Final Statement. Advisory Meeting: Integrating and strengthening responses to mpox, syphilis, and other STIs on the road to elimination. São Paulo, 3–4 April 2024

Despite country-level initiatives and efforts, syphilis and other sexually transmitted infections (STIs) continue to pose a serious public health problem in the Americas. Although there are many activities aimed at eliminating vertical transmission of syphilis, adult syphilis infection rates have risen in many countries. This rise has been recorded in several population groups, as shown by data from different countries, but mainly in pregnant women. In addition to syphilis, other STIs such as gonorrhea—as well as antimicrobial resistance to treatment—pose challenges to the sustainability of the public health response and the elimination of STIs. An estimated 11 million new cases of STIs occur every year in the Americas, and many countries have only limited resources for etiological diagnosis and surveillance of treatment resistance. The purpose of the meeting was to assess the situation and formulate consensus recommendations for innovative, effective, and integrated strategic lines of action for the response to syphilis and other STIs and the elimination of mpox in Latin America and the Caribbean, based on WHO guidance.

Declaración Final. Reunión consultiva Integración y fortalecimiento de las respuestas a mpox, sífilis y otras ITS en el camino hacia la eliminación. San Pablo, 3 y 4 abril de 2024

Esta es un documento de reporte de la reunión cocnsultiva de expertos en torno a la emergencia del mpox y la creciente tendencia del número de casos de sifilis y resistencia a la gonorrea en la región. En ese marco los y las participantes de la reunión consultiva hacen un llamado a los gobiernos, y todos los actores de la salud pública, incluyendo profesionales de la salud, académicos, sociedades científicas, sociedad civil, comunidades y socios de la cooperación internacional en las Américas sobre la urgencia de actuar en la respuesta de salud pública en los siguientes temas integración del abordaje de la mpox en ITS, asi como la integración de las ITS con otros temas de salud , es fundamnetal renovar el compromiso politico para el abordaje de la sifilis , mpox y otras ITS.

Initiative d’élimination du trachome dans la Région des Amériques. Première année de mise en œuvre : rapport annuel 2023-2024

Le rapport annuel 2023-2024 de l'Initiative pour l'Élimination du Trachome dans les Amériques présente les principaux progrès réalisés par les pays participants. Dans la région, le trachome reste endémique au Brésil, en Colombie, au Guatemala et au Pérou, touchant environ 5,6 millions de personnes, en particulier dans les zones rurales et éloignées, avec un impact disproportionné sur les femmes et les enfants. Parmi les résultats les plus significatifs, les pays endémiques ont progressé dans la mise en œuvre de la Stratégie SAFE (Chirurgie, Antibiotiques, Hygiène Faciale et Assainissement Environnemental). Les campagnes chirurgicales pour le traitement de la trichiasis trachomateuse ont été particulièrement mises en avant. Au Mexique, deux campagnes chirurgicales ont été menées au Chiapas, tandis qu'au Guatemala et dans d'autres pays, le personnel de santé a été formé aux techniques chirurgicales recommandées pour le trachome.Dans le cadre de la surveillance, la Bolivie, l'Équateur et El Salvador ont complété leurs protocoles d'évaluation rapide du trachome. Au Brésil, une enquête de prévalence du trachome à l'échelle de la population a été réalisée, incluant l'évaluation de plus de 3 000 individus. Ces activités de surveillance ont été soutenues par des formations pour la reconnaissance de la maladie, permettant de déterminer la présence du trachome dans diverses zones. Des actions axées sur la diversité culturelle et de genre ont été promues au Guatemala et en Bolivie, avec des formations orientées vers des dialogues interculturels afin d'augmenter l'acceptation des interventions. Le composant WASH (eau, assainissement et hygiène) a été fondamental, mettant l'accent sur l'éducation communautaire et le développement de matériaux adaptés pour améliorer les pratiques d'hygiène. Enfin, le rapport souligne les efforts de communication et de visibilité, qui incluent la réalisation d'ateliers de communication avec un focus sur le genre et l'interculturalité, la production de matériel promotionnel et la création d'un plan de communication intégrant les actions à mettre en œuvre au niveau national et régional. Un engagement envers une communication efficace est essentiel pour sensibiliser les communautés et promouvoir des changements de comportement en faveur de l'élimination du trachome. Ce rapport est le reflet du travail continu et de la collaboration entre les pays de la région, les organisations non gouvernementales et la société civile pour relever le défi du trachome. Ensemble, nous continuons à progresser vers l'élimination de cette maladie, en promouvant la santé, la dignité et l'égalité pour tous.

