the patients. Issues related to "social influences" (40 studies) and "social/professional role and identity" (37 studies) were also frequently addressed, indicating the negative impact of lack of support from family and friends and clinicians' paternalistic attitude. 25 studies identified patients beliefs as important barriers, identifying issues such as a lack of patients' trust in the effectiveness of the medication and/or the doctor's advice, or preferences for alternative therapies. CONCLUSIONS: Successful diabetes management in LAC is highly dependent on factors that are beyond the control of the individual patients. Successful disease control will require emphasis on public policies to reinforce health care access and resources, the promotion of a patient-centred care approach, and health promoting infrastructures at environmental level.


Asunto(s)
Diabetes Mellitus Tipo 2/epidemiología , Diabetes Mellitus Tipo 2/terapia , Región del Caribe/epidemiología , Diabetes Mellitus Tipo 2/prevención & control , Manejo de la Enfermedad , Accesibilidad a los Servicios de Salud , Humanos , América Latina/epidemiología , Atención Dirigida al Paciente , Factores de Riesgo
9.
Cien Saude Colet ; 25(9): 3557-3562, 2020 Sep.
Artículo en Español | MEDLINE | ID: mdl-32876262

RESUMEN

Thinking about the SARS-CoV-2 pandemic implies the study of general and unique dimensions for the historical evolution of Latin America and the Caribbean. From the individual to the collective, from biomedical sciences to social sciences and collective health, from risk groups to exclusive societies and the inequities constituting the colonial, patriarchal, modern capitalist heritage in the State and societies. The objective of this article is to review what are called the three intersections for Latin American critical health thinking. Seeking to analyze and reflect on the assumptions and logic present in the responses to the health emergency with reference to: 1. Critical health theory and its intersections with Latin American critical thinking; 2. The decolonial implications of problematizing the State and public health systems; and 3. The geopolitics of global health security as a roadmap for the global North. They outline approaches on the risks of capitalism's acceleration of the post-pandemic disaster and the alternative ways of addressing creative tensions in the reconstruction of emancipatory processes for regional health sovereignty and Health from the South.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Neumonía Viral/epidemiología , Salud Pública , Capitalismo , Región del Caribe/epidemiología , Composición Familiar , Salud Global , Disparidades en el Estado de Salud , Humanos , América Latina/epidemiología , Pandemias , Pensamiento
10.
Medwave ; 20(8)30-09-2020.
Artículo en Inglés, Español | LILACS | ID: biblio-1128191

RESUMEN

Introducción La enfermedad por coronavirus 2019 ha sido reportada en la población pediátrica; sin embargo, existe limitada información en países de América Latina y El Caribe. Objetivos Describir la frecuencia de casos, defunciones, incidencia acumulada y letalidad atribuida a COVID-19 en niños y adolescentes de países de América Latina y El Caribe. Métodos Se realizó un estudio observacional utilizando los registros de casos atribuidos a COVID-19 en niños y adolescentes publicados por los Ministerios de Salud de 16 países de América Latina y tres países de El Caribe hasta el 20 de mayo de 2020. Se clasificaron los casos y las defunciones por sexo y grupo de edad. Además, se calcularon la incidencia acumulada y letalidad por cada país. Resultados Se reportaron 20 757 casos de COVID-19 de 0 a 19 años (4,2% del total de enfermos). El 52,4% fue en el grupo de 10 a 19 años. El 50,6% fueron del sexo masculino. Se registraron 139 (0,26% del total) defunciones de 0 a 19 años. La incidencia acumulada fue mayor en Chile, Panamá y Perú. La incidencia acumulada por 100 000 habitantes varió de 1,26 a 77,55 en la población de 0 a 9 años, de 1,57 a 98,84 entre 10 a 19 años y de 0,91 a 88,34 entre 0 a 19 años. La letalidad de 0 a 19 años tuvo un rango de 0 a 9,09%. Conclusiones En 19 países de Latinoamérica y El Caribe, la frecuencia de casos, incidencia acumulada, letalidad en niños y adolescentes fue heterogénea. Estos resultados contribuyen a comprender el comportamiento epidemiológico de esta enfermedad en niños y adolescentes en los países incluidos en el estudio.


