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Rev Assoc Med Bras (1992) ; 65(6): 914-921, 2019 Jul 22.
Artigo em Inglês | MEDLINE | ID: mdl-31340325


OBJECTIVE: The objective of this review was to investigate the epidemiology of Fulminant Acute Hepatitis in Latin America and the Caribbean and identify possible measures aimed at a better understanding and improvement of patient support. METHODS: We used 3 different researchers to investigate the topic of Fulminant Acute Hepatitis in pediatrics in papers published by Latin American and Caribbean authors in the PubMed and SciELO databases from 2000 to 2016. RESULTS: We found 2,879 articles in the databases searched. After selecting and excluding articles according to the study protocol, 68 remaining studies were obtained for analysis. A total of 1,265 cases of acute fulminant hepatitis were detected, with a predominance of females (42.9%), followed by males (39.4%), with no description of sex in 17.7% of the cases. The main cause was viral hepatitis, representing 45.1% of the cases. The hepatitis A virus was responsible for 34.7% of the total cases and 76.9% of the infectious causes. Of the total number of patients, 26.9% were described as idiopathic, and 11.5% had no cause. CONCLUSION: The preventable causes of Fulminant Acute Hepatitis include hepatitis viruses - primarily the hepatitis A virus - and poisoning. Active vaccination, basic sanitation, and public awareness can reduce the number of patients and, consequently, the costs of liver transplantation due to these causes.

Hepatite/epidemiologia , Falência Hepática Aguda/epidemiologia , Região do Caribe/epidemiologia , Feminino , Humanos , América Latina/epidemiologia , Masculino
Rev Lat Am Enfermagem ; 27: e3132, 2019 Jul 18.
Artigo em Português, Inglês, Espanhol | MEDLINE | ID: mdl-31340339


OBJECTIVE: this paper aims to describe the first phase of a project whose general goal was to develop a consensus-based set of advanced practice nurse competencies applicable to Latin American countries and, based on these competencies, produce an advanced practice nurse curricular prototype adapted to Latin American countries. The project was framed in a competency-based approach to advanced practice nursing education. The specific aims of the first phase of the project described in this paper were: 1) to identify a set of potential advanced practice nurse competencies that would serve as the template for Core Advanced Practice Nurse Competencies in Latin American countries and 2) to establish consensus for Core Advanced Practice Nurse Competencies in Latin American countries. METHOD: advanced practice nurse competencies were derived from a comprehensive review of published competencies and informed the development of a survey designed to assess the relevance of advanced practice nurse competencies in Latin American countries. The survey was distributed to nurse leaders and nurse educators. Data were analyzed using descriptive statistics. RESULTS: consensus for Core Competencies was established. CONCLUSION: the Core Advanced Practice Nurse Competencies presented can provide a structured framework to build educational programs aligned to the needs of the regional environment.

Prática Avançada de Enfermagem/normas , Competência Clínica/normas , Acesso aos Serviços de Saúde , Prática Avançada de Enfermagem/educação , Educação em Enfermagem/métodos , Humanos , América Latina , Padrões de Prática em Enfermagem/normas , Inquéritos e Questionários
Washington, D. C.; PAHO; 2019-07-15.
em Inglês | PAHO-IRIS | ID: phr-51366


[Foreword]. Early childhood development (ECD) – including the physical (or motor), communication, cognitive and social - emotional capacities – is indivisible from the child survival, health and education agendas and represents one of the important stages for breaking the intergenerational cycles of poverty and for promoting sustainable development. Development during the early years lays the critical foundations for health, learning and behaviour across the life course… Investment in early childhood programmes is essential because ECD programmes and interventions can provide a “good and fair start” to children and help to modify distressing socio-economic and gender-related inequities. There is strong evidence regarding interventions that can address the causal factors and reduce the burden of poor child development… The health sector in countries has the capacity to play a unique role in the field of ECD because the most important window of opportunity for ensuring optimal development and preventing risk of long-term damage is from pregnancy through the first five years of life – especially from birth to three years of age... For some countries, ECD is currently not systematically incorporated into initiatives to promote and protect maternal and child health. Moreover, families are often not prepared or aware of the critical role they can play in promoting cognitive and socio-emotional development in the early years. To address this gap, WHO, PAHO/WHO and UNICEF have collaborated closely to strengthen their advocacy and technical support to regions and countries and have extended partnership to national leaders and governments, development agencies, researchers, academics, non-governmental organizations, professional associations, media and advocacy groups. We have also developed the present evidence-based set of materials to help international staff, national governments and their partners promote Care for Child Development within all relevant programme activities of the health sector, with the emerging involvement of education, social protection, rehabilitation and other ECD partners.