Initiative for the elimination of trachoma in the Americas: First year of implementation. Annual report 2023-2024

The Annual Report 2023-2024 of the Initiative for the Elimination of Trachoma in the Americas presents the key advances made by participating countries. In the region, trachoma remains endemic in Brazil, Colombia, Guatemala, and Peru, affecting approximately 5.6 million people, especially in rural and remote areas, with a disproportionate impact on women and children. Among the most significant outcomes, endemic countries have made progress in implementing the SAFE Strategy (Surgery, Antibiotics, Facial Hygiene, and Environmental Sanitation). Notably, surgical campaigns for the treatment of trachomatous trichiasis have been highlighted. In Mexico, two surgical campaigns were conducted in Chiapas, while in Guatemala and other countries, health personnel were trained in the recommended surgical techniques for trachoma. In the surveillance component, Bolivia, Ecuador, and El Salvador completed their rapid assessment protocols for trachoma. In Brazil, a population-based prevalence survey for trachoma was conducted, which included the assessment of over 3,000 individuals. These surveillance activities were supported by training for disease recognition, allowing for the determination of trachoma presence in various areas. Actions with a focus on cultural diversity and gender were promoted in Guatemala and Bolivia, including training sessions aimed at intercultural dialogues to increase acceptance of interventions. The WASH (Water, Sanitation, and Hygiene) component was fundamental, emphasizing community education and the development of tailored materials to improve hygiene practices. Finally, the report highlights efforts in communication and visibility, which include the implementation of workshops on communication with a gender and intercultural focus, the production of promotional materials, and the creation of a communication plan that integrates actions to be implemented at the country and regional levels. A commitment to effective communication is essential for raising community awareness and promoting behavioral changes that favor the elimination of trachoma. This report reflects the ongoing work and collaboration among countries in the region, non-governmental organizations, and civil society to address the challenge of trachoma. Together, we continue to make strides toward eliminating this disease, promoting health, dignity, and equality for all.

Relatório Anual 2023-2024 da Iniciativa para a Eliminação do Tracoma nas Américas

O relatório anual 2023-2024 da Iniciativa para a Eliminação do Trachoma nas Américas apresenta os principais avanços dos países participantes. Na região, o trachoma permanece endêmico em Brasil, Colômbia, Guatemala e Peru, afetando cerca de 5,6 milhões de pessoas, especialmente em áreas rurais e remotas, e tendo um impacto desproporcional em mulheres e crianças. Dentre os resultados mais significativos, os países endêmicos avançaram na implementação da Estratégia SAFE (cirurgia, antibióticos, higiene facial e saneamento ambiental). Destacam-se as jornadas cirúrgicas para o tratamento da triquíase tracomatosa. No México, foram realizadas duas jornadas cirúrgicas em Chiapas, enquanto que em Guatemala e outros países, o pessoal de saúde foi capacitado nas técnicas cirúrgicas recomendadas para o trachoma. No componente de vigilância, Bolívia, Equador e El Salvador concluíram seus protocolos de avaliações rápidas de trachoma. No Brasil, foi realizada uma pesquisa de prevalência de trachoma em base populacional, que incluiu a avaliação de mais de 3.000 pessoas. Essas atividades de vigilância foram apoiadas por capacitações para o reconhecimento da doença, permitindo determinar a presença do trachoma em diversas áreas. Ações com enfoque em diversidade cultural e de gênero foram promovidas em Guatemala e Bolívia, incluindo capacitações voltadas para diálogos interculturais, a fim de aumentar a aceitação das intervenções. O componente WASH (água, saneamento e higiene) foi fundamental, com ênfase na educação comunitária e no desenvolvimento de materiais adaptados para melhorar as práticas de higiene. Por fim, o relatório destaca os esforços de comunicação e visibilidade, que incluem a realização de oficinas de comunicação com enfoque de gênero e interculturalidade, a produção de materiais promocionais e a criação de um plano de comunicação, que integra as ações a serem implementadas nos países e em nível regional. O compromisso com a comunicação eficaz é essencial para sensibilizar as comunidades e promover mudanças comportamentais que favoreçam a eliminação do trachoma. Esse relatório é um reflexo do trabalho contínuo e da colaboração entre os países da região, organizações não governamentais e a sociedade civil para enfrentar o desafio do trachoma. Juntos, continuamos a avançar em direção à eliminação dessa doença, promovendo saúde, dignidade e igualdade para todos.

