Mapping Human Resources to Guide Ophthalmology Capacity-Building Projects in Honduras: Sub-national Analyses of Physician Distribution and Surgical Practices.

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.

El papel de los profesionales de enfermería en el desarrollo y atención de la salud adolescente en Honduras / The role of nursing professionals in the development and care of adolescent health in Honduras / Papel dos profissionais de enfermagem no desenvolvimento e na atenção à saúde de adolescentes em Honduras

[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.

Off-premises demand elasticities for pure alcohol in five Latin American countries: The case of Argentina, Chile, Costa Rica, Honduras, and Uruguay.

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.

Moral reasoning about gang violence in context: A comparative study with children and adolescents exposed to maras in Honduras and not exposed in Nicaragua.

This study examined how youth morally deliberate about conditions of gang violence shaping their communities. Participants (N = 80; 10-11 and 14-15 years; 50% female) exposed to gangs (maras) in Honduras and not exposed to maras in Nicaragua evaluated hypothetical situations of physical harm in contexts of chronic gang violence. Results indicated that mara-exposed youth were more likely to endorse harming a rival gang member in some contexts, but not others. Moreover, in some contexts, males were more likely to endorse harming others as necessary. Few age differences emerged, suggesting comparability among children and adolescents. Discussion focuses on how children and adolescents coordinate different moral and social concepts and concerns pertaining to acts of physical harm in situations involving gangs.

One World Surgery: The Evolution of a Locally Run Surgical Mission in Honduras.

ABSTRACT: One World Surgery (OWS) is a medical mission organization that treats a variety of orthopaedic conditions and focuses on local partnerships, education, capacity-building, and high-quality care. OWS runs a Honduran ambulatory surgery center (ASC) with >50 full-time local staff; it operates year-round and accommodates visiting surgical teams bimonthly. Across its 12-year history, 8,703 surgical procedures have been performed and 54,940 total consults have been completed, with increasing autonomy of the local medical staff. From 2009 through 2021, OWS has provided 74 million U.S. dollars in surgical and consult patient care. By addressing global surgical disparities via life-enhancing surgical care in low- and middle-income country (LMIC) settings, the OWS ASC mission model may be a useful blueprint for other medical missions.

Anidación de la tortuga marina Lepidochelys olivacea (Testudinata: Cheloniidae) en Campamento Tortuguero Cedeño, Honduras (2011-2021) / Nesting of olive ridley sea turtle Lepidochelys olivacea (Testudinata: Cheloniidae) in Campamento Tortuguero Cedeño, Honduras (2011-2021)

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.

Frequency of strongyloidiasis and associated factors: Analysis of 13 years of laboratory results in a tertiary referral hospital in Honduras, 2010-2022. / Frecuencia de estrongiloidiasis y factores asociados: análisis de 13 años de resultados de laboratorio en un hospital de tercer nivel de Honduras, 2010-2022

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.

Honduras HIV cohort: HLA class I and CCR5-Δ32 profiles and their associations with HIV disease outcome.

IMPORTANCE: We identify both canonical and novel human leukocyte antigen (HLA)-HIV associations, providing a first step toward improved understanding of HIV immune control among the understudied Honduras Mestizo population. Our results are relevant to understanding the protective or detrimental effects of HLA subtypes in Latin America because their unique HLA diversity poses challenges for designing vaccines against HIV and interpreting results from such vaccine trials. Likewise, the description of the HLA profile in an understudied population that shows a unique HLA immunogenetic background is not only relevant for HIV immunology but also relevant in population genetics, molecular anthropology, susceptibility to other infections, autoimmune diseases, and allograft transplantation.

The enmity paradox.

The "friendship paradox" of social networks states that, on average, "your friends have more friends than you do". Here, we theoretically and empirically explore a related and overlooked paradox we refer to as the "enmity paradox". We use empirical data from 24,678 people living in 176 villages in rural Honduras. We empirically show that, for a real negative undirected network (created by symmetrizing antagonistic interactions), the paradox exists as it does in the positive world. Specifically, a person's enemies have more enemies, on average, than a person does. Furthermore, in a mixed world of positive and negative ties, we study the conditions for the existence of the paradox, which we refer to as the "mixed-world paradox", both theoretically and empirically, finding that, for instance, a person's friends typically have more enemies than a person does. We also confirm the "generalized" enmity paradox for non-topological attributes in real data, analogous to the generalized friendship paradox (e.g., the claim that a person's enemies are richer, on average, than a person is). As a consequence, the naturally occurring variance in the degree distribution of both friendship and antagonism in social networks can skew people's perceptions of the social world.

Presence, Co-Occurrence, and Daily Intake Estimates of Aflatoxins and Fumonisins in Maize Consumed in Food-Insecure Regions of Western Honduras.