Cuidado da Criança , Desenvolvimento Infantil , Saúde Pública , Setor de Assistência à Saúde , América Latina , Região do Caribe
Memorandum ; 36: 1-31, jun. 2019.
Artigo em Português | LILACS | ID: biblio-1007194


Neste estudo, objetivou-se analisar as representações sociais da história da América Latina para latino-americanos. Os dados foram coletados por meio de questionário online, contendo questões de evocação livre sobre acontecimentos e personalidades importantes na história latino-americana. Participaram do estudo 213 estudantes brasileiros, chilenos e mexicanos, com idades entre 18 e 35 anos. Seguindo orientação teórico-metodológica da análise estrutural da Teoria das Representações Sociais, os dados foram processados com o Programa EVOC. Os resultados indicaram que, para os participantes, os eventos mais centrais à memória social da América Latina são a colonização e as independências, enquanto as principais personalidades mencionadas foram Cristóvão Colombo e Simón Bolívar, em consonância com a dinâmica nuclear conquista/descobrimento, colonização e independências.Discute-se a articulação entre memória, identidade e representações sociais para a compreensão da forma como os grupos lidam com o seu passado, a partir do presente

In this study, the aim was to analyse social representations of the history of Latin America among Latin Americans. Data were collected through an online questionnaire, containing free-recall questions about important events and historical figures in Latin American history. A total of 213 Brazilian, Chilean and lexican students, aged 18 to 35 years old, participated in the study. Following the theoretical-methodological orientation of the structural approach of Social Representations Theory, data were processed with the EVOC software. The results indicated that, for the participants, the most central events to the social memory of Latin America are colonizationand independence, while the main historical figures mentioned were Christopher Columbus and Simón Bolívar, in line with the nuclear dynamics conquest/discovery, colonization and independence. The articulation between memory, identity and social representations is discussed in order to understand the way groups deal with their past, in the present

América Latina , Identificação Social , História
J Int Bioethique Ethique Sci ; 30(1): 95-115, 2019 05 28.
Artigo em Espanhol | MEDLINE | ID: mdl-31210528


The issue of equality in diversity and the recognition of the rights of homosexuals has been in recent years an intense and interesting point of debates, interrogations and mutations of the legal world. The case of Argentina is a typical example. On July 15, 2010, Argentina became the first country in Latin America to change its national legislation by the adoption of Law 26 618 to allow themarriage between people of the same sex.

Homossexualidade Feminina , Homossexualidade Masculina , Direitos Humanos , Legislação como Assunto , Casamento , Argentina , Feminino , Humanos , América Latina , Masculino
Rev Assoc Med Bras (1992) ; 65(5): 669-677, 2019 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-31166444


BACKGROUND: Epidemiological studies with dietary variables are complex methodologically, being the researcher responsible for anticipating, controlling, reducing and preventing methodological errors. Obesity accounts for almost one-third of the world's population and has consequences for childhood and adolescence. Multifactorial disorder must be faced in several aspects, being food and physical activity, modifiable risk factors. The EBANS aims to perform a diagnosis of the nutritional status of the Brazilian population from 15 to 65 years old, from all regions, and the parameters associated with obesity, with several possibilities of correlating data. METHODOLOGICAL PROCESS: Part of the ELANS study (n = 9218), the EBANS (n = 2000) has a weighted sample and data collection that allows: to evaluate the socioeconomic level of the population; perform a diagnosis of nutritional status (through anthropometric variables); to evaluate food intake (R24h and FFQ for beverages); and evaluate physical activity practice (IPAQ-long and accelerometer). METHODOLOGICAL OPPORTUNITIES: With national coverage, EBANS has the potential to compose regional analyzes, portray the current nutritional epidemiological condition, food consumption and physical activity pattern of the Brazilian population, at different life stages, and may have their data analyzed together or stratified, offering useful subsidies for the formulation of public policies. METHODOLOGICAL CHALLENGES: Each methodological step was designed to reduce errors and biases related to methodological challenges. CAAE REGISTRATION: 31670314.8.0000.5567. FINAL CONSIDERATIONS: Of great potential for future data analysis, EBANS tries to contribute to the generation of knowledge to foment policies and actions capable of changing the current obesity scenario.

