Establishing priorities to strengthen National Immunization Technical Advisory Groups in Latin America and the Caribbean.

Following the COVID-19 pandemic, the Americas faced a significant decline in vaccination coverage as well as increased vaccine hesitancy. The objective of this paper is to summarize the challenges and opportunities outlined by the National Immunization Technical Advisory Groups (NITAGs) in Latin America and the Caribbean (LAC) and prioritize targeted interventions. The exploratory survey included open-ended questions on two primary components: challenges, and opportunities. Free-text comments presented by each NITAG were collated and classified using indicators and sub-indicators of the NITAG Maturity Assessment Tool (NMAT). Opportunities were classified thematically, and priority actions were generated from the responses. All 21 NITAGs in LAC, representing 40 countries, 76 % of which have been active for over a decade, responded to the survey. The most common challenges were establishment and composition (62 %), integration into policymaking (62 %), resources and secretariat (52 %), and stakeholder recognition (48 %). The distribution of responses was seen across the whole sample and did not suggest a more pronounced need in relation to year of establishment. Opportunities included maximizing the Regional NITAG Network of the Americas (RNA) to facilitate collaboration, information sharing, visibility, and communication; existing global, regional, and systemic analyses; the World Health Organization/Pan American Health Organization (WHO/PAHO) templates for standard operating procedures; twinning programs with mature NITAGs; and NITAGs in governance structures. Action plans were outlined to formalize the establishment of NITAGs and broaden their composition; strengthen decision-making and access to data resources; and enhance the credibility of evidence-based recommendations and their uptake by policymakers and the public. NITAG challenges are not unique to LAC. NITAGs have outlined a short-term prioritized action plan which is critical to enhancing NITAG value and importance in countries.

Growth retardation and severe anemia in children with Trichuris dysenteric syndrome

Objective: To document epidemiologic data, clinical manifestations and treatment in hospitalized children with Trichuris dysenteric syndrome from Honduras during 2010-2012. Methods: Severe trichuriasis cases were identified by routine stool examinations from hospitalized patients (12 years old or less). Relevant epidemiologic, clinical and management data were obtained from review of clinical histories in the ward. Results:Of 122 Trichuris infections diagnosed in 11 528 (1.0%) stool samples for all ages, 81 (66.4%) were identified in the age group 2-12 years old, 21 (25.9%) of which were severe (≥100 eggs in 2 mg of feces). Thirteen of those 21 patients collaborated in this study. Patients (9 males and 4 females) were of rural precedence, from large poor or very poor families, chronically parasitized, and between 2 and 12 years old. Dysentery of months duration, severe anemia and stunting were common complaints;clinical characteristics associated with heavy Trichuris infections included egg counts from 232-3 520 eggs per direct smear, hemoglobin from 3.4-10.8 g/dL, eosinophilia up to 43%, severe malnutrition and growth stunting. Orally administered drugs mebendazole, albendazole, metronidazole, nitaxozanide, and piperazine were prescribed at different dosages and duration other than recommended;no cure or egg excretion control was exercised before patient release. A range of 340 to about 10 000 worms were recovered after treatment from 8 patients. Conclusions:This report underlines the need for detailed community studies in trichuriasis morbidity, effective treatment assessment and clinical response in severely malnourished parasitized children.

Metodos utilizados en el proyecto rhizobiologia para estudiar la interaccion entre la bacteria rhxizobiaceae y la planta leguminosae

Contiene: Introducción. Bacteria Rhizobiaceae, clasificación, aislamiento, mantenimiento y multiplicación. Cultivo de la planta leguminosae. Evaluación de la interacción entre la bacteria y la planta. Referencias bibliográficas