Colaboração entre o setor de WASH e o setor da saúde: guia prático para programas de doenças tropicais negligenciadas. Segunda edição

A Segunda edição do manual “Colaboração entre o setor de WASH e o setor da saúde: guia prático para programas de doenças tropicais negligenciadas” elaborado pela Organização Mundial de Saúde (OMS) em parceria com o grupo de trabalho em Água, Saneamento e Higiene da Neglected Tropical Disease NGO Network (NNN), é uma revisão da primeira edição lançada em 2019. Essa revisão tem como base a implementação das ferramentas e recursos do manual em diversos países desde o ano de seu lançamento. O objetivo do manual é auxiliar gerentes de programas contra as DTNs, e parceiros, na construção de parcerias multissetoriais bem-sucedidas entre os setores de água, saneamento e higiene (WASH, por sua sigla em inglês) e doenças tropicais negligenciadas (DTN), na mobilização de recursos, e na elaboração, implementação e avaliação das intervenções. Com base em ferramentas e práticas que podem ser utilizadas em programas, coordenados e integrados, de controle e eliminação de DTNs, o manual poderá auxiliar na construção de parcerias multissetoriais; no desenvolvimento de programas inteligentes com foco na prestação de contas e em metas compartilhadas; na construção de uma abordagem adaptável e flexível; na garantia da sustentabilidade das ações apoiando a capacidade local, em todos os níveis; e no apoio e complementaridade de intervenções clínicas e de saúde pública para o controle, eliminação e erradicação das DTNs. O kit de ferramentas foi desenvolvido com base em programas e experiências práticas e pode ser adaptado as diferentes necessidades e contextos.

Neglected Infectious Diseases Safety Program — delivering community benefits while minimizing harm: Experiences and lessons learned from the Americas

Neglected infectious diseases (NIDs) affect more than 1 billion people globally, causing serious long-term health effects on the most vulnerable populations. In 2020 the World Health Assembly endorsed a global road map 2021–2030 for tackling neglected tropical diseases that sets targets and milestones as well as cross-cutting targets aligned with the Sustainable Development Goals. To treat infected persons and reduce disease transmission, the World Health Organization (WHO) advocates for a rapid impact intervention: preventive chemotherapy (PC). PC is the administration of safe and effective treatment to a defined population at regular time intervals, regardless of infection status. In the Americas, more than 100 million people suffer from one or more NIDs. Of the people at risk of NIDs in Latin America and the Caribbean, many are receiving safe and effective treatment through mass administration of medications for five diseases: lymphatic filariasis, onchocerciasis, blinding trachoma, soil-transmitted helminthiasis (STH), and schistosomiasis. These medications are donated, while others are procured through the Strategic Fund of the Pan American Health Organization (PAHO) or through the Global Fund to Fight AIDS, Tuberculosis and Malaria. Safety should be assured at every step of the process, from the manufacture of the drugs and assuring their quality and regulatory standards, to shipment and management of drugs in the supply chain, to their administration in the community. A critical condition to success when implementing PC is to “do no harm” while delivering the health services, which relies largely on careful planning, communication, training, monitoring and prompt investigation of serious adverse events (SAEs), and supervision at all levels. In 2021 WHO updated the guidelines and developed training modules for community drug distributors, health workers, and other front-line workers and partners. The modules address key aspects of drug safety, which include management, storage, and packaging of medicines; safe administration of medicines to ensure safety and prevent choking; identification, management, and reporting of adverse events (AEs); and effective communication with communities and health staff. The Fred Hollows Foundation and IZUMI Foundation funded PAHO to implement a two-year project to strengthen safety in administration of medications to eliminate NIDs in the countries of the Americas. Planning and tailoring the educational materials to train different audiences were conducted as a joint effort with the participation of partners from RTI international, Task Force for Global Health, and The Fred Hollows Foundation. This report describes the experience and lessons learned for strengthening regional and national capacities to plan, prepare, and monitor the safe administration of medicines for treatment of NIDs in the endemic countries of the Americas.

