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1.
Buenos Aires; OPS; 2020-09-08. (OPS/ARG/20-0002).
em Espanhol | PAHO-IRIS | ID: phr2-52639

RESUMO

El proyecto Hacia la Salud Universal de la Población del Gran Chaco Suramericano 2016-2019 involucró a cuatro países: Argentina, Estado Plurinacional de Bolivia (Bolivia), Brasil y Paraguay. Se implementó en municipios muy cercanos al corredor fronterizo entre Argentina, Bolivia y Paraguay, durante 2016-2019, con la cooperación técnica de la Organización Panamericana de la Salud (OPS). El presente informe describe las líneas de acción en Argentina y profundiza sobre los resultados de implementación del proyecto en el área materno-infantil. En el área seleccionada, Chaco salteño, se brindó cooperación técnica al Ministerio de Salud Pública provincial a fin de promover acciones para la reducción de la mortalidad materno-infantil, el fortalecimiento de redes y servicios de salud integrados e integrales, el abordaje de determinantes ambientales como agua y saneamiento, la gestión de riesgos, el fortalecimiento de la vigilancia epidemiológica y los sistemas de información para la toma de decisiones oportunas.


Assuntos
Saúde Materno-Infantil , Argentina , Paraguai , Bolívia , Brasil , Assistência de Saúde Universal
2.
Artigo em Espanhol | PAHO-IRIS | ID: phr-52617

RESUMO

[RESUMEN]. Objetivo. Describir el comportamiento y las desigualdades sociales en indicadores priorizados del Objetivo de Desarrollo Sostenible 3 (ODS-3) entre subpoblaciones y departamentos de Bolivia. Métodos. Se realizó un análisis del comportamiento de indicadores seleccionados del ODS-3 en el tiempo. Además, se llevó a cabo un estudio de desigualdades sociales en estos indicadores para estratificadores de equidad seleccionados. Se obtuvieron las medidas simples (brecha absoluta y brecha relativa) y las medidas complejas (índice de desigualdad de la pendiente e índice de concentración) para explorar la magnitud de las desigualdades sociales. Resultados. Los indicadores del ODS-3 que han tenido un aumento importante a nivel nacional y departamental son la prevalencia de cuatro controles prenatales y la prevalencia de parto atendido por personal de salud calificado. Las desigualdades sociales en estos indicadores han disminuido de manera significativa en el tiempo. La prevalencia de embarazo en adolescentes y sus desigualdades sociales se han mantenido sin mayores cambios, aunque con desigualdades bajas. La prevalencia de uso de métodos anticonceptivos modernos ha disminuido en forma leve, aunque la desigualdad social ha tenido una disminución más rápida. La razón de muerte materna ha disminuido a nivel nacional y en la mayoría de los departamentos, pero aún se requiere atacar la desigualdad social en este indicador. Conclusiones. Los promedios nacionales ocultan diferencias entre las subpoblaciones y los departamentos de Bolivia. Los hallazgos muestran que se ha mejorado en el comportamiento y desigualdad social de algunos indicadores del ODS-3, pero que en otros se deben fortalecer las intervenciones por diferentes actores para disminuir las desigualdades sociales en salud.


[ABSTRACT]. Objective. To describe the behavior and social inequalities in prioritized indicators of Sustainable Development Goal 3 (ODS-3) among subpopulations and departments of Bolivia. Methods. An analysis of the behavior of selected ODS-3 indicators over time was conducted. In addition, a study of social inequalities in these indicators was carried out for selected equity stratifiers. Simple measures (absolute gap and relative gap) and complex measures (slope inequality index and concentration index) were obtained to explore the magnitude of social inequalities. Results. The ODS-3 indicators that have increased significantly at the national and departmental levels are the prevalence of four prenatal controls and the prevalence of births attended by qualified health personnel. Social inequalities in these indicators have decreased significantly over time. The prevalence of adolescent pregnancy and its social inequalities have remained unchanged, although with low inequalities. The prevalence of modern contraceptive methods use has decreased slightly, although social inequality has declined more rapidly. The maternal mortality rate has decreased nationally and in most departments, but social inequality on this indicator still needs to be addressed. Conclusions. National averages hide differences between subpopulations and departments in Bolivia. The findings show that the behavior and social inequality of some ODS-3 indicators have improved, but regarding other indicators interventions by different stakeholders must be strengthened to reduce social inequalities in health.


