ABSTRACT
In 2022, the program on Applying the Human Security Approach to Advance an integrated response to Health and Migration in the Northern Triangle of Central America and Mexico was jointly launched by the Pan American Health Organization/World Health Organization (PAHO/WHO) and the International Organization for Migration (IOM). The program grant was sponsored by the United Nations Trust Fund for Human Security (UNTFHS). Among its main goals was the intention of raising awareness of the human security approach and how it can be used as a successful operational tool to advance universal access to health and universal health coverage, as well as the Sustainable Development Goals (SDGs), by contextualizing the added value of human security to health and migration in the four countries in which it was implemented: El Salvador, Guatemala, Honduras, and Mexico. Sustainability and replicability of the program were specifically integrated in the program’s design to promote continuity and scale-up of the activities, ensuring that knowledge obtained on the ground be disseminated and used to mainstream the human security approach throughout the region and beyond. This guide is part of those activities to facilitate the process of further replicating the program and its outcomes, taking into consideration lessons learned through its implementation also this publication is crucial in promoting the human security approach as an operational tool in health and migration, demonstrating its effectiveness in improving universal health access and advancing the SDGs. It also provides a practical guide for replicating the program in other regions, ensuring the sustainability and expansion of its benefits.
Subject(s)
Health Systems , Health System Resilience , Human Migration , Public Policy , Universal Health Coverage , Universal Access to Health Care Services , El Salvador , Guatemala , Honduras , MexicoABSTRACT
This study sought to analyze an explanatory model on the relationship among sociodemographic factors, health-promoting lifestyle behaviors and psychological distress (depression, anxiety and stress) in college students. This is an observational, analytical and cross-sectional study conducted on a national sample of 4203 students who entered a macro university in Honduras in 2021, 2022 and 2023. We used a sociodemographic survey, the Health-Promoting Lifestyle Profile (HPLP-II) and the Depression, Anxiety and Stress Scales (DASS-21). Univariate analysis and a multivariate structural equation model were conducted. The average HPLP-II score was 117.45 (±â 23.41), and the average DASS-21 score was 20.06 (±â 14.16). The multivariate model showed a good data fit (comparative fit indexâ =â 0.951; Tucker-Lewis indexâ =â 0.957; root mean square error of approximationâ =â 0.067 [90% CIâ =â 0.067-0.068]). Results indicate that being a woman (ßâ =â 0.11; pâ <â 0.001) and being enrolled in biological and health sciences (ßâ =â 0.09; pâ <â 0.001) significantly predict HPLP-II scores. Furthermore, being a woman (ßâ =â 0.17; pâ <â 0.001), age (ßâ =â 0.10; pâ <â 0.001) and having pre-existing medical conditions (ßâ =â 0.16; pâ <â 0.001) significantly explain part of the variance of DASS-21. A significant reverse relationship between health-promoting behavior and psychological distress was shown (râ =â -0.36; pâ <â 0.001). This study identifies protective and risky sociodemographic factors linked to health-promoting lifestyle behaviors and psychological distress. Our findings have implications for developing comprehensive intervention policies and strategies to promote health in higher education settings.
Subject(s)
Healthy Lifestyle , Students , Humans , Female , Male , Cross-Sectional Studies , Students/psychology , Students/statistics & numerical data , Universities , Young Adult , Honduras , Psychological Distress , Adult , Stress, Psychological/psychology , Stress, Psychological/epidemiology , Depression/epidemiology , Depression/psychology , Sociodemographic Factors , Latent Class Analysis , Adolescent , Surveys and Questionnaires , Life Style , Health Promotion , Anxiety/epidemiology , Anxiety/psychologyABSTRACT
INTRODUCTION: Diarrheal diseases constitute a significant public health problem in terms of mortality and morbidity. In Honduras and around the world, RVs have consistently emerged as the single most important etiologic agent in acute childhood diarrhea. However, other viruses, such as NoVs and HAstVs, have also been shown to be responsible for viral gastroenteritis. Unfortunately, the country has limited information concerning the etiologic role of these viral agents in acute gastroenteritis. This study investigated the frequency, genotypes, and epidemiological characteristics of RV-A, NoVs, and HAstVs among children under 5 years old in Distrito Central, Honduras. METHODS: Stool samples and their corresponding epidemiological data were collected from children with acute gastroenteritis in three healthcare centers in Distrito Central. All samples were screened by immunoassays for RV-A and HAstVs. RV-A-positive samples were molecularly characterized by RT-PCR and genotyping assays. RT-PCR was also applied to confirm HAstVs positivity and to detect NoVs, followed by nucleotide sequencing to assign their genotypes. RESULTS: Our results show that at least one viral agent was detected in 31% of the children. The frequency of RV-A, NoVs, and HAstVs was 14%, 13%, and 5%, respectively. The most frequent RV-A genotype was G2P[4], occurring in 93% of cases. 92.3% of NoVs-positive samples belonged to genogroup II, with GII.4 and GII.16 being the most common. HAstVs were clustered into three genotypes: HAstV-1, HAstV-2, and HAstV-8. Only one sample showed coinfection with NoVs and HAstVs. CONCLUSION: This comprehensive molecular and epidemiological characterization of enteric viruses demonstrates the vast diversity of these agents and describes for the first time NoVs and HAstVs as causative agents of acute childhood gastroenteritis in Distrito Central, Honduras. This suggests that further in-depth studies of the pediatric population are necessary to develop and implement effective preventive and control measures in the country.