Regional workshop on the safety of preventive chemotherapy for the elimination of neglected infectious diseases in the Region of the Americas. 1–3 June and 30 June 2022. Workshop report

The "Regional workshop on the safety of preventive chemotherapy for the elimination of neglected infectious diseases in the the Region of the Americas " was a significant event organized by the Pan American Health Organization (PAHO) to enhance the safety of neglected infectious disease (NID) programs that use preventive chemotherapy (PC). Despite the generally safe administration of PC, the workshop addressed several areas needing improvement, including the reporting and investigation of serious adverse events (SAEs), coordination between NID programs and national pharmacovigilance agencies, safety training for community drug distributors, and crisis communication, especially concerning SAEs and rumors. Supported by the IZUMI Foundation and the Fred Hollows Foundation, the workshop aimed to provide additional guidance and support to national NID programs in the Americas. Participants from Colombia, the Dominican Republic, Guyana, Honduras, Nicaragua, and Paraguay, along with facilitators from PAHO and observers from various NGOs, focused on key issues in NID safety. The workshop was structured into two parts: the first three days concentrated on sharing experiences, successes, and challenges in NID safety across different countries. After a brief hiatus, participants reconvened to present their analyses and propose steps to address identified challenges. Innovative approaches in this workshop, such as the use of pre-workshop questionnaires, facilitated breakout groups, and the separation of the main workshop from the "country report" session, proved effective in identifying gaps and developing strategies to strengthen NID safety. The workshop's recommendations include incorporating these innovations into future regional and national NID safety workshops, using the pre-workshop survey as a baseline safety assessment tool, and creating an online repository of safety resources for national NID programs. The workshop underscored the importance of safety in NID programs and the need for ongoing improvements in training, supervision, and practice at all levels. By integrating these safety measures more deeply into national health systems, the workshop participants took important steps toward ensuring the safe and effective elimination of NIDs in the Americas.

Guidance for the Elimination of Syphilis and Congenital Syphilis in the Americas

The countries of the Americas have made a commitment to eliminate syphilis and congenital syphilis as a public health problem by 2030. This goal translates into reducing the incidence of congenital syphilis to less than 0.5 cases per 1000 live births and a 90 percent reduction in the number of syphilis cases (as compared to 2018). However, incident cases of syphilis are increasing in the Americas. This trend has accelerated in recent years and is reflected in higher prevalence of syphilis in pregnant women and, consequently, an increase on the rate of congenital syphilis that is far from the target set for 2030. Besides of reaching the impact target, elimination of congenital syphilis requires meeting the following programmatic targets: 95 percent of pregnant women receive prenatal care; 95 percent of pregnant women are tested for syphilis; and 95 percent of pregnant women with syphilis receive appropriate treatment. However, in settings with a high prevalence of syphilis, meeting these programmatic targets may not guarantee the elimination of congenital syphilis. Therefore, in addition to actions framed around quality antenatal care, implementing a syphilis response aimed at reducing the prevalence of the disease in pregnant women and their partners may help reduce the incidence of congenital syphilis. This technical note consolidates World Health Organization (WHO) recommendations for the prevention and control of syphilis and congenital syphilis. It shares best practices from different countries in the Americas to implement these recommendations. It also provides WHO recommendations for surveillance and monitoring of syphilis and congenital syphilis. Finally, it details the supplies for the diagnosis and treatment of the disease, available through the Strategic Fund of the Pan American Health Organization.