Foodborne mycotoxins are a significant food safety risk in developing countries. Our objective was to determine the occurrence of and exposure levels to aflatoxins (AFs) and fumonisins (FBs) in maize intended for human and animal consumption in food-insecure regions of western Honduras. Total AFs and FBs were quantified with a monoclonal antibody-based affinity spectrofluorimetric method. FBs were detected in 614/631 samples of maize destined for human consumption at 0.3 to 41 mg/kg (mean, 2.7 mg/kg). Of the 614 positive samples, 147 had FB levels exceeding the U.S. Food and Drug Administration (FDA) advisory threshold of 4.0 mg/kg. AFs were detected in 109/631 samples of maize for human consumption with concentrations between 1.0 and 490 µg/kg (mean, 10 µg/kg). AF levels in 34 samples exceeded the FDA regulatory limit (i.e., 20 µg/kg). The average probable daily intake of AFs in western Honduras ranged from 0 to 260 ng/kg body weight/day, and for FBs, the average probable daily intake ranged from 17 to 53 µg/kg body weight/day. AFs and FBs co-occurred in 106/631 samples with 60 samples containing both toxins at levels greater than the FDA regulatory levels. Samples of maize intended for animal feed had significantly higher AF (mean, 22 µg/kg) and FB (mean, 7.6 mg/kg) contamination levels than those observed in samples destined for human consumption. Thus, the maize supply chain in western Honduras is contaminated with mycotoxins at levels that pose health risks to both humans and livestock. More effective mycotoxin surveillance and implementation of effective mitigation strategies are needed to reduce mycotoxin contamination and exposure.

Perfil de carga de enfermedad por diabetes 2023: Honduras

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.

A distinctive new species of the coral shrimp genus Microprosthema Stimpson, 1860 from the Atlantic coast of Florida and Honduras (Decapoda: Stenopodidea: Spongicolidae).

A new species of the spongicolid coral shrimp genus Microprosthema Stimpson, 1860 is described on the basis of three specimens collected by hand while scuba diving off the Atlantic coast of southern Florida, with additional photographic records from Roatan, Honduras. Microprosthema dimitrisorum sp. nov. can be separated from all presently known species of the genus by a unique combination of morphological characters, and most easily, by its highly diagnostic and conspicuous colour pattern consisting of large red spots on most of the body and appendages.

Trans-Holocene Bayesian chronology for tree and field crop use from El Gigante rockshelter, Honduras.

El Gigante rockshelter in western Honduras provides a deeply stratified archaeological record of human-environment interaction spanning the entirety of the Holocene. Botanical materials are remarkably well preserved and include important tree (e.g., ciruela (Spondias), avocado (Persea americana)) and field (maize (Zea mays), beans (Phaseolus), and squash (Cucurbita)) crops. Here we provide a major update to the chronology of tree and field crop use evident in the sequence. We report 375 radiocarbon dates, a majority of which are for short-lived botanical macrofossils (e.g., maize cobs, avocado seeds, or rinds). Radiocarbon dates were used in combination with stratigraphic details to establish a Bayesian chronology for ~9,800 identified botanical samples spanning the last 11,000 years. We estimate that at least 16 discrete intervals of use occurred during this time, separated by gaps of ~100-2,000 years. The longest hiatus in rockshelter occupation was between ~6,400 and 4,400 years ago and the deposition of botanical remains peaked at ~2,000 calendar years before present (cal BP). Tree fruits and squash appeared early in the occupational sequence (~11,000 cal BP) with most other field crops appearing later in time (e.g., maize at ~4,400 cal BP; beans at ~2,200 cal BP). The early focus on tree fruits and squash is consistent with early coevolutionary partnering with humans as seed dispersers in the wake of megafaunal extinction in Mesoamerica. Tree crops predominated through much of the Holocene, and there was an overall shift to field crops after 4,000 cal BP that was largely driven by increased reliance on maize farming.

Accuracy of Dengue, Chikungunya, and Zika diagnoses by primary healthcare physicians in Tegucigalpa, Honduras.

BACKGROUND: Dengue, Chikungunya, and Zika are co-endemic in Honduras and are often misdiagnosed due to similar clinical and epidemiological behavior. Most arboviral infections reported in primary care are based on clinical diagnoses without laboratory confirmation. Therefore, the accuracy of physicians' diagnoses and the factors that affect them needs to be evaluated. METHODS: A cross-sectional study with convenience sampling at primary healthcare centers was conducted from June to September 2016 and 2017. Clinical data and dried blood spots on Whatman 903 filter paper from 415 arboviral cases and 248 non-arboviral febrile cases were collected. Viral RNA was extracted from a 6-mm DBS paper disc and confirmed by RT-qPCR and sequencing. RESULTS: Only 30.84% of diagnostic accuracy was observed in physicians in primary care when comparing arboviral clinical diagnosis with RT-qPCR detection. Moreover, in Dengue and Zika clinical cases, only 8.23% and 27.08% were RT-qPCR confirmed, respectively. No Chikungunya cases were confirmed. In 2017, 20.96% of febrile cases were RT-qPCR confirmed arboviral infections. The symptoms of 45.5% of arboviral cases can fit more than one case definition for arboviruses. The "symptom compliance" and "patient with suspected close contact" were the criteria most utilized by physicians for arboviral diagnosis. The pattern of the epidemiological curves of the arboviral clinical cases didn't match the one of the RT-qPCR confirmed cases. CONCLUSIONS: Low diagnostic accuracy for overall and individual arboviral infections was observed in physicians. Unspecific symptomatology, overlapping case definitions, and reported close contact to an arboviral patient might contribute to misdiagnosis. Without laboratory confirmation, surveillance data may not reflect the real behavior of these diseases and could impact health interventions.