Subject(s)
Feces , Gastroenteritis , Genotype , Humans , Honduras/epidemiology , Gastroenteritis/virology , Gastroenteritis/epidemiology , Child, Preschool , Infant , Feces/virology , Male , Female , Diarrhea/virology , Diarrhea/epidemiology , Phylogeny , Rotavirus/genetics , Rotavirus/isolation & purification , Rotavirus/classification , RNA, Viral/genetics , Norovirus/genetics , Norovirus/classification , Norovirus/isolation & purification , Caliciviridae Infections/epidemiology , Caliciviridae Infections/virology , Acute Disease/epidemiology , Infant, Newborn , Enterovirus Infections/virology , Enterovirus Infections/epidemiologyABSTRACT
INTRODUCTION: It is estimated that up to 28% of global disease burden is surgical with hernias representing a unique challenge as the only definitive treatment is surgery. Surgical Outreach for the Americas (SOfA) is a nongovernmental organization focused primarily on alleviating the disease burden of inguinal and umbilical hernias in Central America. We present the experience of SOfA, a model focused on partnership and education. METHODS: SOfA was established in 2009 to help individuals recover from ailments that are obstacles to working and independent living. Over the past 15 years, SOfA has partnered with local healthcare providers in the Dominican Republic, El Salvador, Honduras, and Belize. The SOfA team consists of surgeons, surgery residents, triage physicians, an anesthesiologist, anesthetists, operating room nurses, recovery nurses, a pediatric critical care physician, sterile processing technicians, interpreters, and a team coordinator. Critical partnerships required include the CMO, internal medicine, general surgery, nursing, rural health coordinators and surgical training programs at public hospitals. RESULTS: SOfA has completed 24 trips, performing 2074 procedures on 1792 patients. 71.4% of procedures were hernia repairs. To enhance sustainability of healthcare delivery, SOfA has partnered with the local facilities through capital improvements to include OR tables, OR lights, anesthesia machines, monitors, hospital beds, stretchers, sterilizers, air conditioning units, and electrosurgical generators. A lecture series and curriculum on perioperative care, anesthesia, anatomy, and operative technique is delivered. Local surgery residents and medical students participated in patient care, learning alongside SOfA teammates. Recently, SOfA has partnered with SAGES Global Affairs Committee to implement a virtual Global Laparoscopic Advancement Program, a simulation-based laparoscopic training curriculum for surgeons in El Salvador. CONCLUSION: A sustainable partnership to facilitate surgical care in low resource settings requires longitudinal, collaborative relationships, and investments in capital improvements, education, and partnership with local healthcare providers, institutions, and training programs.
Subject(s)
Herniorrhaphy , Humans , Belize , Herniorrhaphy/education , Herniorrhaphy/methods , Honduras , El Salvador , Medical Missions/organization & administration , Hernia, Inguinal/surgery , Dominican Republic , Central America , International Cooperation , Models, OrganizationalABSTRACT
Despite a growing interest in the gut microbiome of non-industrialized countries, data linking deeply sequenced microbiomes from such settings to diverse host phenotypes and situational factors remain uncommon. Using metagenomic data from a community-based cohort of 1,871 people from 19 isolated villages in the Mesoamerican highlands of western Honduras, we report associations between bacterial species and human phenotypes and factors. Among them, socioeconomic factors account for 51.44% of the total associations. Meta-analysis of species-level profiles across several datasets identified several species associated with body mass index, consistent with previous findings. Furthermore, the inclusion of strain-phylogenetic information modifies the overall relationship between the gut microbiome and the phenotypes, especially for some factors like household wealth (e.g., wealthier individuals harbor different strains of Eubacterium rectale). Our analysis suggests a role that gut microbiome surveillance can play in understanding broad features of individual and public health.
Subject(s)
Gastrointestinal Microbiome , Socioeconomic Factors , Humans , Honduras , Gastrointestinal Microbiome/genetics , Female , Male , Adult , Bacteria/classification , Bacteria/genetics , Phylogeny , Middle AgedABSTRACT
BACKGROUND: Dengue is a disease that accounts for a major morbidity and mortality in Honduras. METHODS: This descriptive study used an analytical component based on the data from the National Virology Laboratory between 2016-2022. Ordinal logistic regression was used to identify the factors associated with the classification of dengue without warning signs (DWOS), dengue with warning signs (DWS), and severe dengue (SD). RESULTS: Overall, 14,687 dengue cases were included; 50.1% had DWOS, 36.5% had DWS, and 13.4% had SD. Patients that were more associated with a higher probability of DWS and SD were patients in the age groups 1-4 years (DWS OR 1.61; 95%CI:1.33-1.94), (SD OR 1.52; 95% CI:1.26-1.84), 5-9 years (DWS OR 2.01; 95% CI:1.68-2.40), (SD OR 2.00; 95% CI:1.67-2.40), and 10-19 years (DWS OR 1.55; 95% CI:1.30-1.85) (SD OR 1.57; 95% CI:1.31-1.88). The departments that were associated with a higher probability of DWS and SD were La Paz (OR 6.35; 95% CI:3.53-11.42), (OR 10.94; 95% CI:5.96-20.08), Copán (OR 6.94; 95% CI:5.05-9.53) (OR 7.33; 95% CI: 5.35-10.03), Valle (OR 5.22; 95% CI:1.25-21.82) (OR 10.71; 95% CI:2.21-51.88). CONCLUSIONS: During the study period, dengue presented endemic behavior, with peaks consistent with the last two epidemics in Honduras in 2015 and 2019. The main factors associated with dengue severity were age< 19 years, male sex, and being from La Paz, Copán, or Valle.
Subject(s)
Dengue , Severity of Illness Index , Humans , Honduras/epidemiology , Male , Adolescent , Child , Female , Dengue/epidemiology , Adult , Young Adult , Child, Preschool , Infant , Middle Aged , Risk Factors , Severe Dengue/epidemiologyABSTRACT
OBJECTIVES: To assess the efficacy of a sustained educational intervention to affect diverse outcomes across the pregnancy and infancy timeline. SETTING: A multi-arm cluster-randomised controlled trial in 99 villages in Honduras' Copán region, involving 16 301 people in 5633 households from October 2015 to December 2019. PARTICIPANTS: Residents aged 12 and older were eligible. A photographic census involved 93% of the population, with 13 881 and 10 263 individuals completing baseline and endline surveys, respectively. INTERVENTION: 22-month household-based counselling intervention aiming to improve practices, knowledge and attitudes related to maternal, neonatal and child health. PRIMARY AND SECONDARY OUTCOME MEASURES: Primary outcomes were prenatal/postnatal care behaviours, facility births, exclusive breast feeding, parental involvement, treatment of diarrhoea and respiratory illness, reproductive health, and gender/reproductive norms. Secondary outcomes were knowledge and attitudes related to the primary outcomes. RESULTS: Parents targeted for the intervention were 16.4% (95% CI 3.1%-29.8%, p=0.016) more likely to have their newborn's health checked in a health facility within 3 days of birth; 19.6% (95% CI 4.2%-35.1%, p=0.013) more likely to not wrap a fajero around the umbilical cord in the first week after birth; and 8.9% (95% CI 0.3%-17.5%, p=0.043) more likely to report that the mother breast fed immediately after birth. Changes in knowledge and attitudes related to these primary outcomes were also observed. We found no significant effect on various other practices. CONCLUSION: A sustained counselling intervention delivered in the home setting by community health workers can meaningfully change practices, knowledge and attitudes related to proper newborn care following birth, including professional care-seeking, umbilical cord care and breast feeding. TRIAL REGISTRATION NUMBER: NCT02694679.