Assuntos
Desenvolvimento Sustentável , Fatores Socioeconômicos , Bolívia , Desenvolvimento Sustentável , Fatores Socioeconômicos
3.
Washington, D.C.; PAHO; 2020-08-05. (PAHO/FPL/IM/COVID-19/20-0013).
Não convencional em Inglês | PAHO-IRIS | ID: phr-52544

RESUMO

Both the World Health Organization (WHO) and the Pan American Health Organization (PAHO) have recommended that uninterrupted vaccination be maintained as an essential health service. To this end, PAHO's Comprehensive Family Immunization Unit of the Family, Health Promotion, and Life Course Department has worked assiduously with the countries of the Region to maintain sound national immunization programs on several fronts, such as the preparation of documents and guidelines for continuing vaccination in the context of COVID-19; monitoring the disease’s impact on vaccination coverage; assessing the effects of the postponement of measles vaccination campaigns (Plurinational State of Bolivia, Colombia, Dominican Republic, Honduras, Paraguay) due to the pandemic; and strengthening vaccination against seasonal influenza. The data presented in this publication were collected through a survey, sent every two weeks to IM focal points and advisors in the at PAHO country offices in the Region. The SurveyMonkey virtual platform was used and the data were analyzed with MS Excel tools. All the variables included in the survey were described using the appropriate univariate statistics. Categorical variables were described using proportions and percentages. Ordinal variables were described using the mean and median. Work has also been carried out to monitor the functioning of immunization services and the main problems they face because of the pandemic. To date, five-country surveys have been conducted; the first was sent out on 16 April, the last on 6 July. This document summarizes the surveys' main findings and developments. The responses in this report represent the opinions of survey participants, and do not represent reports officially sent or solicited by PAHO; the data should, therefore, be interpreted with caution.


Assuntos
Coronavirus , Infecções por Coronavirus , Imunização , Cobertura Vacinal , Prioridades em Saúde , Serviços de Saúde , Bolívia , Colômbia , República Dominicana , Honduras , Paraguai
4.
J Appl Physiol (1985) ; 129(2): 257-262, 2020 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-32702272

RESUMO

The emergence of COVID-19 infection (caused by the SARS-CoV-2 virus) in Wuhan, China in the latter part of 2019 has, within a relatively short time, led to a global pandemic. Amidst the initial spread of SARS-CoV-2 across Asia, an epidemiologic trend emerged in relation to high altitude (HA) populations. Compared with the rest of Asia, SARS-CoV-2 exhibited attenuated rates of expansion with limited COVID-19 infection severity along the Tibetan plateau. These characteristics were soon evident in additional HA regions across Bolivia, central Ecuador, Nepal, Bhutan, and the Sichuan province of mainland China. This mini-review presents a discussion surrounding attributes of the HA environment, aspects of HA physiology, as well as, genetic variations among HA populations which may provide clues for this pattern of SARS-CoV-2 expansion and COVID-19 infection severity. Explanations are provided in the hypothetical, albeit relevant historical evidence is provided to create a foundation for future research.


Assuntos
Altitude , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Pandemias , Pneumonia Viral/epidemiologia , Bolívia/epidemiologia , China/epidemiologia , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/metabolismo , Humanos , Nepal/epidemiologia , Pandemias/estatística & dados numéricos , Peptidil Dipeptidase A/metabolismo , Pneumonia Viral/diagnóstico , Pneumonia Viral/metabolismo
5.
Nat Commun ; 11(1): 3772, 2020 07 29.
Artigo em Inglês | MEDLINE | ID: mdl-32728114