A Qualitative Assessment of Social Norms Related to Seeking Help for Intimate Partner Violence in Honduras.

Intimate partner violence (IPV) is a major public health issue in Honduras and other low- and middle-income countries, with few victims seeking help. While structural factors, such as lack of services and economic barriers, are often cited as reasons for not seeking help, social and cultural factors may also play a role. This study aims to describe the normative social environment that may hinder women's help-seeking behaviors for IPV. Thematic analysis was conducted on data from four focus group discussions with 30 women at a busy health center in urban Tegucigalpa, Honduras. Data were coded inductively and themes were identified deductively using the theory of normative social behavior and its components (descriptive and injunctive social norms, expected outcomes, and groups of reference). Four themes emerged: social norms and expected outcomes that discourage IPV help-seeking; factors that determine the direction of a social norm, either discouraging or encouraging help-seeking; groups of reference for IPV victims; and society sets women up for failure. Social norms, expected outcomes, and groups of reference hinder women's help-seeking behavior after IPV. These findings have significant implications for designing effective interventions and policies to support women and their families affected by IPV.

Trophic state resilience to hurricane disturbance of Lake Yojoa, Honduras.

Cyclones are a poorly described disturbance in tropical lakes, with the potential to alter ecosystems and compromise the services they provide. In November 2020, Hurricanes Eta and Iota made landfall near the Nicaragua-Honduras border, inundating the region with a large amount of late-season precipitation. To understand the impact of these storms on Lake Yojoa, Honduras, we compared 2020 and 2021 conditions using continuous (every 16 days) data collected from five pelagic locations. The storms resulted in increased Secchi depth and decreased algal abundance in December 2020, and January and February 2021, and lower-than-average accumulation of hypolimnetic nutrients from the onset of stratification (April 2021) until mixus in November 2021. Despite the reduced hypolimnetic nutrient concentrations, epilimnetic nutrient concentrations returned to (and in some cases exceeded) pre-hurricane levels following annual water column turnover in 2021. This response suggests that Lake Yojoa's trophic state had only an ephemeral response to the disturbance imposed by the two hurricanes, likely due to internal input of sediment derived nutrients. These aseasonal storms acted as a large-scale experiment that resulted in nutrient dilution and demonstrated the resilience of Lake Yojoa's trophic state to temporary nutrient reductions.

Can domestic dogs be considered a good reservoir of Leishmania (L.) infantum chagasi in an endemic area of nonulcerated cutaneous leishmaniasis in Southern Honduras?

Dogs are considered to be the main domestic reservoir associated with the transmission of Leishmania (L.) infantum chagasi to humans in endemic areas of visceral leishmaniasis in America. However, little is known about the role of canines as a source of infection in endemic areas of nonulcerated cutaneous leishmaniasis (NUCL). Therefore, the objective of the present study was to investigate the role of dogs as a possible reservoir of the parasite in Southern Honduras. Dogs (n = 107) living with individuals affected by NUCL were clinically examined and biological material was collected for parasitological and immunological diagnosis. Most animals showed a healthy appearance and a few presented slight weight loss (64%), alopecia (7%), onychogryphosis (5%) and skin lesions (1%). The overall seroprevalence of Leishmania infection based on the DDP ® quick test and/or in-house ELISA serological test was 41%. The presence of the parasite's DNA was confirmed in 94% of the dogs; however, the average parasite load in the buffy coat was low at 6.09 parasites/µL, ranging between 0.221 and 50.2. The skin of seropositive dogs examined by histopathology using paraffin sections stained by hematoxylin and immunohistochemistry did not show cutaneous lesions or parasite amastigotes. Based on the absence of parasites in the skin and the low parasite load detected in the buffy coat, it seems that the dog does not represent a good source of infection for the vector in the endemic area of NUCL transmission in Southern Honduras. Other domestic and/or wild animals should be investigated.

The Honduran diaspora and infectious diseases: An urgent need for action.

Recently, there has been a significant increase in irregular migration from Central America's northern triangle (Honduras, Guatemala and El Salvador). Hondurans who migrate to North America face numerous risks to their lives and health. Infectious diseases are one of the most serious threats to migrants both during the migration process and once they arrive in the host country. The major infectious diseases affecting both migrants and the health services in non-endemic countries that care for these migrants are discussed.