Subject(s)
Health Knowledge, Attitudes, Practice , Humans , Honduras , Female , Adult , Pregnancy , Infant, Newborn , Male , Health Promotion/methods , Child , Breast Feeding , Counseling/methods , Infant , Adolescent , Child Health , Young Adult , Prenatal Care/methods , Postnatal Care/methodsABSTRACT
Negative or antagonistic relationships are common in human social networks, but they are less often studied than positive or friendly relationships. The existence of a capacity to have and to track antagonistic ties raises the possibility that they may serve a useful function in human groups. Here, we analyze empirical data gathered from 24,770 and 22,513 individuals in 176 rural villages in Honduras in two survey waves 2.5 y apart in order to evaluate the possible relevance of antagonistic relationships for broader network phenomena. We find that the small-world effect is more significant in a positive world with negative ties compared to an otherwise similar hypothetical positive world without them. Additionally, we observe that nodes with more negative ties tend to be located near network bridges, with lower clustering coefficients, higher betweenness centralities, and shorter average distances to other nodes in the network. Positive connections tend to have a more localized distribution, while negative connections are more globally dispersed within the networks. Analysis of the possible impact of such negative ties on dynamic processes reveals that, remarkably, negative connections can facilitate the dissemination of information (including novel information experimentally introduced into these villages) to the same degree as positive connections, and that they can also play a role in mitigating idea polarization within village networks. Antagonistic ties hold considerable importance in shaping the structure and function of social networks.
Subject(s)
Rural Population , Social Support , Humans , Honduras , Social Networking , Male , Female , Interpersonal Relations , Social Network AnalysisABSTRACT
We aimed to measure the association between Trypanosoma cruzi infection in pregnancy and reduced fetal growth in the absence of T. cruzi congenital transmission. We conducted a cross-sectional study of secondary data of all singleton live births between 2011 and 2013 in five hospitals from Argentina, Honduras, and Mexico. We excluded newborns with T. cruzi infection. Noninfected pregnant people were those without any positive rapid tests. The main study outcomes were birth weight, head circumference, and length for gestational age and sex. Logistic regression models were adjusted for country, age, education level, and obstetric history. Of the 26,544 deliveries, 459 (1.7%) pregnant people were found by rapid tests to be positive for T. cruzi. Of these, 320 were positive by enzyme-linked immunosorbent assay and 231 had a positive polymerase chain reaction (PCR) test. Uninfected newborns from T. cruzi-infected pregnant people were more likely to have birth weights below the 5th and 10th percentiles and head circumferences below the 3rd and 10th percentiles. Among T. cruzi-infected pregnant people diagnosed by PCR, the odds ratios were 1.58 for birth weight below the 10th percentile (95% CI, 1.12-2.23) and 1.57 for birth weight below the 5th percentile (95% CI, 1.02-2.42). Higher T. cruzi parasitic loads in pregnancy had a stronger association with reduced fetal growth (both in birth weight and head circumference), with an odds ratio of 2.31 (95% CI, 1.36-3.91) for a birth weight below the 5th percentile. The association shows, irrespective of causality, that newborns of pregnancies with T. cruzi have an increased risk of reduced fetal growth. We recommend further studies to assess other potential confounders and the causality of these associations.
Subject(s)
Birth Weight , Chagas Disease , Trypanosoma cruzi , Humans , Female , Pregnancy , Chagas Disease/transmission , Chagas Disease/epidemiology , Chagas Disease/congenital , Cross-Sectional Studies , Honduras/epidemiology , Argentina/epidemiology , Trypanosoma cruzi/isolation & purification , Adult , Mexico/epidemiology , Infant, Newborn , Pregnancy Complications, Parasitic/epidemiology , Male , Young Adult , Fetal Growth Retardation/epidemiology , Fetal Growth Retardation/parasitology , Fetal DevelopmentABSTRACT
The squash family (Cucurbitaceae) contains some of the most important crops cultivated worldwide and has played an important ecological, economic, and cultural role for millennia. In the American tropics, squashes were among the first cultivated crop species, but little is known about how their domestication unfolded. Here, we employ direct radiocarbon dating and morphological analyses of desiccated cucurbit seeds, rinds, and stems from El Gigante Rockshelter in Honduras to reconstruct human practices of selection and cultivation of Lagenaria siceraria, Cucurbita pepo, and Cucurbita moschata. Direct radiocarbon dating indicates that humans started using Lagenaria and wild Cucurbita starting ~ 10,950 calendar years before present (cal B.P.), primarily as watertight vessels and possibly as cooking and drinking containers. A rind directly dated to 11,150-10,765 cal B.P. represents the oldest known bottle gourd in the Americas. Domesticated C. moschata subsequently appeared ~ 4035 cal B.P., followed by domesticated C. pepo ~ 2190 cal B.P. associated with increasing evidence for their use as food crops. Multivariate statistical analysis of seed size and shape show that the archaeological C. pepo assemblage exhibits significant variability, representing at least three varieties: one similar to present-day zucchini, another like present-day vegetable marrow, and a native cultivar without modern analogs. Our archaeobotanical data supports the hypothesis that Indigenous cucurbit use started in the Early Holocene, and that agricultural complexity during the Late Holocene involved selective breeding that encouraged crop diversification.