Inquéritos Nutricionais/normas , Estado Nutricional , Adolescente , Adulto , Distribuição por Idade , Idoso , Antropometria , Brasil , Estudos Transversais , Exercício , Comportamento Alimentar , Feminino , Humanos , América Latina , Masculino , Pessoa de Meia-Idade , Inquéritos Nutricionais/métodos , Obesidade/prevenção & controle , Distribuição por Sexo , Fatores Socioeconômicos , Inquéritos e Questionários , Adulto Jovem
Value Health ; 22(6): 739-749, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31198192


BACKGROUND: Real-world evidence (RWE) is increasingly used to inform health technology assessments for resource allocation, which are valuable tools for emerging economies such as in America. Nevertheless, the characteristics and uses in South America are unknown. OBJECTIVES: To identify sources, characteristics, and uses of RWE in Argentina, Brazil, Colombia, and Chile, and evaluate the context-specific challenges. The implications for future regulation and responsible management of RWE in the region are also considered. METHODS: A systematic literature review, database mapping, and targeted gray literature search were conducted to identify the sources and characteristics of RWE. Findings were validated by key opinion leaders attending workshops in 4 South American countries. RESULTS: A database mapping exercise revealed 407 unique databases. Geographic scope, database type, population, and outcomes captured were reported. Characteristics of national health information systems show efforts to collect interoperable data from service providers, insurers, and government agencies, but that initiatives are hampered by fragmentation, lack of stewardship, and resources. In South America, RWE is mainly used for pharmacovigilance and as pure academic research, but less so for health technology assessment decision making or pricing negotiations and not at all to inform early access schemes. CONCLUSIONS: The quality of real-world data in the case study countries vary and RWE is not consistently used in healthcare decision making. Authors recommend that future studies monitor the impact of digitalization and the potential effects of access to RWE on the quality of patient care.

Tomada de Decisões , Prática Clínica Baseada em Evidências/normas , Prática Clínica Baseada em Evidências/tendências , Humanos , América Latina
BMC Public Health ; 19(1): 809, 2019 Jun 24.
Artigo em Inglês | MEDLINE | ID: mdl-31234866


BACKGROUND: Physical activity is a cornerstone in the prevention and treatment of obesity. There are relatively few studies that explore the effect of accelerometer-determined moderate-to-vigorous physical activity (MVPA) on neck circumference (NC), most of them confined to single high-income countries. The present study investigated the association of accelerometer-determined MVPA with NC in adolescents and adults from eight Latin American countries, which are mostly upper-middle income countries. METHODS: The sample consisted of 2370 participants (47.8% male) from the Latin American Study of Nutrition and Health, a multicenter cross-sectional nutrition and health surveillance study of a nationally representative sample from eight Latin American countries (Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Peru, and Venezuela). Times (min/day) in MVPA (defined as time accumulated at ≥1952 activity counts/min) was assessed by ActiGraph GT3X+ accelerometer over 7 days. NC for adolescent was categorized as abnormal if circumference was > 34.5 cm for boys and > 31.25 for girls, whereas for adults the cut-off points for abnormal were > 39 cm for men and > 35 cm women. Multilevel logistic models, including country and region as random effects and adjusted for sex, age, socioeconomic level, and educational level, were used to study the association between MVPA and NC. RESULTS: The average time of MVPA was 34.88 min/day, ranging from 31.16 in Venezuela to 40.27 in Chile. Concerning NC, 37.0% of the sample was classified as having elevated NC. Chile was the country with the highest percentage of people with elevated NC (56.9%), and Colombia had the lowest percentage (24.8%). Overall, the MVPA (min/day) was associated with elevated NC (OR = 0.994, CI95% = 0.990-0.998). In Costa Rica and Peru, there were significant associations between MVPA and NC when analyzed by country. CONCLUSIONS: The present study provided evidence of significant associations between MVPA and NC in adolescents and adults from Latin America, independent of sex, age, socioeconomic level, and educational level. This analysis of accelerometry data and NC represents the first examination of these associations in eight Latin America countries. Further research is required to understand the differences between countries in the observed associations. TRIAL REGISTRATION: ClinicalTrials.Gov NCT02226627 . Retrospectively registered on August 27, 2014.

Acelerometria/estatística & dados numéricos , Tamanho Corporal , Exercício , Pescoço/fisiopatologia , Vigilância da População , Adolescente , Adulto , Argentina/epidemiologia , Brasil/epidemiologia , Chile/epidemiologia , Colômbia/epidemiologia , Costa Rica/epidemiologia , Estudos Transversais , Equador/epidemiologia , Feminino , Humanos , América Latina , Masculino , Pessoa de Meia-Idade , Estado Nutricional , Obesidade/epidemiologia , Peru/epidemiologia , Venezuela/epidemiologia , Adulto Jovem
BMC Public Health ; 19(1): 826, 2019 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-31242875