RESUMO

Selective and neutral forces shape human microbiota assembly in early life. The Tsimane are an indigenous Bolivian population with infant care-associated behaviors predicted to increase mother-infant microbial dispersal. Here, we characterize microbial community assembly in 47 infant-mother pairs from six Tsimane villages, using 16S rRNA gene amplicon sequencing of longitudinal stool and tongue swab samples. We find that infant consumption of dairy products, vegetables, and chicha (a fermented drink inoculated with oral microbes) is associated with stool microbiota composition. In stool and tongue samples, microbes shared between mothers and infants are more abundant than non-shared microbes. Using a neutral model of community assembly, we find that neutral processes alone explain the prevalence of 79% of infant-colonizing microbes, but explain microbial prevalence less well in adults from river villages with more regular access to markets. Our results underscore the importance of neutral forces during microbiota assembly. Changing lifestyle factors may alter traditional modes of microbiota assembly by decreasing the role of neutral processes.


Assuntos
Horticultura , Povos Indígenas , Microbiota , Adolescente , Adulto , Bolívia , Criança , Pré-Escolar , DNA Bacteriano/isolamento & purificação , Fezes/microbiologia , Feminino , Humanos , Lactente , Recém-Nascido , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Filogenia , RNA Ribossômico 16S/genética , Língua/microbiologia , Adulto Jovem
6.
Infez Med ; 28(2): 238-242, 2020 Jun 01.
Artigo em Inglês | MEDLINE | ID: covidwho-528245

RESUMO

The present study is aimed to assess the risk factors for mortality in the first 107 rRT-PCR confirmed cases of SARS-CoV-2 infections in Bolivia. For this observational, retrospective and cross-sectional study, the epidemiological data records were collected from the Hospitals and the Ministry of Health of Bolivia, obtaining the clinical and epidemiological data of the COVID-19 cases that were laboratory-diagnosed during March 2-29, 2020. Samples were tested by rRT-PCR to SARS-CoV-2 at the Laboratory of the National Center of Tropical Diseases (CENETROP), following the protocol Charite, Berlin, Germany. The odds ratio (OR) with respective 95% confidence interval (95%CI) for mortality as dependent variable was calculated. When we comparatively analyzed survivors and non-survivors in this first group of 107 cases in Bolivia, we found that at bivariate analyses, age (±60 years old), hypertension, chronic heart failure, diabetes, and obesity, as well as the requirement of ICU, were significantly exposure variables associated with death. At the multivariate analysis (logistic regression), two variables remained significantly associated, age, ±60 years-old (OR=9.4, 95%CI 1.8-104.1) and hypertension (OR=3.3, 95%CI 1.3-6.3). As expected, age and comorbidities, particularly hypertension, were independent risk factors for mortality in Bolivia in the first 107 cases group. More further studies are required to better define risk factors and preventive measures related to COVID-19 in this and other Latin American countries.


Assuntos
Betacoronavirus , Infecções por Coronavirus/mortalidade , Pneumonia Viral/mortalidade , Adolescente , Adulto , Distribuição por Idade , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Bolívia/epidemiologia , Criança , Intervalos de Confiança , Infecções por Coronavirus/epidemiologia , Estudos Transversais , Complicações do Diabetes/mortalidade , Feminino , Insuficiência Cardíaca/mortalidade , Humanos , Hipertensão/mortalidade , Masculino , Pessoa de Meia-Idade , Obesidade/mortalidade , Razão de Chances , Pandemias , Pneumonia Viral/epidemiologia , Análise de Regressão , Estudos Retrospectivos , Fatores de Risco , Distribuição por Sexo , Adulto Jovem
7.
Artigo em Inglês | MEDLINE | ID: mdl-32578725