Subject(s)
Archaeology , Crops, Agricultural , Cucurbita , Humans , Cucurbita/anatomy & histology , Radiometric Dating/methods , History, Ancient , Cucurbitaceae/anatomy & histology , Domestication , Seeds/chemistry , HondurasABSTRACT
The aim of this study was to estimate the (co)variance components and genetic parameters for milk yield adjusted to 305d (MY305), calving-to-conception interval (CCI), number of services per conception (NSC) and calving interval (CI) of Honduran Holstein cows, by fitting a bivariate animal model using Maximum Restricted Likelihood procedures. Model included the fixed effects of calving number, the contemporary calving group (farm-season-year of calving and the cow age as covariate). The estimated means and standard deviations for MY, CCI, NSC and CI were, 5098.60 ± 1564.32 kg, 168.27 ± 104.71 days, 2.46 ± 1.69 services, and 448.73 ± 109.16 days, respectively; and their estimated heritabilities were 0.21 ± 0.05, 0.03 ± 0.028, 0.02 ± 0.024 and 0.06 ± 0.04, respectively. The genetic correlations between MY305 and CCI, NSC and CI were positive and antagonist, with values of 0.64 ± 0.52, 0.99 ± 0.56, and 0.32 ± 0.24 respectively. Even though moderate to low heritability was estimated for MY305, systematic selection for milk yield, with a reduction in reproductive efficiency, if considered as the only selection criterion is important to be considered. By including reproductive traits and considering permanent environment effects into the breeding program, might yield a slow, but constant and permanent improvement over time.
Subject(s)
Lactation , Milk , Reproduction , Animals , Cattle/genetics , Cattle/physiology , Lactation/physiology , Female , Milk/metabolism , Honduras , Dairying , BreedingABSTRACT
BACKGROUND: This study examined population genetics of Aedes aegypti in El Salvador and Honduras, two adjacent countries in Central America. Aedes aegypti is associated with yellow fever, dengue, chikungunya, and Zika. Each year, thousands of cases of dengue are typically reported in El Salvador and Honduras. METHODS: In El Salvador, collections were obtained from five Departments. In Honduras, samples were obtained from six municipalities in four Departments. Mitochondrial DNA cytochrome oxidase I (COI) was sequenced, and consensus sequences were combined with available sequences from El Salvador to determine haplotype number, haplotype diversity, nucleotide diversity, and Tajima's D. A haplotype network was produced to examine the relationship between genotypes. RESULTS: In El Salvador, there were 17 haplotypes, while in Honduras there were 4 haplotypes. In both El Salvador and Honduras, Haplotype 1 is most abundant and widespread. In El Salvador, haplotype H2 was also widespread in 10 of 11 sampled municipalities, but it was not present in Honduras. The capital of El Salvador (San Salvador) and the eastern region of ES had the highest haplotype diversity of regions sampled. CONCLUSIONS: Haplotype 1 and H2 each belong to different phylogenetic lineages of Ae. aegypti. The most geographically widespread haplotype (H1) may have been present the longest and could be a remnant from previous eradication programs. These data may contribute to future control programs for Ae. aegypti in the two countries.
Subject(s)
Aedes , Genetic Variation , Haplotypes , Mosquito Vectors , Animals , Honduras , Aedes/genetics , Aedes/classification , El Salvador , Mosquito Vectors/genetics , Mosquito Vectors/classification , Mosquito Control , Electron Transport Complex IV/genetics , Phylogeny , DNA, Mitochondrial/genetics , GenotypeABSTRACT
Objective: To map ophthalmologist locations and surgical practices as they vary sub-nationally within Honduras to maximize the impact of efforts to develop cataract surgical capacity. Methods: An anonymous survey was sent to all Honduran ophthalmologists with questions on surgical volume, department-level location, type of facility in which they work, surgical methods, and age. Surgical volume, population, and poverty data sourced through the Oxford Poverty Human Development Initiative were mapped at the department level, and cataract surgical rates (CSR; surgeries per million population per year) were calculated and mapped. Results: Sixty-one of the 102 Honduran ophthalmologists contacted responded. Of those, 85% perform cataract surgery, and 49% work at least part time in a non-profit or governmental facility. Honduras has fewer surgical ophthalmologists per million than the global average, and though national CSR appears to be increasing, it varies significantly between departments. The correlation between CSR and poverty is complex, and outliers provide valuable insights. Conclusion: Mapping ophthalmological surgical practices as they relate to population and poverty at a sub-national level provides important insights into geographic trends in the need for and access to eye care. Such insights can be used to guide efficient and effective development of cataract surgical capacity.
Subject(s)
Cataract , Ophthalmology , Physicians , Humans , Honduras/epidemiology , Cataract/epidemiology , WorkforceABSTRACT
[RESUMEN]. Objetivo. Identificar y analizar el papel de los profesionales de enfermería en el desarrollo y la atención de la salud adolescente en Honduras, por medio del análisis de los contenidos de la formación de los estudiantes de enfermería y de las políticas relacionadas con la salud de los adolescentes. Métodos. Estudio de métodos mixtos, con enfoque explicativo secuencial, desarrollado de mayo a julio del 2023 por medio de encuesta con escuelas de enfermería, análisis de los documentos políticos, encuesta con profesionales de enfermería y grupo focal. Datos cuantitativos analizados mediante estadística descriptiva y datos cualitativos analizados mediante el marco teórico de Walt y Gilson. Resultados. Durante la investigación, se analizaron 18 documentos y participaron siete escuelas de enfer- mería, 141 enfermeras y 10 actores clave en posición de liderazgo. Los resultados apuntan a la necesidad de actualizar y difundir el marco normativo, garantizar recursos y estructura para implementar programas intersectoriales y sostenibles, y capacitar a los profesionales. La escuela representa un espacio importante para la implementación de acciones, contexto en el que la adopción de la enfermera escolar puede ser pro- vechosa. Las enfermeras fueron identificadas como protagonistas en la aplicación de los programas y deben ser consideradas en el desarrollo de políticas dirigidas a este público. Conclusiones. Las enfermeras participan en diversas etapas del proceso de implementación de políticas y pueden hacer importantes contribuciones a la salud escolar en el primer nivel de salud. Para ello, es necesa- rio aumentar la capacidad de las enfermeras y docentes de enfermería en temas actuales y relevantes en la atención a los adolescentes.