Iniciativa para la eliminación del tracoma en las Américas. Primer año de implementación: informe anual 2023-2024

El informe anual 2023-2024 de la Iniciativa para la Eliminación del Tracoma en las Américas presenta los avances más importantes en los países participantes. En la región, el tracoma sigue siendo endémico en Brasil, Colombia, Guatemala y Perú, donde afecta a unos 5,6 millones de personas, especialmente en zonas rurales y remotas, y tiene un impacto desproporcionado en mujeres y niños. Entre los principales resultados, los países endémicos han avanzado en la implementación de la Estrategia SAFE (cirugía, antibióticos, higiene facial y saneamiento ambiental, por su sigla en inglés), en cuyo caso se destacan las jornadas quirúrgicas para tratar la triquiasis tracomatosa. En México, se realizaron dos jornadas de cirugía en Chiapas, mientras que en Guatemala y otros países se capacitó al personal de salud en técnicas quirúrgicas recomendadas para tracoma. En el componente de vigilancia, Bolivia, Ecuador y El Salvador completaron sus protocolos de evaluaciones rápidas de tracoma, y en Brasil se realizó una encuesta de prevalencia de tracoma de base poblacional, que incluyó la evaluación de más de 3000 personas. Estas actividades de vigilancia se apoyaron en capacitaciones para el reconocimiento de la enfermedad, lo que permitió determinar la presencia del tracoma en diferentes áreas. Se promovieron acciones con enfoque de diversidad cultural y de género en Guatemala y Bolivia, con capacitaciones orientadas a diálogos interculturales para aumentar la aceptación de las intervenciones. El componente WASH (agua, saneamiento e higiene) fue fundamental, con un enfoque en la educación comunitaria y el desarrollo de materiales adaptados para mejorar las prácticas de higiene. Finalmente, el informe destaca los esfuerzos de comunicación y visibilidad, lo cual abarca la realización de talleres de comunicación con enfoque de género e interculturalidad, la producción de materiales promocionales y la creación de un plan de comunicaciones, que integra las acciones que se implementarán en los países y a nivel regional.

Orientaciones para la eliminación de la sífilis y la sífilis congénita en las Américas

Los países de las Américas han adoptado el compromiso de eliminar la sífilis congénita como problema de salud pública para el 2030. Esta meta se traduce en reducir la incidencia de sífilis congénita a menos de 0,5 casos por 1000 nacidos vivos. Además de alcanzar la meta de impacto, la eliminación de la sífilis congénita pasa por cumplir con las siguientes metas programáticas: que el 95% de las embarazadas reciba atención prenatal; que, de estas, el 95% se someta a una prueba de sífilis, y que el 95% de las embarazadas y con sífilis reciba tratamiento adecuado. Sin embargo, en entornos con alta prevalencia de sífilis, cumplir estas metas programáticas puede no garantizar la eliminación de la sífilis congénita. Por ello, además de las acciones enmarcadas en una atención prenatal de calidad, implementar una respuesta a la sífilis dirigida a reducir la prevalencia de la enfermedad en las embarazadas y sus parejas puede ayudar a disminuir la incidencia de la sífilis congénita. La presente nota técnica recoge, de forma consolidada, las recomendaciones de la Organización Mundial de la Salud (OMS) para la prevención y el control de la sífilis y la sífilis congénita. En ella se comparten diversas buenas prácticas de distintos países de las Américas, a fin de implementar dichas recomendaciones. Además, se facilitan las recomendaciones de la OMS para la vigilancia y el monitoreo de la sífilis y la sífilis congénita. Por último, se detallan los insumos para el diagnóstico y el tratamiento de la enfermedad, disponibles a través del Fondo Estratégico de la Organización Panamericana de la Salud.