RESUMO

In this study which is part of a research project on Chagas disease (CD) among Bolivian immigrants in Sao Paulo, we describe socioeconomic characteristics, knowledge of CD and implications for acess to health care. We applied a structured questionnaire to a sample of 472 Bolivian adults (> 18 years) living in Sao Paulo and enrolled at the Barra Funda School Health Center. Participants' median age was 28.5 years, 75.0% were from the Bolivian department of La Paz, and >90% worked in the garment industry. Respondents had lived in Sao Paulo for a median of 5.8 years. Only 169 (35.8%) were familiar with CD, while roughly half (50.4%) had lived in natural materials houses in Bolivia, 225 (47.7%) indicated familiarity with the vector, 23.9% had seen the vector in their homes in Bolivia, and 6.4% reported having been bitten by a triatomine bug. Factors associated with awareness of CD were analyzed by chi square tests, and those with p values <0.25 were included in a multivariable logistic regression model. In the multivariable logistic regression analysis, having a relative with CD (OR=4.3, 95% CI=1.5-12.0), having lived in a house with mud or wood walls (OR=0.4, 95% CI=0.2-0.8), and having heard of the triatomine bug, or vinchuca, (OR=10.0, 95% CI=5.1-19.5) were significantly associated with awareness of CD. This study shows a low familiarity with CD among Bolivian migrants living in Sao Paulo, Brazil. Raising awareness of the disease through specific communication strategies should be an essential component of public health programs to reduce the burden of CD in this and other vulnerable populations.


Assuntos
Doença de Chagas , Emigrantes e Imigrantes/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Adolescente , Adulto , Bolívia/etnologia , Brasil , Estudos Transversais , Feminino , Humanos , Masculino , Fatores Socioeconômicos , Inquéritos e Questionários , Adulto Jovem
8.
Infez Med ; 28(2): 238-242, 2020 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-32487789

RESUMO

The present study is aimed to assess the risk factors for mortality in the first 107 rRT-PCR confirmed cases of SARS-CoV-2 infections in Bolivia. For this observational, retrospective and cross-sectional study, the epidemiological data records were collected from the Hospitals and the Ministry of Health of Bolivia, obtaining the clinical and epidemiological data of the COVID-19 cases that were laboratory-diagnosed during March 2-29, 2020. Samples were tested by rRT-PCR to SARS-CoV-2 at the Laboratory of the National Center of Tropical Diseases (CENETROP), following the protocol Charite, Berlin, Germany. The odds ratio (OR) with respective 95% confidence interval (95%CI) for mortality as dependent variable was calculated. When we comparatively analyzed survivors and non-survivors in this first group of 107 cases in Bolivia, we found that at bivariate analyses, age (±60 years old), hypertension, chronic heart failure, diabetes, and obesity, as well as the requirement of ICU, were significantly exposure variables associated with death. At the multivariate analysis (logistic regression), two variables remained significantly associated, age, ±60 years-old (OR=9.4, 95%CI 1.8-104.1) and hypertension (OR=3.3, 95%CI 1.3-6.3). As expected, age and comorbidities, particularly hypertension, were independent risk factors for mortality in Bolivia in the first 107 cases group. More further studies are required to better define risk factors and preventive measures related to COVID-19 in this and other Latin American countries.


Assuntos
Betacoronavirus , Infecções por Coronavirus/mortalidade , Pneumonia Viral/mortalidade , Adolescente , Adulto , Distribuição por Idade , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Bolívia/epidemiologia , Criança , Intervalos de Confiança , Infecções por Coronavirus/epidemiologia , Estudos Transversais , Complicações do Diabetes/mortalidade , Feminino , Insuficiência Cardíaca/mortalidade , Humanos , Hipertensão/mortalidade , Masculino , Pessoa de Meia-Idade , Obesidade/mortalidade , Razão de Chances , Pandemias , Pneumonia Viral/epidemiologia , Análise de Regressão , Estudos Retrospectivos , Fatores de Risco , Distribuição por Sexo , Adulto Jovem
9.
Nat Commun ; 11(1): 2786, 2020 06 03.
Artigo em Inglês | MEDLINE | ID: mdl-32493923

RESUMO

Music perception is plausibly constrained by universal perceptual mechanisms adapted to natural sounds. Such constraints could arise from our dependence on harmonic frequency spectra for segregating concurrent sounds, but evidence has been circumstantial. We measured the extent to which concurrent musical notes are misperceived as a single sound, testing Westerners as well as native Amazonians with limited exposure to Western music. Both groups were more likely to mistake note combinations related by simple integer ratios as single sounds ('fusion'). Thus, even with little exposure to Western harmony, acoustic constraints on sound segregation appear to induce perceptual structure on note combinations. However, fusion did not predict aesthetic judgments of intervals in Westerners, or in Amazonians, who were indifferent to consonance/dissonance. The results suggest universal perceptual mechanisms that could help explain cross-cultural regularities in musical systems, but indicate that these mechanisms interact with culture-specific influences to produce musical phenomena such as consonance.