BACKGROUND: Varicella is a highly contagious childhood disease. Generally benign, serious complications necessitating antibiotic use may occur. The objective of this study was to characterize the rate, appropriateness and patterns of real-world antibiotic prescribing for management of varicella-associated complications, prior to universal varicella vaccination (UVV) implementation. METHODS: Pooled, post-hoc analysis of 5 international, multicenter, retrospective chart reviews studies (Argentina, Hungary, Mexico, Peru, Poland). Inpatient and outpatient primary pediatric (1-14 years) varicella cases, diagnosed between 2009 and 2016, were eligible. Outcomes, assessed descriptively, included varicella-associated complications and antibiotic use. Three antibiotic prescribing scenarios were defined based on complication profile in chart: evidence of microbiologically confirmed bacterial infection (Scenario A); insufficient evidence confirming microbiological confirmation (Scenario B); no evidence of microbiological confirmation (Scenario C). Stratification was performed by patient status (inpatient vs. outpatient) and country. RESULTS: Four hundred one outpatients and 386 inpatients were included. Mean (SD) outpatient age was 3.6 (2.8) years; inpatient age was 3.1 (2.8) years. Male gender was predominant. Overall, 12.2% outpatients reported ≥1 infectious complication, 3.7% ≥1 bacterial infection, and 0.5% ≥1 microbiologically confirmed infection; inpatient complication rates were 78.8, 33.2 and 16.6%, respectively. Antibiotics were prescribed to 12.7% of outpatients and 68.9% of inpatients. Among users, ß-lactamases (class), and clindamycin (agent), dominated prescriptions. Scenario A was assigned to 3.9% (outpatients) vs 13.2% (inpatients); Scenario B: 2.0% vs. 6.0%; Scenario C: 94.1% vs. 80.8%. CONCLUSIONS: High rates of infectious complications and antibiotic use are reported, with low rates of microbiological confirmation suggesting possible antibiotic misuse for management of varicella complications.

Antibacterianos/uso terapêutico , Varicela/tratamento farmacológico , Assistência à Saúde/normas , Prescrições de Medicamentos/estatística & dados numéricos , Adolescente , Infecções Bacterianas/tratamento farmacológico , Infecções Bacterianas/microbiologia , Varicela/epidemiologia , Varicela/virologia , Criança , Pré-Escolar , Clindamicina/uso terapêutico , Europa (Continente)/epidemiologia , Feminino , Hospitalização , Humanos , Lactente , Pacientes Internados , América Latina/epidemiologia , Masculino , Pacientes Ambulatoriais , Estudos Retrospectivos , beta-Lactamases/uso terapêutico
Washington, D.C.; PAHO; 2019-06-17.
em Inglês | PAHO-IRIS | ID: phr-51094


[Introduction]. The rapid increase in the prevalence of overweight and obesity, diabetes, and associated chronic noncommunicable diseases (NCDs) in recent decades, threatens the health and well-being and also the economic prospects of all Latin American and the Caribbean countries, now and in the future. To address one crucial aspect of this crisis, in October 2014, the Member States of the Pan American Health Organization (PAHO) approved a five-year Plan of Action whose purpose is to halt a further increase in obesity in children and adolescents in the Americas. The plan calls for the implementation of fiscal policies, such as taxes on sugar-sweetened beverages and energy-dense nutrient-poor products, regulation of food marketing and labeling, improvement of school nutrition and physical activity environments, and promotion of breastfeeding and healthy eating. Its goal is to halt the rise of the epidemic so that there is no increase in current country prevalence rates of obesity... Ultra-processed products typically contain little or no whole foods. They are industrial formulations made mostly from substances extracted or derived from foods, plus additives. They include soft drinks and other sugar-sweetened juices and drinks, sweet and savory snacks, candies (confectionery), industrial breads, cakes, and cookies (biscuits), sweetened breakfast cereals, reconstituted meat products, and pre-prepared dishes. As well as sugars, oils, fats and salt, ultra-processed products include substances also derived from foods but not used in home cooking, such as hydrogenated oils, modified starches, protein isolates, and additives such as colors, flavors and flavor enhancers. Additives are used to imitate and enhance the sensory qualities of natural foods or to disguise unattractive qualities of the final product...

Obesidade , Saúde Pública , Consumo de Alimentos , Fast Foods , América Latina , Indústria de Bebidas Gaseificadas , Programas e Políticas de Nutrição e Alimentação , Planos e Programas de Saúde
Artigo em Inglês | PAHO-IRIS | ID: phr-50991


[ABSTRACT]. Objectives. Gender continues to be largely neglected in the global response to the noncommunicable dis-ease epidemic. The objectives of this study were to examine current practice and barriers faced by Latin American and Caribbean (LAC) researchers in addressing gender in research on healthy food environments, and to identify future topics for gender-sensitive and gender-transformative research. Methods. This study involved: 1) a descriptive, three-part survey to investigate to what extent LAC researchers are integrating gender considerations in research for healthier food environments and 2) a participatory workshop to coproduce ideas for future gender-sensitive and gender-transformative research. Results. Fifty-four participants, from 19 countries, attended the workshop. Of those 54, 41 of them responded to at least one section of the three-part survey, including with 26 of the 41 responding to the section on gender. Of these 26, 17 (65.4%) had collected sex-disaggregated data and 14 (53.8%) had conducted gender anal-ysis in recent research on food environments. Few participants had integrated gender-related findings in their recommendations and solutions. Challenges included data and methodological limitations (e.g., lack of preex-isting evidence, working with secondary data), knowledge and capacity gaps, subject sensitivity, and biases. Participants identified research topics for enhancing gender equity that included food preparation norms and domestic responsibilities; differential participation of women and men in food production, distribution, and retail; and employment and school policies. Conclusions. The findings from this study suggest that gender inequity is not being well addressed in food environment research from the LAC region. The analytical framework presented here can serve as an important starting point and resource for catalyzing future gender-transformative research. Complementary efforts are needed to overcome other challenges raised by the participating researchers, including capacity gaps, resource and data limitations, and publishing barriers.