Introduction Coronavirus disease 2019 has been reported in the pediatric population; however, there is limited information in Latin American and the Caribbean countries. Objectives To describe the frequency of cases, deaths, incidence, and case fatality rate attributed to COVID-19 in children and adolescents from Latin American and the Caribbean countries. Methods An observational study was carried-out using COVID-19 case registries in children and adolescents published by the Ministries of Health of 19 countries in Latin American and the Caribbean countries until May 20, 2020. Cases and deaths were classified by sex and age group. Also, incidence and case fatality rates were calculated for each country. Results A total of 20,757 (4.2% of all patients) cases of COVID-19 were reported in children from 0 to 19 years of age. 52.4% was in the group aged 10 to 19 years. 50.6% were male. 139 (0.26%) deaths were reported in children from 0 to 19 years. The accumulated incidence was higher in Chile, Panama, and Peru. The cumulative incidence per 100,000 inhabitants ranged from 1.26 to 77.55 in the population from 0 to 9 years old, 1.57 to 98.84 from 10 to 19 years old, and 0.91 to 88.34 from 0 to 19 years old. The case fatality rate in children from 0 to 19 years old ranged from 0 to 9.09%. Conclusion In 19 Latin American and the Caribbean countries, the frequency of cases, cumulative incidence, case fatality rate in children and adolescents was heterogeneous. These results contribute to understanding the epidemiological behavior of this disease in children and adolescents of the countries included in the study.


Asunto(s)
Humanos , Recién Nacido , Lactante , Preescolar , Niño , Adolescente , Adulto Joven , Neumonía Viral/epidemiología , Infecciones por Coronavirus/epidemiología , Betacoronavirus , Neumonía Viral/mortalidad , Incidencia , Distribución por Sexo , Infecciones por Coronavirus/mortalidad , Región del Caribe/epidemiología , Distribución por Edad , Pandemias , América Latina/epidemiología
11.
Belmopan; Ministry of Health Belize; Aug. 31, 2020. 1 p. ilus, maps, graf.
Monografía en Inglés | MedCarib | ID: biblio-1121198

RESUMEN

Infographic update on sarscov 2 screenings done in Belize for August 31, 2020 depicting total persons screened, negative persons, positive cases and those under investigation.


Asunto(s)
Humanos , Masculino , Femenino , Belice/epidemiología , Coronavirus , Región del Caribe/epidemiología , Infecciones/epidemiología
16.
Rev. cuba. hematol. inmunol. hemoter ; 36(2): e1112, abr.-jun. 2020. tab
Artículo en Español | LILACS, CUMED | ID: biblio-1149891

RESUMEN

Introducción: La drepanocitosis es la anemia hemolítica congénita más frecuente y representa un problema de salud a nivel mundial. La enfermedad tuvo su origen en el África subsahariana, la cuenca del Mediterráneo y algunas regiones del Medio Oriente y la India. El comercio de esclavos entre 1650-1830 y la dinámica migratoria humana han afectado la distribución de la enfermedad. Objetivo: Describir la epidemiología y estado actual de la drepanocitosis en América Latina. Método: Se realizó una revisión de la literatura a través de los sitios web PubMed, SciElo y el motor de búsqueda Google Académico de artículos publicados en los últimos 10 años. Se utilizaron como términos de búsqueda: drepanocitosis, epidemiología, frecuencia, screening pre- y posnatal, Latinoamérica. Se hizo un análisis y resumen de la bibliografía revisada. Análisis y síntesis de la información: Las hemoglobinopatías, en particular la drepanocitosis, cobran cada vez mayor importancia a nivel global por su alta frecuencia. El diagnóstico temprano, el uso de penicilina profiláctica en los primeros años de la vida y un mejor conocimiento de los factores genéticos y no genéticos que influyen en la gravedad fenotípica son todavía limitados. Uno de los problemas más críticos en el control y manejo de la esta enfermedad es su extraordinaria variabilidad fenotípica. Conclusiones: Con una atención integral y tratamiento no muy costoso estos pacientes pueden alcanzar la edad adulta con una calidad de vida aceptable, pero desafortunadamente no son tratadas adecuadamente. Sería recomendable que cada país cuente con centros de atención primaria y especializados donde se puedan atender a los pacientes(AU)