[ABSTRACT]. Objective. Identify and analyze the role of nursing professionals in the development and care of adolescent health in Honduras, by analyzing the curricular content of the training provided to nursing students with res- pect to adolescent health, and by studying policies on adolescent health. Methods. Mixed methods study, with a sequential explanatory approach, carried out from May to July 2023 through surveys of nursing schools, analysis of policy documents, a survey with nursing professionals, and a focus group. Quantitative data were analyzed using descriptive statistics and qualitative data, applying the theoretical framework of Walt and Gilson. Results. During the research, 18 documents were analyzed and seven nursing schools, 141 nurses, and 10 key actors in leadership positions participated. The results point to the need to update and disseminate the regulatory framework, ensure the necessary resources and structure to implement sustainable intersectoral programs, and train professionals. Schools are an important space for the implementation of actions; in this context, the adoption of school nursing programs could be beneficial. Nurses were identified as key figu- res in program implementation and should be taken into consideration when developing policies aimed at adolescents. Conclusions. Nurses participate in various stages of the policy implementation process and can make impor- tant contributions to school health at the first level of care. To this end, it is necessary to increase the capacities of nurses and nursing educators in relation to current and relevant issues in adolescent care.
[RESUMO]. Objetivo. Identificar e analisar o papel dos profissionais de enfermagem no desenvolvimento e na atenção à saúde de adolescentes em Honduras por meio de análise do conteúdo da formação dos estudantes de enfermagem em saúde de adolescentes e das políticas relacionadas aos adolescentes. Métodos. Estudo de métodos mistos, com abordagem sequencial explanatória, realizado de maio a julho de 2023 por meio de um questionário aplicado a escolas de enfermagem, análise de documentos de política, um questionário aplicado a profissionais de enfermagem e um grupo focal. Os dados quantitativos foram analisados mediante estatísticas descritivas, e os qualitativos, usando o modelo teórico de Walt e Gilson. Resultados. Durante a pesquisa, foram analisados 18 documentos. Sete escolas de enfermagem, 141 pro- fissionais de enfermagem e 10 atores-chave em cargos de liderança participaram do estudo. Os resultados apontam para a necessidade de atualizar e divulgar o marco normativo, garantir recursos e estrutura para a implementação de programas intersetoriais e sustentáveis e capacitar os profissionais. A escola representa um espaço importante para a implementação de ações, contexto no qual a adoção da enfermagem escolar pode ser proveitosa. Os profissionais de enfermagem foram identificados como atores-chave na implemen- tação dos programas e devem ser levados em consideração no desenvolvimento de políticas voltadas para esse público. Conclusões. Os profissionais de enfermagem estão envolvidos em vários estágios do processo de imple- mentação de políticas e podem fazer aportes importantes para a saúde escolar no nível da atenção primária. Para isso, é necessário aumentar a capacitação dos profissionais e docentes de enfermagem em tópicos atuais e relevantes da atenção a adolescentes.
Subject(s)
Nursing , Adolescent Health , Health Human Resource Training , Health Policy , Comprehensive Health Care , Adolescent Health Services , Honduras , Nursing , Adolescent Health , Health Human Resource Training , Health Policy , Comprehensive Health Care , Adolescent Health Services , Nursing , Adolescent Health , Health Human Resource Training , Health Policy , Comprehensive Health Care , Adolescent Health ServicesABSTRACT
BACKGROUND AND AIMS: There is ample evidence from high-income countries that fiscal policies such as alcohol taxes can affect the consumption of alcohol by increasing alcohol prices. In the case of Latin American countries, much less is known about how sensitive alcohol demand is to alcohol price changes. This study aims to expand the evidence base on the sensitivity of off-premises pure alcohol demand to price and expenditure increases in five Latin American countries: Argentina, Chile, Costa Rica, Honduras, and Uruguay, which have different socioeconomic profiles and alcohol consumption patterns. DESIGN AND SETTING: Cross-sectional study MEASUREMENTS: The price and expenditure elasticities were estimated using an Almost Ideal Demand System (AIDS). Own price and expenditure elasticities for off-premises pure alcohol were estimated using representative household surveys, which collect data on households' expenses to construct the consumer basket of goods and services used to calculate the consumer price index (CPI) for the country. FINDINGS: Own price elasticities of off-premises pure alcohol for all countries were negative, inelastic, and significant at 1 %. They were -0.418 for Argentina; -0.656 for Chile; and for Costa Rica, Honduras, and Uruguay, they were equal to -0.608, -0.509, and -0.32, respectively. Expenditure elasticities were positive and significant at 1 %, except for Costa Rica, which was significant at 10 %. They were equal to 0.865 in Argentina; 0.943 in Chile; 1.182 in Costa Rica; 0.874 in Honduras; and 0.857 in Uruguay. Elasticities for Costa Rica should be interpreted cautiously, as there is insufficient geographical price variability to identify the demand correctly. CONCLUSIONS: Results were consistent with previous literature for countries from other regions. Governments should expand this study to measure total demand elasticities to improve the design of alcohol tax policies.
Subject(s)
Commerce , Taxes , Humans , Chile , Uruguay , Costa Rica , Honduras , Latin America , Argentina , Cross-Sectional StudiesABSTRACT
INTRODUCTION: The frequency of detected strongyloidiasis is affected by the selected laboratory method in the studied population. Considering that Honduras has few community-based studies, the analysis of the laboratory record data can provide information helping to understand this parasitosis. OBJECTIVE: To estimate the frequency and to identify the factors associated with strongyloidiasis, analyzing the laboratory records of the Servicio de Parasitología at Hospital Escuela in Tegucigalpa (Honduras) between 2010 and 2022. MATERIALS AND METHODS: We carried out a descriptive, cross-sectional, analytical study. The laboratory diagnosis consisted of stool samples' examination by direct smear and modified Baermann technique. We estimated frequencies and percentages. The statistical association was calculated with prevalence ratios and a 95% confidence interval. Software R, version 4.2.0, and epiR package, version 2.0.46, were used to perform the analysis. RESULTS: The frequency of strongyloidiasis was 0.29% (112/38,085). It was higher with the modified Baermann technique (0.87%; 40/4,575) among male patients (0.44%; 70/15,758). Regarding the age, strongyloidiasis was higher in the 20-40 years old group (0.41%; 28/6,886) with direct smear and 41-61 years old (1.14%; 14/1,232) group with the modified Baermann technique. Among the factors associated with strongyloidiasis were age between 20 and 61 years old (PR=2.26, CI 95%=1.53-3.31), male patients (PR=2.34, CI 95%=1.603.44), mucus (PR=1.86, CI 95%=1.22-2.83) and Charcot-Leyden crystals in stool (PR=8.47, CI 95%=5.14-13.96); watery stool (PR=2.39, CI 95%=1.55-3.68), and other helminthiases (PR=6.73, CI 95%=3.98-11.38). Associated factors to cases detected with the modified Baermann technique were outpatient consultation (PR=4.21, CI 95%=1.91-9.28) and formed stools (PR=3.99, CI 95%=1.94-8.19). CONCLUSIONS: The modified Baermann technique increased the detection of strongyloidiasis almost four times. Most cases were distributed among male adults. The cases diagnosed exclusively with the modified Baermann technique have differences from those with observed larvae in the direct smear. It is necessary to develop community-based population studies.