[RESUMEN]. Objetivos. La perspectiva de género se sigue descuidando en gran medida en la respuesta mundial a la epidemia de las enfermedades no transmisibles. Los objetivos de este estudio fueron examinar el procedimiento actual y los obstáculos a los que se enfrentan los investigadores de América Latina y el Caribe al abordar la perspectiva de género en investigaciones sobre entornos propicios a la alimentación saludable y determinar los temas para futuras investigaciones que estén atentas a los temas de género y sean transformadoras de las cuestiones de género. Métodos. Este estudio incluyó: 1) una encuesta descriptiva en tres partes para conocer hasta qué punto los investigadores de America Latina y el Caribe están integrando las consideraciones de género en la investigación de entornos alimentarios más saludables y 2) un taller participativo de coprodución de ideas para futuras investigaciones sensibles al género y transformadoras de género. Resultados. Asistieron al taller 54 participantes de 19 países. De esos 54, 41 de ellos respondieron al menos una de las secciones de la encuesta en tres partes, y 26 de los 41 respondieron a la sección sobre género. De estos 26, 17 (65,4 %) habían recopilado datos desglosados por sexo y 14 (53,8 %) habían realizado análisis de cuestiones de género en investigaciones recientes sobre los entornos de la alimentación. Pocos participantes habían incorporado resultados en materia de género en sus recomendaciones y soluciones. Algunos desafíos habían sido las limitaciones de los datos y la metodología (por ejemplo, falta de evidencia previa, trabajar con datos secundarios), falta de conocimiento y capacitación, sensibilidad de las personas y sesgos. Los participantes señalaron temas de investigación para mejorar la equidad de género, como normas de preparación de alimentos y responsabilidades domésticas; la participación diferenciada de hombres y mujeres en la producción, distribución y venta al por menor de alimentos; y el empleo y las políticas escolares. Conclusiones. Los resultados de este estudio indican que la inequidad de género no se está abordando adecuadamente en la investigación sobre el entorno de la alimentación en América Latina y el Caribe. El marco analítico que se presenta aquí puede servir como un importante punto de partida y como recurso para catalizar investigaciones futuras transformadoras de las cuestiones de género. Se necesitan esfuerzos complementarios para superar otros desafíos que plantean los investigadores participantes, como la falta de capacitación, las limitaciones de los recursos y datos, y los obstáculos para la publicación.

[RESUMO]. não transmissíveis. Este estudo teve por objetivo examinar a conduta e as barreiras atualmente enfrentadas pelos pesquisadores da América Latina e Caribe (ALC) ao comtemplar o gênero em pesquisas sobre ambiente alimentar saudável e identificar tópicos para futuras pesquisas sensíveis ao gênero e transformativas de gênero. Métodos. Este estudo envolveu: 1) uma pesquisa descritiva em três partes para investigar em que medida os pesquisadores da LAC estão integrando considerações de gênero na pesquisa para ambientes alimentares mais saudáveis e 2) um workshop participativo para co-produzir ideias para pesquisas futuras sensíveis a gênero e transformadoras de gênero. Resultados. O seminário contou com 54 participantes provenientes de 19 países. Do número total de participantes, 41 responderam ao menos uma das três partes da pesquisa, sendo que 26 responderam a parte sobre gênero. Dentre estes, 17 (65,4%) haviam conduzido coleta de dados desagregados por sexo e 14 (53,8%) haviam realizado análise de gênero em pesquisas recentes sobre o ambiente alimentar. Um pequeno número informou ter incluído os achados relativos ao gênero em recomendações e soluções. As dificuldades encontradas pelos participantes foram limitação metodológica e de dados (como a falta de evidências preexistentes e o uso de dados secundários), lacunas de conhecimento e capacidade, sensibilidade do assunto e vieses. Os tópicos de pesquisa identificados para melhorar a equidade de gênero foram normas para o preparo dos alimentos e responsabilidades domésticas, participação diferencial de homens e mulheres na produção, distribuição e comércio a varejo de alimentos e políticas escolares e de trabalho. Conclusões. O estudo indicou que a iniquidade de gênero não está sendo devidamente contemplada em pesquisas sobre ambiente alimentar na região da ALC. A estrutura analítica aqui exposta pode servir como um importante ponto de partida e recurso para incentivar futuras pesquisas transformativas de gênero. Outros esforços são necessários para vencer os desafios mencionados pelos pesquisadores que participaram do estudo, como lacunas de capacidade, limitação de dados e recursos e barreiras à publicação dos trabalhos.