Assuntos
Povos Indígenas , Música , Nível de Percepção Sonora/fisiologia , Estimulação Acústica , Adulto , Bolívia , Feminino , Humanos , Masculino , Som
10.
Phytochemistry ; 177: 112435, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32562919

RESUMO

Two alkaloids were isolated and identified for the first time in the black tubers of Tropaeolum tuberosum, collected from the Titicani-Taca, Ingavi province in La Paz, Bolivia. Their structures were elucidated by extensive NMR and MS spectroscopic analyses. The isolated compounds were evaluated for their cytotoxicity and apoptotic capacity against four human cancer cell lines. 2-Benzyl-3-thioxohexahydropyrrolo[1,2-c]imidazole-1-one (1) showed slight cytotoxic activity against all the cancer cell lines which were tested, with IC50 values ranging from 27.45 ± 0.80 to 31.07 ± 0.87 µM. Moreover, N-(4-acetyl-5-methyl-5-phenyl-4,5-dihydro-1,3,4-thiadiazol-2-yl) acetamide (2) showed significant anti-cancer potential, with IC50 values between 1.26 ± 0.57 µM and 1.37 ± 0.09 µM against all human cancer cell lines which were tested. Treatment of tumour cell lines with the compounds caused an increase in the apoptotic rate of these cells, observing that compound 2 presented an apoptotic effect which was double with respect to the control (Dimethylenastron).


Assuntos
Alcaloides , Antineoplásicos Fitogênicos , Tropaeolum , Bolívia , Linhagem Celular Tumoral , Humanos
11.
PLoS Negl Trop Dis ; 14(6): e0008311, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32497037

RESUMO

BACKGROUND: Trypanosoma cruzi has a high genetic and biological diversity and has been subdivided into seven genetic lineages, named TcI-TcVI and TcBat. DTUs TcI-TcII-TcV and TcVI are agents of ChD in different regions of Latin America. Due to population movements, the disease is an emergent global public health problem. Thus, the aim of this study was to quantify the parasitic load and identify the presence of T. cruzi DTUs in 101 Latin American immigrants with chronic ChD, residing in Barcelona, Spain. METHODOLOGY / PRINCIPAL FINDINGS: 5ml of peripheral blood were collected in guanidine/EDTA from each patient for DNA extraction, quantification of the parasitic load and genotyping. A great variation of the parasitic load of the patients was verified: from 0.001 to 22.2 T. cruzi DNA (fg) / Blood DNA (ng). In patients from Bolivia the parasitic load was 3.76±4.43 T. cruzi DNA (fg) / Blood DNA (ng) (mean ± SD), in patients of other countries was 0.95±1.38 T. cruzi DNA (fg) / Blood DNA (ng). No statistically significant difference was observed in the parasitic load between patients with the indeterminate and cardiac forms of ChD (p = 0,57). Parasite genotyping was performed by multilocus conventional PCR. In patients from Bolivia there was a nearly equal prevalence of DTUs TcV (27/77), TcII/TcV/TcVI (26/77), and TcII/TcVI (22/77). TcVI was detected in only 2 samples (2/77). A higher prevalence of TcII/TcVI (19/24) was verified in patients of other countries, with low prevalence of TcII/TcV/TcVI (4/24) and TcV (1/24). CONCLUSIONS/SIGNIFICANCE: In this study, low/medium parasitic load was found in all patients evaluated. Our data corroborate previous conclusions indicating that patients from the Bolivia, living in Spain, are predominantly infected by TcV, and TcVI DTUs. On the other hand, in Non-Bolivians patients TcII/TcVI predominated. Surprisingly, in our cohort of 101 patients no infection by TcI DTU was observed.