Introducción: La detección de estrongiloidiasis depende del método de diagnóstico utilizado y la población estudiada. Dado que en Honduras hay pocos estudios poblacionales, el análisis de los datos de laboratorio puede generar información que ayude a entender esta parasitosis. Objetivo: Estimar la frecuencia e identificar los factores asociados a la estrongiloidiasis mediante el análisis de los registros de laboratorio del Servicio de Parasitología del Hospital Escuela en Tegucigalpa (Honduras) durante el periodo 2010-2022. Materiales y métodos: Se llevó a cabo un estudio descriptivo, transversal y analítico. El diagnóstico de laboratorio consistió en el análisis de muestras de heces con los métodos directo y Baermann modificado. Se estimaron frecuencias y porcentajes, y la asociación estadística se calculó con razón de prevalencia e intervalos de confianza del 95 %. Se utilizaron los programas R, versión 4.2.0, y el paquete epiR, versión 2.0.46, para ejecutar los análisis estadísticos. Resultados: La frecuencia general de estrongiloidiasis fue 0,29 % (112/38.085). Dicha frecuencia de detección fue mayor con el método de Baermann modificado (0,87 %; 40/4.575), entre pacientes masculinos (0,44 %; 70/15.758). También fue mayor en el rango de edad 20-40 años (0,41%; 28/6.886) por examen directo y entre los 41-61 años (1,14%; 14/1.232) con el método de Baermann modificado. Entre los factores asociados con la estrongiloidiasis se encontraron: edad entre los 20 y los 61 años (RP=2,26; IC 95%=1,53-3,31), sexo masculino (RP=2,34; IC 95% =1,60-3.44), moco (RP=1,86; IC 95%=1,22-2,83) y cristales de Charcot-Leyden en heces (RP=8,47, IC 95%=5,14-13,96), heces líquidas (RP=2,39, IC 95%=1,55-3,68) y otras helmintiasis (RP=6,73, IC 95%=3,98-11,38). Como factores asociados a los casos detectados con el método de Baermann modificado están consulta externa (RP=4,21, IC 95%=1,91-9,28) y heces formadas (RP=3,99, IC 95%=1,94-8,19). Conclusiones: El método de Baermann modificado aumentó la frecuencia de detección de estrongiloidiasis casi cuatro veces. La mayoría de los casos se distribuyeron entre pacientes masculinos adultos. Los casos diagnosticados exclusivamente con el método de Baermann modificado tuvieron diferencias con los casos diagnosticados por examen directo. Es necesario realizar estudios poblacionales.
Subject(s)
Strongyloidiasis , Adult , Humans , Male , Young Adult , Middle Aged , Strongyloidiasis/diagnosis , Strongyloidiasis/epidemiology , Tertiary Care Centers , Honduras/epidemiology , Cross-Sectional Studies , LaboratoriesABSTRACT
Introducción: El Campamento Tortuguero de Cedeño ha sido el sitio menos investigado del Golfo de Fonseca, donde se protege a la tortuga golfina en Honduras desde 1975. Objetivo: Evaluar la anidación de la tortuga Golfina (Lepidochelys olivacea) durante la temporada de veda entre el 2011 y 2021 en Campamento Tortuguero Cedeño, Choluteca, Honduras. Métodos: Entre 2011 a 2021, se llevó a cabo el monitoreo diario de las actividades de anidación durante la veda del 1 al 25 de septiembre. Los patrullajes se realizaron entre las 6:00-18:00 h, y las 18:00-5:00 h. Se registró el número total de tortugas que anidaban y se recogieron sus huevos, que se transportaron al criadero, donde se tabularon los resultados de las puestas y las crías. Resultados: Se registró un total 1 065 tortugas de L. olivacea, 95 051 huevos recolectados, 1 065 nidos marcados en tres playas que fueron reubicados en viveros artificiales y una eclosión exitosa de 62 747 neonatos. La playa Las Doradas fue el sitio con el mayor número de tortugas anidadoras, seguido de Los Delgaditos y por último Cedeño. El promedio de la frecuencia de anidación fue de 96 nidos. Del 2011 al 2021 el esfuerzo de recolección de los nidos aumentó en un 91.6 %, pasando de 84 a 161 nidos. El número de personas patrullando se asoció con la cantidad de nidos detectados en las playas. Conclusión: Los esfuerzos de monitoreo y conservación para la especie han indicado que ha habido un incremento en la anidación de L. olivacea en las tres playas, con un mayor incremento en Playa Las Doradas. Este escenario comprueba la funcionalidad de la veda en esta zona.
Introduction: The Cedeño Turtle Camp has been the least researched site in the Fonseca Gulf, where Olive Ridley Turtles in Honduras have been protected since 1975. Objective: To evaluate the nesting of Olive Ridley turtles (Lepidochelys olivacea) during the closed season from 2011 to 2021 in Campamento Tortuguero Cedeño, Choluteca, Honduras. Methods: From 2011 to 2021, daily monitoring of nesting activities was conducted during the closed season from the 1st to 25th of September. Patrols were conducted between 6:00-18:00 h, and 18:00-5:00 h. The total number of nesting turtles was recorded, and their eggs were collected and transported to the hatchery, where clutch and hatchling performance were tabulated. Results: A total of 1 065 L. olivacea turtles were recorded, 95 051 eggs collected, 1 065 nests marked on three beaches that were relocated in artificial hatcheries and a successful hatching of 62 747 hatchlings. Las Doradas beach was the site with the highest number of nesting turtles, followed by Los Delgaditos and lastly Cedeño. The average nesting frequency was 96 nests. From 2011 to 2021 the nest collection effort increased by 91.6 %, from 84 to 161 nests. The number of people patrolling was associated with the number of nests detected on the beaches. Conclusion: Monitoring and conservation efforts for L. olivacea in the Campamento Tortuguero Cedeño show a positive trend in nesting with a greater increase in Playa Las Doradas. This scenario proves the functionality of the closed season in this area.