Alimentos , Saúde Pública , Doenças não Transmissíveis , Saúde da Mulher , Equidade , América Latina , Região do Caribe , Nutrição em Saúde Pública , Alimentos , Nutrição em Saúde Pública , Doenças não Transmissíveis , Saúde da Mulher , Equidade , América Latina , Região do Caribe , Nutrição em Saúde Pública , Doenças não Transmissíveis , Saúde da Mulher , Equidade , Região do Caribe
Artigo em Espanhol | PAHO-IRIS | ID: phr-50989


[RESUMEN]. Objetivos. Conocer la disponibilidad de los sistemas nacionales de vigilancia de anomalías congénitas en América Latina y el Caribe y describir sus características. Métodos. Estudio transversal mediante una encuesta semiestructurada y autoadministrada en línea remitida en el 2017 por las representaciones locales de la Organización Panamericana de la Salud a las autoridades de los ministerios de salud de todos los países de América Latina y el Caribe. La encuesta recabó información sobre la disponibilidad de un sistema nacional de vigilancia de anomalías congénitas en el país y sus características. Resultados. Once países cuentan con sistema nacional de vigilancia de anomalías congénitas: Argentina, Colombia, Costa Rica, Cuba, Guatemala, México, Panamá, Paraguay, República Dominicana, Uruguay y Venezuela. Los sistemas tienen características heterogéneas: 6 son sistemas de base hospitalaria; 10 incluyen en su definición de caso los nacidos vivos y los fetos muertos. En todos los sistemas de vigilancia se incluyen los casos con anomalías mayores y menores, excepto en Argentina, Colombia y Guatemala que solo registran anomalías congénitas mayores. Solo Argentina, Costa Rica y Uruguay elaboran informes periódicos que consolidan y presentan los resultados de la vigilancia; los registros de Argentina y Costa Rica disponen de manuales operativos. Conclusiones. Se comprobó la aún escasa disponibilidad de sistemas nacionales de vigilancia de anomalías congénitas en América Latina y el Caribe y su elevada heterogeneidad. Es prioritario avanzar hacia la expansión y el fortalecimiento de este tipo de vigilancia en nuestros países.

[ABSTRACT]. Objectives. To determine the availability of national systems for surveillance of birth defects in Latin America and the Caribbean and describe their characteristics. Methods. Cross-sectional study based on a semi-structured, self-administered online survey sent in 2017 by local representative offices of the Pan American Health Organization to authorities at the ministries of health of all countries in Latin America and the Caribbean. The survey obtained information on the availability and characteristics of national systems for surveillance of birth defects in each country. Results. Eleven countries have a national system for surveillance of birth defects: Argentina, Colombia, Costa Rica, Cuba, Dominican Republic, Guatemala, Mexico, Panama, Paraguay, Uruguay, and Venezuela. These systems have heterogeneous features: six are hospital-based; 10 include both live births and stillbirths in their case definition. All the surveillance systems include cases with severe and minor defects, except in Argentina, Colombia, and Guatemala, where only severe birth defects are recorded. Only Argentina, Costa Rica, and Uruguay prepare periodic reports that consolidate and present the results of surveillance. The registries in Argentina and Costa Rica have operational manuals. Conclusions. The availability of national systems for surveillance of birth defects remains limited and highly heterogeneous in Latin America and the Caribbean. Priority should be given to continued expansion and strengthening of this type of surveillance in these countries.

[RESUMO]. Objetivos. Conhecer a existência de sistemas nacionais de vigilância de anomalias congênitas na América Latina e Caribe e descrever as características destes sistemas. Métodos. Estudo transversal realizado por meio de uma pesquisa online com uso de questionário semiestruturado e autoaplicado enviado no 2017 pelas representações locais da Organização Pan-Americana da Saúde (OPAS) às autoridades dos ministérios da Saúde em todos os países da América Latina e Caribe. Foram coletados dados sobre a existência de sistema nacional de vigilância de anomalias congênitas e as características destes sistemas. Resultados. Onze países possuem um sistema nacional de vigilância de anomalias congênitas: Argentina, Colômbia, Costa Rica, Cuba, Guatemala, México, Panamá, Paraguai, República Dominicana, Uruguai e Venezuela. Os sistemas são de natureza heterogênea, seis são baseados em registros hospitalares e 10 incluem nascidos vivos e morte fetal na definição de caso. A maioria dos sistemas de vigilância abrange casos de anomalias congênitas maiores e menores, exceto na Argentina, Colômbia e Guatemala em que são registradas apenas as anomalias congênitas maiores. A Argentina, Costa Rica e Uruguai são os únicos países que apresentam relatórios periódicos reunindo os achados da vigilância e a Argentina e Costa Rica possuem manuais operacionais para o registro. Conclusões. Verificou-se que, na América Latina e no Caribe, os sistemas nacionais de vigilância de anomalias congênitas são ainda em um pequeno número e bastante heterogêneos. É uma prioridade expandir e reforçar esta forma de vigilância nos países da região.