Interim guidance on entomological surveillance and prevention measures for oropouche virus vectors

The document presents an update on the epidemiological situation of the Oropouche virus in the Region of the Americas and highlights aspects related to its vectors. Among the main aspects, the bionomics and life cycle of the vectors, surveillance and control methods, and entomological studies are discussed during the investigation of an outbreak. It also provides information on the preservation, storage, and processing of the collected entomological material.

Elimination Initiative Committed to eliminating 30+ communicable diseases in the Americas by 2030

The Pan American Health Organization´s initiative to eliminate communicable diseases, known as the Elimination Initiative (EI), aims to eradicate more than 30 communicable diseases and related conditions across the Americas by 2030. The EI spans a wide range of diseases including vaccine preventable, neglected infectious, vector-borne, sexually transmitted, mother-to-child transmitted, and zoonotic diseases, as well as tuberculosis, cervical cancer, and environmental risk factors (open defecation and polluting fuels in the household). The purpose of the EI is not just to eliminate and sustain the elimination targets, but to save and improve the quality of people’s lives through guaranteeing equitable access to integrated health services, addressing mechanisms of vulnerability and social and environmental determinants of health, and empowering communities.

Orientações provisórias de vigilância entomológica e medidas de prevenção contra vetores do vírus Oropouche

O documento apresenta uma atualização da situação epidemiológica do Oropuche na Região das Américas e destaca aspectos relacionados aos seus vetores transmissores. Entre os principais aspectos, a bionomia e o ciclo de vida dos vetores, os métodos de vigilância e captura e os estudos entomológicos são discutidos durante a investigação de um surto. Além disso, apresenta informações sobre a conservação, acondicionamento e processamento do material entomológico coletado.

Striving toward health equity in the Americas

The Americas is the region where the largest socioeconomical disparities are found, as well as health inequities between countries and within countries among minority and excluded population groups. These health inequities are refl ected in diff erences in life expectancy; health at the start of life and over the life course; burden of infectious as well as noncommunicable diseases; health behaviors such as smoking, alcohol and drug use; and accidents, violence, and confl ict. Low-income groups, informal workers, lower educational level population, indigenous peoples, people of African descent, and other groups in situations of vulnerability in the Americas are at an enormous disadvantage and face considerable health inequities, reflected in higher rates of both communicable and noncommunicable diseases and maternal and infant mortality. PAHO has committed to work toward reducing health inequities, refl ected in its Policy on Ethnicity and Health, the Strategy and Plan of Action on Health Promotion within the context of the Sustainable Development Goals 2019–2030, and the Policy for Recovering Progress toward the Sustainable Development Goals with Equity through Action on the Social Determinants of Health and Intersectoral Work.

Tratamiento de las enfermedades infecciosas 2024-2026. Novena edición

Esta guía de Tratamiento de las enfermedades infecciosas 2024-2026 es una referencia útil para guiar la prescripción de antimicrobianos en medicina familiar y comunitaria, así como para orientar a especialistas en formación. La publicación contiene recomendaciones sobre el tratamiento más apropiado de las enfermedades infecciosas, considerando la epidemiología de los microorganismos causales y los patrones de sensibilidad en los países de América Latina y el Caribe, a la vez que se busca contribuir a la contención de la resistencia que surge del uso excesivo o incorrecto de fármacos antimicrobianos. Para la presente edición, se hizo una revisión exhaustiva del tratamiento de la sepsis y el síndrome de sepsis, con hincapié en su detección y tratamiento tempranos para reducir la morbilidad y mortalidad por sepsis. También se han incorporado principios del sistema AWaRe (Acceso, Precaución y Reserva) de la Organización Mundial de la Salud, que proporciona orientación concisa, con base en información comprobada, sobre el tratamiento de las 30 infecciones más comunes de niños y adultos.