Introduction: Sickle cell disease is the most common congenital hemolytic anemia and is a worldwide health concern. The disease originated in Sub-Saharan Africa, the Mediterranean basin, and some regions of the Middle East and India. Slave trade between 1650 and 1830 and human migratory dynamics have affected the distribution of the disease. Objective: To describe the epidemiology and current status of sickle cell disease in Latin America. Methods: A literature review was carried out through the PubMed and SciElo websites, as well as the Google Scholar search engine, of articles published in the last ten years. The search terms were drepanocitosis [sickle cell disease], epidemiología [epidemiology], frecuencia [frequency], screening prenatal y postnatal [pre- and post-natal screening], Latinoamérica [Latin America]. An analysis and summary of the revised bibliography was made. Information analysis and synthesis: Hemoglobinopathies, particularly sickle cell disease, are becoming increasingly important globally, due to their high frequency of appearance. Early diagnosis, the use of prophylactic penicillin in the first years of life, and better understanding of the genetic and non-genetic factors that influence phenotypic severity are still limited. One of the most critical problems in management and control of this disease is its extraordinary phenotypic variability. Conclusions: With comprehensive care and inexpensive treatment, these patients can reach adulthood with acceptable quality of life, but unfortunately they are not treated properly. It would be advisable for each country to have primary and specialized care centers where patients can be cared for(AU)


Asunto(s)
Humanos , Rasgo Drepanocítico/epidemiología , Región del Caribe/epidemiología , América Latina/epidemiología
17.
Washington; Organización Panamericana de la Salud; jun. 15, 2020. 26 p.
No convencional en Español | LILACS | ID: biblio-1099999

RESUMEN

La finalidad de este documento es brindar orientación a los países de América Latina y el Caribe a fin de mejorar la vigilancia de la mortalidad por COVID-19. En este documento se amplían los métodos deanálisis de la mortalidad por todas las causas como uno de los enfoques propuestos para contribuir a la evaluación de la magnitud real de la carga de la epidemia de COVID-19 en los países de América Latina y el Caribe. Este documento está dirigido a las autoridades nacionales de salud, incluidos los equipos de vigilancia epidemiológica y de emergencia de salud pública que participan en la respuesta a la epidemia de COVID-19, así como a otros profesionales o instituciones a cargo de la vigilancia (como los departamentos de epidemiología) y de seguimiento de la mortalidad (como los institutos nacionales de estadística).


Asunto(s)
Humanos , Neumonía Viral/prevención & control , Infecciones por Coronavirus/mortalidad , Infecciones por Coronavirus/prevención & control , Infecciones por Coronavirus/epidemiología , Pandemias/prevención & control , Vigilancia en Salud Pública/métodos , Betacoronavirus/patogenicidad , Estadísticas Vitales , Región del Caribe/epidemiología , Servicios Médicos de Urgencia/organización & administración , Monitoreo Epidemiológico , América Latina/epidemiología
18.
Recurso de Internet en Inglés, Español | LIS - Localizador de Información en Salud | ID: lis-47549

RESUMEN

El Reino Unido acordó contribuir con 3 millones de libras (unos 3,8 millones de dólares) a la Organización Panamericana de la Salud (OPS) para ayudar a ocho países del Caribe a contener la propagación de la pandemia por la nueva enfermedad por el coronavirus del 2019 (COVID-19) y mitigar su impacto. Los países beneficiarios son Antigua y Barbuda, Belice, Dominica, Granada, Guyana, Jamaica, Santa Lucía y San Vicente y las Granadinas.


Asunto(s)
Infecciones por Coronavirus , Región del Caribe/epidemiología , Betacoronavirus
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