Anormalidades Congênitas , Serviços de Vigilância Epidemiológica , América Latina , Região do Caribe , Anormalidades Congênitas , Serviços de Vigilância Epidemiológica , América Latina , Região do Caribe , Anormalidades Congênitas , Serviços de Vigilância Epidemiológica , Região do Caribe
HNO ; 67(7): 515-518, 2019 Jul.
Artigo em Alemão | MEDLINE | ID: mdl-31197423


Nowadays, social projects are usually oriented in such a way that after a given period of time, they can either support themselves independently or even allow a pecuniary reimbursement. In the latter case, experts speak of a profit-oriented reimbursement. On the other hand, there is so-called social reimbursement, which in contrast to the abovementioned form is not profit oriented, but, for example, considers its task fulfilled by the fact of successful knowledge transfer. The Spanish-German Society for ENT Medicine and Head and Neck Surgery (SDGHNO) launched the Latin America project in 2001 under the patronage of the then President Prof. Dr. Wolfgang Draf (Fulda). The goal of the SDGHNO was and is to create a professional as well as cultural platform for Spanish- and German-speaking ENT doctors. This platform can and should be used for professional purposes, e.g., for knowledge transfer. Since the beginning of its existence, the Latin America project has thus brought numerous scientific events into being and created specific contacts which have lasted until today or have even been continued and further developed. Particularly successful examples are Chile, Colombia, and Peru. This is a vivid example of social reimbursement, because the participating German-speaking members/speakers carried out their tasks on an entirely voluntary basis. Thus, the SDGHNO did not bear any travel, catering, or accommodation costs. The activities of the SDGHNO within the framework of the Latin America project are explained.

Otolaringologia , América Latina , Condições Sociais
J Bras Pneumol ; 45(2): e20180420, 2019 Apr 25.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31038653


OBJECTIVE: Most studies of tuberculosis originate from high-income countries with a low incidence of tuberculosis. A review of the scientific production on tuberculosis in Latin American countries, most of which are low- or middle-income countries (some with high or intermediate tuberculosis incidence rates), would improve the understanding of public health challenges, clinical needs, and research priorities. The aims of this systematic review were to determine what has been published recently in Latin America, to identify the leading authors involved, and to quantify the impact of international collaborations. METHODS: We used PubMed to identify relevant manuscripts on pulmonary tuberculosis (PTB), drug-resistant tuberculosis (DR-TB), or multidrug-resistant tuberculosis (MDR-TB), published between 2013 and 2018. We selected only studies conducted in countries with an annual tuberculosis incidence of ≥ 10,000 reported cases and an annual MDR-TB incidence of ≥ 300 estimated cases, including Brazil, Peru, Mexico, Colombia, and Argentina. Articles were stratified by country, type, and topic. RESULTS: We identified as eligible 395 studies on PTB and 188 studies on DR/MDR-TB-of which 96.4% and 96.8%, respectively, were original studies; 35.5% and 32.4%, respectively, had an epidemiological focus; and 52.7% and 36.2%, respectively, were conducted in Brazil. The recent Latin American Thoracic Association/European Respiratory Society/Brazilian Thoracic Association collaborative project boosted the production of high-quality articles on PTB and DR/MDR-TB in Latin America. CONCLUSIONS: Most of the recent Latin American studies on tuberculosis were conducted in Brazil, Mexico, or Peru. Collaboration among medical societies facilitates the production of scientific papers on tuberculosis. Such initiatives are in support of the World Health Organization call for intensified research and innovation in tuberculosis.