Technical note on accelerating P. falciparum elimination in the Americas

All malaria-endemic countries in the Region of the Americas have taken on the challenge of eliminating malaria and have focused their health programs and strategies on that goal. The risk of emergence of artemisinin resistance in the Americas, the characteristics of P. falciparum parasite, and the epidemiological evidence of subnational territories experiencing reintroduction of P. falciparum urge for a call to push for P. falciparum elimination as an intermediate goal of the elimination of all malaria human species. Derived from the elimination of P. falciparum, other important results are expected, such as the empowerment of different actors and entities for the elimination of malaria inspired by the achievements of the elimination of P. falciparum, using early victories as a catalyst. This technical note provides guidance on actions to accelerate P. falciparum elimination in areas close to achieving this goal without compromising unified malaria elimination efforts (P. vivax - P. falciparum), while contributing to the country's ultimate goal of eliminating malaria overall. The acceleration of P. falciparum elimination has several goals: mitigating the risk that resistance to artemisinin and associated drugs will emerge and spread; accelerating the reduction in the total number of malaria cases in areas with a significant proportion of P. falciparum; accelerating malaria elimination (both P. vivax and P. falciparum), considering that P. falciparum is one of the triggers of P. vivax relapses; developing capacities in interventions to accelerate malaria elimination by building on the experience of P. falciparum elimination; and empowering different actors, including high-level authorities, donors, municipalities, and other entities involved in malaria elimination, by inspiring them with the achievements of P. falciparum elimination.

The Burden and Risk Factors Associated with Infectious Diseases among Refugees in a Camp for Migrants in Porto Alegre: A Cross-Sectional Survey.

Refugees usually face a disproportionate burden of infectious diseases. Recently, Brazil has experienced an influx of refugees which demands the need for scaling up public health efforts to address the challenges. The research sought to study the burden and risk factors associated with infectious diseases among refugees received in the city of Porto Alegre. This was a cross-sectional study of 261 newly arrived refugees. The study sample was predominantly composed of Venezuelans (50.6%) and Haitians (44%), male (146: 56.7%), single (30.7%), with an average age of 33.38 (± 7.30) years. The average schooling was 10.42 (± 2.09) years. Diseases with the highest prevalence were influenza, whooping cough, diphtheria, and tuberculosis. There was significant association between the country of origin and presence of symptoms for infectious and contagious diseases, which warrants targeted interventions for reducing the incidence of these diseases among refugees in Brazil.

Alcohol use disorder in people with infectious and chronic diseases and mental disorders: Brazil, 2015. / Transtornos relacionados ao uso de álcool entre pessoas com doenças infecciosas, crônicas e mentais: Brasil, 2015.

The study aimed to estimate the prevalence of alcohol use disorder (AUD) and associated factors in Brazilian adults that reported chronic noncommunicable diseases (NCDs), mental disorders (MDs), and infectious diseases (IDs). This was a secondary analysis of the 3rd National Survey on Drug Use by the Brazilian Population in which the principal outcome was presence of AUD. Prevalence of AUD was estimated for three subgroups: individuals that reported NCDs, MDs, and IDs. Factors associated with AUD in each group were analyzed using logistic regression models. Of the 15,645 adults interviewed, 30.5% (95%CI: 29.4-31.5) reported NCDs, 17.6% (95%CI: 16.5-18.7) MDs, and 1.6% (95%CI: 1.2-1.9) IDs. Considering comorbidities, the analytical sample was 6,612. No statistically significant difference was found in the prevalence of AUD between individuals with NCDs (7.5% [95%CI: 6.1- 8.7]), MDs (8.4% [95%CI: 6.7-10.2]), and IDs (12.4% [95%CI: 7.0-17.8]). The main factors associated with AUD in all the groups were male sex and young adult age. Considering the high prevalence of AUD in all the groups, systematic screening of AUD is necessary in health services that treat NCDs, MDs, and IDs.