Assuntos
Doença de Chagas/etnologia , Doença de Chagas/parasitologia , DNA de Protozoário/genética , Emigrantes e Imigrantes , Trypanosoma cruzi/classificação , Adulto , Idoso , Idoso de 80 Anos ou mais , Animais , Bolívia/etnologia , Feminino , Variação Genética , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade , Tipagem Molecular , Carga Parasitária , Análise de Sequência de DNA , Espanha/epidemiologia , Trypanosoma cruzi/isolamento & purificação , Adulto Jovem
12.
Psychiatry Res ; 291: 113174, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32585436

RESUMO

During the COVID-19 pandemic, healthcare workers are facing high workloads with resource constraints and risk of virus exposure, and healthcare organizations need to support their healthcare workers to reduce their anxiety. Based on a recent 8-point framework of COVID-19 specific organization support, we devised a measure of COVID-19 Organizational Support (COVID-OS). We tested the new measure with 712 healthcare workers in Bolivia, Ecuador, and Peru and found the new measure formed three factors to predict healthcare workers' anxiety and life satisfaction during the COVID-19 pandemic. We call for further studies to test COVID-OS in other countries and settings.


Assuntos
Ansiedade/terapia , Infecções por Coronavirus/psicologia , Pessoal de Saúde , Estresse Ocupacional/terapia , Satisfação Pessoal , Pneumonia Viral/psicologia , Apoio Social , Carga de Trabalho , Ansiedade/psicologia , Betacoronavirus , Bolívia , Equador , Humanos , Estresse Ocupacional/psicologia , Pandemias , Peru
13.
Lancet ; 395(10238): 1727-1734, 2020 05 30.
Artigo em Inglês | MEDLINE | ID: covidwho-276547

RESUMO

Indigenous communities worldwide share common features that make them especially vulnerable to the complications of and mortality from COVID-19. They also possess resilient attributes that can be leveraged to promote prevention efforts. How can indigenous communities best mitigate potential devastating effects of COVID-19? In Bolivia, where nearly half of all citizens claim indigenous origins, no specific guidelines have been outlined for indigenous communities inhabiting native communal territories. In this Public Health article, we describe collaborative efforts, as anthropologists, physicians, tribal leaders, and local officials, to develop and implement a multiphase COVID-19 prevention and containment plan focused on voluntary collective isolation and contact-tracing among Tsimane forager-horticulturalists in the Bolivian Amazon. Phase 1 involves education, outreach, and preparation, and phase 2 focuses on containment, patient management, and quarantine. Features of this plan might be exported and adapted to local circumstances elsewhere to prevent widespread mortality in indigenous communities.


Assuntos
Controle de Doenças Transmissíveis/métodos , Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Grupos Populacionais , Isolamento Social , Betacoronavirus , Bolívia , Busca de Comunicante , Humanos , Populações Vulneráveis
14.
Nature ; 581(7807): 190-193, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32404996

RESUMO

The onset of plant cultivation is one of the most important cultural transitions in human history1-4. Southwestern Amazonia has previously been proposed as an early centre of plant domestication, on the basis of molecular markers that show genetic similarities between domesticated plants and wild relatives4-6. However, the nature of the early human occupation of southwestern Amazonia, and the history of plant cultivation in this region, are poorly understood. Here we document the cultivation of squash (Cucurbita sp.) at about 10,250 calibrated years before present (cal. yr BP), manioc (Manihot sp.) at about 10,350 cal. yr BP and maize (Zea mays) at about 6,850 cal. yr BP, in the Llanos de Moxos (Bolivia). We show that, starting at around 10,850 cal. yr BP, inhabitants of this region began to create a landscape that ultimately comprised approximately 4,700 artificial forest islands within a treeless, seasonally flooded savannah. Our results confirm that the Llanos de Moxos is a hotspot for early plant cultivation and demonstrate that-ever since their arrival in Amazonia-humans have markedly altered the landscape, with lasting repercussions for habitat heterogeneity and species conservation.