Cooperação Internacional , Publicações Periódicas como Assunto/estatística & dados numéricos , Editoração/estatística & dados numéricos , Sociedades Médicas/estatística & dados numéricos , Tuberculose , Pesquisa Biomédica/estatística & dados numéricos , América Latina , Fatores de Tempo
BMC Public Health ; 19(1): 528, 2019 May 08.
Artigo em Inglês | MEDLINE | ID: mdl-31068173


BACKGROUND: Varicella is typically mild and self-limiting, but can be associated with complications and even death. The limited data available on varicella in Latin America and the Caribbean (LAC) indicate substantial burden in countries where varicella vaccine is not part of publicly funded childhood national immunization programs. METHODS: A systematic literature review of published studies was complemented by "gray" literature on varicella incidence, complications, mortality, and economic consequences, in the absence and presence of universal varicella vaccination (UVV) in LAC. RESULTS: Seroprevalence data indicate that varicella is usually a disease of childhood in LAC. Varicella incidence rates, while unreliable in the absence of mandatory reporting, show a trend to increased incidence due to greater urbanization and population density. The introduction of UVV in national immunization programs has led to significant reductions in varicella incidence in these areas. CONCLUSIONS: Varicella continues to pose a substantial healthcare burden in LAC. The future introduction of UVV in additional countries is predicted to provide substantial reductions in cases, with important economic benefits. For countries that have already implemented UVV, the challenge is to maintain high rates of coverage and, where relevant, consider inclusion of a second dose to reduce breakthrough cases. Given the significant proportion of the region now implementing UVV, a regional recommendation in order to prevent any potential for age-shifts in varicella infection might be considered.

Vacina contra Varicela/administração & dosagem , Varicela/epidemiologia , Efeitos Psicossociais da Doença , Vacinação/estatística & dados numéricos , Região do Caribe/epidemiologia , Varicela/prevenção & controle , Criança , Pré-Escolar , Grupos Étnicos , Feminino , Humanos , Programas de Imunização/estatística & dados numéricos , Incidência , América Latina/epidemiologia , Notificação de Abuso , Estudos Soroepidemiológicos , Resultado do Tratamento
BMC Public Health ; 19(1): 530, 2019 May 09.
Artigo em Inglês | MEDLINE | ID: mdl-31072386


BACKGROUND: The recent Zika virus (ZIKAV) epidemics disclosed a major public health threat and a scientific and technological (S&T) challenge. The lessons learned from the S&T response of Latin America and the Caribbean (LAC) countries are critical to inform further research and guide scientific investments. The present study aimed to assess how new S&T knowledge produced and disseminated regionally can contribute to address global health challenges. METHODS: Scientometric and social network analysis methods were used to assess the LAC scientific contribution and potential technological development on ZIKAV up to December 2017. ZIKAV-related publications were retrieved from the Web of Science, Scopus, and PubMed databases. Regionally published articles were obtained from SciELO (Scientific Electronic Library Online) and LILACS (Literature in the Health Sciences in Latin America and the Caribbean) databases. Patent registries were retrieved using Orbit Intelligence and Derwent Innovation. Records from each database were individually downloaded, integrated, standardized and analyzed. RESULTS: We retrieved 5421 ZIKAV-related publications, revealing a sharp increase from 2015 onwards. LAC countries accounted for 20% of all publications and Brazil was among the top three most central countries in the global network for ZIKAV research. A total of 274 patent families backed up by experimental evidence were retrieved. Only 5% were filed by LAC assignees, all of them based in Brazil. The largest contribution of LAC research was on the clinical manifestations of the ZIKAV infection, along with vector control, which was also the main focus of patents. CONCLUSIONS: Our analysis offered a comprehensive overview of ZIKAV's research and development and showed that (i) LAC countries had a key role in generating and disseminating scientific knowledge on ZIKAV; (ii) LAC countries have expressively contributed to research on ZIKAV clinical manifestations; (iii) the Brazilian scientific community was potentially very effective in knowledge sharing and diffusion in the ZIKAV research network; (iv) Brazil was the single LAC country filing patents, mostly represented by independent inventors and low-tech patents. The paper advocates the need for a continued interdisciplinary approach to improve LAC countries ability to prevent, prepare for and control future outbreaks.

Pesquisa Biomédica/tendências , Epidemias/estatística & dados numéricos , Infecção por Zika virus/epidemiologia , Zika virus , Brasil , Região do Caribe/epidemiologia , Surtos de Doenças , Saúde Global , Humanos , América Latina/epidemiologia , Saúde Pública/tendências , Fatores Socioeconômicos , Infecção por Zika virus/prevenção & controle
Rev Saude Publica ; 53: 37, 2019.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31066815


We will analyze and comment on the book Health Diplomacy and Global Health: Latin American Perspectives, edited by Paulo Marchiori Buss and Sebastián Tobar and published by Editora Fiocruz. Throughout its 653 pages, the book brings prominent national and foreign authors in the field of Health Diplomacy and Global Health, depicting a decade in which Brazil had great international protagonism in the field of Public Health, especially in South-South cooperation, in an innovative and structuring manner. Furthermore, the chapters present theoretical aspects and basic principles of Global Health as a new field of knowledge, in which the country has been developing and sharing scientific production with a Latin American perspective, focused on the pursuit of equity and health for all peoples of the world.

Resenhas de Livros como Assunto , Diplomacia/tendências , Saúde Global/tendências , Brasil , Humanos , América Latina