O objetivo do artigo é estimar a prevalência de transtornos relacionados ao uso de álcool (TRA) e fatores associados entre indivíduos da população brasileira que reportaram doenças crônicas não-transmissíveis (DCNT), transtornos mentais (TM) e doenças infeciosas (DI). Análise secundária do III Levantamento Nacional sobre o Uso de Drogas pela População Brasileira, cujo desfecho principal foi a presença de TRA. A prevalência de TRA foi estimada para três subgrupos: indivíduos que reportaram DCNT, TM e DI. Os fatores associados a TRA dentro de cada grupo foram analisados utilizando modelos de regressão logística. Dos 15.645 adultos entrevistados, 30,5% (IC95%: 29,4-31,5) reportaram DCNT, 17,6% (IC95%: 16,5-18,7) TM e 1,6% (IC95%: 1,2-1,9) DI. Considerando as comorbidades, a amostra analítica foi de 6.612. Não foi encontrada diferença estatisticamente significativa na prevalência de TRA entre indivíduos com DCNT (7,5% [IC95% 6,1-8,7]), TM (8,4% [IC95% 6,7-10,2]) e DI (12,4% [IC95% 7,0-17,8]). Os principais fatores associados a TRA, em todos os grupos, foram ser do sexo masculino e jovem. Considerando a alta prevalência de TRA em todos os grupos é necessário seu rastreio sistemático em serviços de saúde que atendam DCNT, TM e DI.

Cálculo de un indicador estandarizado de la proporción de los impuestos en los precios de las bebidas azucaradas y de otros indicadores relativos a los precios y las políticas tributarias en América Latina y el Caribe: Nota metodológica

En el Plan de acción mundial para la prevención y el control de las enfermedades no transmisibles 2013-2020, de la Organización Mundial de la Salud (OMS), se reconoce la importancia fundamental de reducir el grado de exposición de las personas y los grupos poblacionales a los factores de riesgo comunes de las enfermedades no transmisibles (ENT), entre ellos, la alimentación poco saludable. En el plan de acción se recomienda concretamente aplicar impuestos a bebidas azucaradas como una política regulatoria costo‑eficaz para prevenir las ENT. El consumo de bebidas azucaradas se vincula con el aumento de peso en la población infantil y adulta, y con una mayor incidencia de la diabetes de tipo 2, las enfermedades cardiovasculares, las caries dentales y la osteoporosis. Los impuestos sobre las bebidas azucaradas se aplican con cada vez mayor frecuencia en América Latina y el Caribe, y ofrecen un beneficio triple para los gobiernos porque 1) mejoran la salud de la población, 2) generan ingresos y 3) pueden reducir los costos conexos de la atención de salud y las pérdidas de productividad a largo plazo. Si bien la OMS da seguimiento a los impuestos y precios del tabaco mediante indicadores cuantitativos estandarizados, entre ellos un indicador para comparar la proporción de los impuestos sobre el tabaco entre todos los Estados Miembros a lo largo del tiempo, desde el 2008 no se dispone de información sobre la tributación de las bebidas azucaradas comparable entre los países a lo largo del tiempo. Dicho seguimiento es importante para analizar tendencias, realizar comparaciones estandarizadas entre los países, establecer las mejores prácticas y disponer de una herramienta poderosa para la promoción de la causa. La Organización Panamericana de la Salud (OPS) se compromete a proporcionar a sus Estados Miembros información precisa, pertinente y comparable a nivel internacional que se pueda utilizar para orientar la elaboración de políticas y evaluar el impacto de las medidas para prevenir el sobrepeso y la obesidad. En esta nota se describe la metodología desarrollada por la OPS para estimar un indicador estandarizado de la proporción que representan los impuestos en los precios de ciertas bebidas no alcohólicas y otros indicadores relativos a los precios y las políticas tributarias, con base en el método utilizado por la OMS para dar seguimiento a los precios e impuestos aplicados a los productos de tabaco desde el 2008. En la nota se define el alcance y las bebidas para los cuales se calcula la proporción que los impuestos representan en los precios minoristas finales; se describe el proceso de recopilación y análisis de los datos; y se explican los componentes clave del cálculo. También se definen otros indicadores relativos a los precios, la asequibilidad y las políticas tributarias.