Subject(s)
Animals , Embryo Implantation , Turtles/embryology , HondurasABSTRACT
Introduction. The frequency of detected strongyloidiasis is affected by the selected laboratory method in the studied population. Considering that Honduras has few community-based studies, the analysis of the laboratory record data can provide information helping to understand this parasitosis. Objective. To estimate the frequency and to identify the factors associated with strongyloidiasis, analyzing the laboratory records of the Servicio de Parasitología at Hospital Escuela in Tegucigalpa (Honduras) between 2010 and 2022. Materials and methods. We carried out a descriptive, cross-sectional, analytical study. The laboratory diagnosis consisted of stool samples' examination by direct smear and modified Baermann technique. We estimated frequencies and percentages. The statistical association was calculated with prevalence ratios and a 95% confidence interval. Software R, version 4.2.0, and epiR package, version 2.0.46, were used to perform the analysis. Results. The frequency of strongyloidiasis was 0.29% (112/38,085). It was higher with the modified Baermann technique (0.87%; 40/4,575) among male patients (0.44%; 70/15,758). Regarding the age, strongyloidiasis was higher in the 20-40 years old group (0.41%; 28/6,886) with direct smear and 41-61 years old (1.14%; 14/1,232) group with the modified Baermann technique. Among the factors associated with strongyloidiasis were age between 20 and 61 years old (PR=2.26, CI 95%=1.53-3.31), male patients (PR=2.34, CI 95%=1.60-3.44), mucus (PR=1.86, CI 95%=1.22-2.83) and Charcot-Leyden crystals in stool (PR=8.47, CI 95%=5.14-13.96); watery stool (PR=2.39, CI 95%=1.55-3.68), and other helminthiases (PR=6.73, CI 95%=3.98-11.38). Associated factors to cases detected with the modified Baermann technique were outpatient consultation (PR=4.21, CI 95%=1.91-9.28) and formed stools (PR=3.99, CI95% =1.94-8.19). Conclusions. The modified Baermann technique increased the detection of strongyloidiasis almost four times. Most cases were distributed among male adults. The cases diagnosed exclusively with the modified Baermann technique have differences from those with observed larvae in the direct smear. It is necessary to develop community-based population studies.
Introducción. La detección de estrongiloidiasis depende del método de diagnóstico utilizado y la población estudiada. Dado que en Honduras hay pocos estudios poblacionales, el análisis de los datos de laboratorio puede generar información que ayude a entender esta parasitosis. Objetivo. Estimar la frecuencia e identificar los factores asociados a la estrongiloidiasis mediante el análisis de los registros de laboratorio del Servicio de Parasitología del Hospital Escuela en Tegucigalpa (Honduras) durante el periodo 2010-2022. Materiales y métodos. Se llevó a cabo un estudio descriptivo, transversal y analítico. El diagnóstico de laboratorio consistió en el análisis de muestras de heces con los métodos directo y Baermann modificado. Se estimaron frecuencias y porcentajes, y la asociación estadística se calculó con razón de prevalencia e intervalos de confianza del 95 %. Se utilizaron los programas R, versión 4.2.0, y el paquete epiR, versión 2.0.46, para ejecutar los análisis estadísticos. Resultados. La frecuencia general de estrongiloidiasis fue 0,29 % (112/38.085). Dicha frecuencia de detección fue mayor con el método de Baermann modificado (0,87 %; 40/4.575), entre pacientes masculinos (0,44 %; 70/15.758). También fue mayor en el rango de edad 20-40 años (0,41%; 28/6.886) por examen directo y entre los 41-61 años (1,14%; 14/1.232) con el método de Baermann modificado. Entre los factores asociados con la estrongiloidiasis se encontraron: edad entre los 20 y los 61 años (RP=2,26; IC 95%=1,53-3,31), sexo masculino (RP=2,34; IC95%=1,60-3.44), moco (RP=1,86; IC 95%=1,22-2,83) y cristales de Charcot-Leyden en heces (RP=8,47, IC 95%=5,14-13,96), heces líquidas (RP=2,39, IC 95%=1,55-3,68) y otras helmintiasis (RP=6,73, IC 95%=3,98-11,38). Como factores asociados a los casos detectados con el método de Baermann modificado están consulta externa (RP=4,21, IC 95%=1,91-9,28) y heces formadas (RP=3,99, IC 95%=1,94-8,19). Conclusiones. El método de Baermann modificado aumentó la frecuencia de detección de estrongiloidiasis casi cuatro veces. La mayoría de los casos se distribuyeron entre pacientes masculinos adultos. Los casos diagnosticados exclusivamente con el método de Baermann modificado tuvieron diferencias con los casos diagnosticados por examen directo. Es necesario realizar estudios poblacionales.
Subject(s)
Strongyloides stercoralis , Parasitic Diseases , Strongyloidiasis , Helminthiasis , HondurasABSTRACT
Resumen: Introducción: El control de cargas de entrenamiento es importante para optimizar el rendimiento. Por lo tanto, se deben documentar metodologías que mejoren la preparación de selecciones nacionales en eventos como los juegos olímpicos. Objetivo: Determinar si los datos del GPS en combinación con medidas subjetivas de bienestar, fatiga y recuperación son apropiados para el control de las cargas durante un periodo preparatorio para los Juegos Olímpicos. Metodología: Participaron 22 jugadores profesionales sub-23 durante 5 microciclos y 27 sesiones de entrenamiento. Se recopilaron datos de carga externa a través de un sistema global de posicionamiento (GPS): Distancia total (DT), zonas de rendimiento Z0 (0-15 km/h), Z1 (15.1-18 km/h), Z2 (18.1-24 km/h), Z3 (>24.1 km/h)), velocidad máxima (Vmax (km/h)), aceleraciones (>2.5m/s2) y desaceleraciones (<2.5m/s2). También, se obtuvo la carga interna a través de medidas subjetivas de percepción del esfuerzo (RPE), calidad de la recuperación (TQR), predisposición para entrenar (RTT%) derivada de las variables de calidad del sueño, dolor muscular, niveles de energía, estado de ánimo, estrés, calidad de la alimentación y la salud. Luego se calculó la ratio subjetiva de fatiga-recuperación (F-R). Se aplicó un test ANOVA, análisis de componentes principales (ACP) y una regresión múltiple lineal. Resultados: Las variables DT (p=0.00 TE=0.22), Z0 (p= 0.00 TE=0.08), Z2 (p=0.00 TE= 0.05), Vmax (p=0.00 TE=0.42), suma de aceleración y deceleración (p=0.00 TE=0.08) y valores relativos de la carga/min (p=0.00 TE=0.17) se identificaron como variables más sensibles al cambio de la carga entre microciclos. El RTT% y ratio subjetivo F-R mostraron un tamaño del efecto moderado (p=0.04 TE=0.06 y p=0.06 TE=0.06), pero fueron sensibles al cambio entre los microciclos. El ACP extrajo 15 variables GPS y 11 variables subjetivas que explicaron el 78% de la varianza de la carga de entrenamiento. Conclusión: Utilizar datos GPS junto con medidas subjetivas implicadas en la fatiga-recuperación puede ser una buena estrategia para el control de la carga de entrenamiento en futbolistas.