Assuntos
Produção Agrícola/história , Produtos Agrícolas/história , Florestas , Pradaria , Atividades Humanas , Biodiversidade , Bolívia , Conservação dos Recursos Naturais , Cucurbita/crescimento & desenvolvimento , Mapeamento Geográfico , História Antiga , Manihot/crescimento & desenvolvimento , Manihot/história , Amido , Zea mays/crescimento & desenvolvimento
15.
Sci Total Environ ; 738: 139495, 2020 Oct 10.
Artigo em Inglês | MEDLINE | ID: mdl-32425257

RESUMO

Evidence of exposure to enteric pathogens through the air and associated risk of infection is scarce in the literature outside of animal- or human-waste handling settings. Cities with poor sanitation are important locations to investigate this aerial exposure pathway as their rapid growth will pose unprecedented challenges in waste management. To address this issue, simple surveillance methods are needed. Therefore, the objectives of this study were to optimize a community exposure bioaerosol surveillance strategy for urban outdoor locations with poor sanitation, and to determine which bioaerosols could contribute to exposure. Passive and active bioaerosol sampling methods were used to characterize the fate and transport of sanitation-related bioaerosols during the rainy and dry seasons in La Paz, Bolivia. Median coliform bacteria fluxes were 71 CFU/(m2 × h) during the rainy season and 64 CFU/(m2 × h) during the dry season, with 38% of the dry season samples testing positive for E. coli. Wind speed, relative humidity and UVB irradiance were identified as significant covariates to consider in bioaerosol transport models in La Paz. Active sampling yielded one positive sample (10%) for human adenovirus (HadV) and one sample (10%) for influenza A virus during the rainy season. HadV was detected at the site with the highest bacterial flux. Four samples (8%) were positive for influenza A virus in the dry season. These findings suggest that aerosols can contribute to community exposure to potentially pathogenic microorganisms in cities with poor sanitation. The use of passive sampling, despite its limitations, can provide quantitative data on microorganisms' viability within realistic timeframes of personal exposure.


Assuntos
Saúde Única , Saneamento , Aerossóis , Microbiologia do Ar , Animais , Bolívia , Cidades , Estudos Transversais , Escherichia coli , Humanos
16.
PLoS Negl Trop Dis ; 14(5): e0008078, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32463835
17.
Lancet ; 395(10238): 1727-1734, 2020 05 30.
Artigo em Inglês | MEDLINE | ID: mdl-32422124

RESUMO

Indigenous communities worldwide share common features that make them especially vulnerable to the complications of and mortality from COVID-19. They also possess resilient attributes that can be leveraged to promote prevention efforts. How can indigenous communities best mitigate potential devastating effects of COVID-19? In Bolivia, where nearly half of all citizens claim indigenous origins, no specific guidelines have been outlined for indigenous communities inhabiting native communal territories. In this Public Health article, we describe collaborative efforts, as anthropologists, physicians, tribal leaders, and local officials, to develop and implement a multiphase COVID-19 prevention and containment plan focused on voluntary collective isolation and contact-tracing among Tsimane forager-horticulturalists in the Bolivian Amazon. Phase 1 involves education, outreach, and preparation, and phase 2 focuses on containment, patient management, and quarantine. Features of this plan might be exported and adapted to local circumstances elsewhere to prevent widespread mortality in indigenous communities.


Assuntos
Controle de Doenças Transmissíveis/métodos , Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Grupos Populacionais , Isolamento Social , Betacoronavirus , Bolívia , Busca de Comunicante , Humanos , Populações Vulneráveis
18.
Respir Physiol Neurobiol ; 277: 103443, 2020 06.
Artigo em Inglês | MEDLINE | ID: covidwho-164993

RESUMO

In the present study we analyze the epidemiological data of COVID-19 of Tibet and high-altitude regions of Bolivia and Ecuador, and compare to lowland data, to test the hypothesis that high-altitude inhabitants (+2,500 m above sea-level) are less susceptible to develop severe adverse effects in acute SARS-CoV-2 virus infection. Analysis of available epidemiological data suggest that physiological acclimatization/adaptation that counterbalance the hypoxic environment in high-altitude may protect from severe impact of acute SARS-CoV-2 virus infection. Potential underlying mechanisms such as: (i) a compromised half-live of the virus caused by the high-altitude environment, and (ii) a hypoxia mediated down regulation of angiotensin-converting enzyme 2 (ACE2), which is the main binding target of SARS-CoV-2 virus in the pulmonary epithelium are discussed.


Assuntos
Betacoronavirus/fisiologia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/virologia , Pneumonia Viral/epidemiologia , Pneumonia Viral/virologia , Altitude , Betacoronavirus/patogenicidade , Bolívia/epidemiologia , Suscetibilidade a Doenças , Equador/epidemiologia , Humanos , Oxigênio , Pandemias , Tibet/epidemiologia , Virulência
19.
Respir Physiol Neurobiol ; 277: 103443, 2020 06.
Artigo em Inglês | MEDLINE | ID: covidwho-102152

RESUMO

In the present study we analyze the epidemiological data of COVID-19 of Tibet and high-altitude regions of Bolivia and Ecuador, and compare to lowland data, to test the hypothesis that high-altitude inhabitants (+2,500 m above sea-level) are less susceptible to develop severe adverse effects in acute SARS-CoV-2 virus infection. Analysis of available epidemiological data suggest that physiological acclimatization/adaptation that counterbalance the hypoxic environment in high-altitude may protect from severe impact of acute SARS-CoV-2 virus infection. Potential underlying mechanisms such as: (i) a compromised half-live of the virus caused by the high-altitude environment, and (ii) a hypoxia mediated down regulation of angiotensin-converting enzyme 2 (ACE2), which is the main binding target of SARS-CoV-2 virus in the pulmonary epithelium are discussed.


Assuntos
Betacoronavirus/fisiologia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/virologia , Pneumonia Viral/epidemiologia , Pneumonia Viral/virologia , Altitude , Betacoronavirus/patogenicidade , Bolívia/epidemiologia , Suscetibilidade a Doenças , Equador/epidemiologia , Humanos , Oxigênio , Pandemias , Tibet/epidemiologia , Virulência
20.
Travel Med Infect Dis ; 35: 101653, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32247926

RESUMO

INTRODUCTION: In March 2020, Coronavirus Disease 2019 (COVID-19) arrived in Bolivia. Here, we report the main clinical findings, and epidemiological features of the first series of cases, and a cluster, confirmed in Bolivia. METHODS: For this observational, retrospective and cross-sectional study, information was obtained from the Hospitals and the Ministry of Health for the cases that were laboratory-diagnosed and related, during March 2020. rRT-PCR was used for the detection of the RNA of SARS-CoV-2 following the protocol Charité, Berlin, Germany, from nasopharyngeal swabs. RESULTS: Among 152 suspected cases investigated, 12 (7.9%) were confirmed with SARS-CoV-2 infected by rRT-PCR. The median age was 39 years (IQR 25-43), six of them male. Two cases proceed from Italy and three from Spain. Nine patients presented fever, and cough, five sore throat, and myalgia, among other symptoms. Only a 60 y-old woman with hypertension was hospitalized. None of the patients required ICU nor fatalities occurred in this group. CONCLUSIONS: This is the first report of surveillance of COVID-19 in Bolivia, with patients managed mainly with home isolation. Preparedness for a significant epidemic, as is going on in other countries, and the deployment of response plans for it, in the country is now taking place to mitigate the impact of the COVID-19 pandemic in the population.


Assuntos
Betacoronavirus/genética , Doenças Transmissíveis Importadas/epidemiologia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/fisiopatologia , Monitoramento Epidemiológico , Pneumonia Viral/epidemiologia , Pneumonia Viral/fisiopatologia , Adolescente , Adulto , Bolívia/epidemiologia , Análise por Conglomerados , Doenças Transmissíveis Importadas/virologia , Infecções por Coronavirus/virologia , Tosse , Estudos Transversais , Feminino , Febre , Humanos , Itália , Masculino , Pessoa de Meia-Idade , Pandemias , Isolamento de Pacientes/métodos , Pneumonia Viral/virologia , RNA Viral/genética , Estudos Retrospectivos , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Espanha , Adulto Jovem
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