Abstract: Background: Training control is essential to optimize performance. Therefore, methodologies that improve the preparation of national teams in events such as the Olympic Games should be documented. Purpose: To determine whether GPS data in combination with subjective measures of well-being, fatigue and recovery are appropriate for load monitoring during a preparatory period for the Olympic Games. Methodology: Twenty-two under-23 professional players participated during 5 micro-cycles and 27 training sessions. External load data was collected via a global positioning system (GPS): Total distance (DT), performance zones Z0 (0-15 km/h), Z1 (15.1-18 km/h), Z2 (18.1 -24 km/h), Z3 (>24.1 km/h), maximum speed (km/h), accelerations (>2.5m/s.) and decelerations (<2.5m/s.). Also, internal load was obtained through subjective measures of Rating Perceived Exertion (RPE), Total Quality Recovery (TQR), Readiness to Train (RTT%) obtained from the sleep quality, muscle pain, energy levels, mood, stress, food quality and health. The subjective rate of fatigue-recovery (F-R) was then calculated. An ANOVA test, Principal Component Analysis (PCA) and multiple linear regression were applied. Results: the variables DT (p=0.00 ES=0.22), Z0 (p= 0.00 TE=0.08), Z2 (p=0.00 ES= 0.05), maximum speed (p= 0.00 ES=0.42), sum of acceleration and deceleration (p=0.00 ES=0.08) and values relative to load/min (p=0.00 ES=0.17) were identified as variables more sensitive to load change between micro-cycles. RTT% and subjective rate F-R showed a moderate effect size (p=0.04 ES=0.06 and p=0.06 ES=0.06), but were sensitive to change between micro-cycles. PCA extracted 15 GPS variables and 11 subjective variables that explained 78% of the training load variance. Conclusion: Using GPS data together with subjective measures involved in fatigue-recovery may be a good strategy to control training load in footballers.
Resumo: Introdução: O monitoramento das cargas de treinamento é importante para otimizar o desempenho. Portanto, as metodologias devem ser documentadas para melhorar a preparação das equipes nacionais para eventos como os Jogos Olímpicos. Objetivo: Determinar se os dados GPS em combinação com medidas subjetivas de bem-estar, fadiga e recuperação são apropriados para o monitoramento da carga durante um período preparatório para os Jogos Olímpicos. Metodologia: 22 jogadores profissionais U-23 participaram durante 5 microciclos e 27 sessões de treinamento. Os dados de carga externa foram coletados através de um sistema de posicionamento global (GPS): distância total (DT), zonas de desempenho Z0 (0- 15 km/h), Z1 (15,1-18 km/h), Z2 (18,1-24 km/h), Z3 (>24,1 km/h), velocidade máxima (Vmax (km/h)), acelerações (>2,5m/ s2) e desacelerações (<2,5m/s2). Além disso, a carga interna foi obtida através de medidas subjetivas de percepção do esforço (RPE), qualidade de recuperação (TQR), predisposição para o treinamento (RTT%) derivada das variáveis de qualidade do sono, dor muscular, níveis de energia, humor, estresse, qualidade alimentar e saúde. Posteriormente a taxa subjetiva de fadiga-recuperação (F-R) foi calculada. Um teste ANOVA, análise de componentes principais (ACP) e regressão linear múltipla foram aplicados. Resultados: As variáveis DT (p=0,00 TE=0,22), Z0 (p= 0,00 TE=0,08), Z2 (p=0,00 TE= 0,05), Vmax (p=0,00 TE=0,42), soma de aceleração e desaceleração (p=0,00 TE=0,08) e valores de carga relativa/min (p=0,00 TE=0,17) foram identificadas como as variáveis mais sensíveis à mudança de carga entre microciclos. RTT% e a relação F-R subjetiva mostraram tamanho de efeito moderado (p=0,04 TE=0,06 e p=0,06 TE=0,06 TE=0,06), mas foram sensíveis à mudança entre microciclos. O ACP extraiu 15 variáveis GPS e 11 variáveis subjetivas que explicaram 78% da variância na carga de treinamento. Conclusão: O uso de dados GPS junto com medidas subjetivas envolvidas na fadiga#recuperação pode ser uma boa estratégia para o monitoramento da carga de treinamento em jogadores de futebol.
Subject(s)
Humans , Physical Education and Training/methods , Soccer , Information Technology , COVID-19 , HondurasABSTRACT
El propósito fundamental de esta serie de perfiles nacionales de la carga de enfermedad por diabetes y de enfermedad renal crónica debida a diabetes es apoyar a los países de la Región de las Américas en el seguimiento de las estrategias puestas en marcha para enfrentar la diabetes. Esta primera versión de los perfiles, que abarca el período comprendido entre el 2000 y el 2019, muestra la tendencia de la mortalidad, los años de vida perdidos por muerte prematura, los años vividos con discapacidad y los años de vida ajustados por discapacidad de ambas enfermedad. Se han elaborado con los últimos datos disponibles de las estimaciones mundiales de salud de la Organización Mundial de la Salud y tiene como objetivo convertirse en una herramienta útil para llevar a cabo el monitoreo de las estrategias conexas.