Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 653
Filtrar
1.
Artigo em Inglês | MEDLINE | ID: mdl-33374643

RESUMO

Although motor vehicle collisions (MVCs) are a worldwide public health concern due to their high injury, mortality, and fatality rates, few studies have addressed the epidemiologic behavior of MVCs in Latin American youth. Thus, this study was aimed at describing and comparing the characteristics of MVCs involving 0 to 14-year-olds in Costa Rica, Guatemala, and Panama. A secondary aim was to estimate the crude MVC-related injury, fatality, and mortality rates and their trends over time. We conducted a descriptive, retrospective study using publicly available data for Costa Rica, Panama, and Guatemala between 2012 and 2015. We examined the reported MVC cases and calculated the crude injury, fatality, and mortality rates and their trends over time (α = 0.05). Publicly available data reported 12,020 MVC-related injuries and 431 MVC-related deaths involving 0 to 14-year-olds. The most frequent mechanisms involved 0 to 14-year-olds as passengers or pedestrians in MVCs (>85% of all cases). The highest crude MVC-related injury and mortality rates were reported for Panama (119.35 and 2.14 per 100,000 population, respectively, in 0 to 14-years-olds), while Guatemala had the highest median MVC-related fatality rate (8.84 per 100,000 events; χ2 [2] = 377.8; p < 0.001) with a statistically significant trend increasing over time (r = 0.947; p = 0.027). Although several factors play a role in the prevention of MVCs among 0 to 14-year-olds, we found that Costa Rica was the only country that implemented a policy on child restraint systems resulting in the lowest rates of MVC-related injury, mortality, and fatality. These results could be used by decision makers from the aforementioned Central American countries to develop adequate policies addressing MVC preventative strategies to protect Central American infants and children.


Assuntos
Acidentes de Trânsito/estatística & dados numéricos , Ferimentos e Lesões/epidemiologia , Adolescente , Criança , Pré-Escolar , Costa Rica/epidemiologia , Guatemala/epidemiologia , Humanos , Lactente , Recém-Nascido , Panamá/epidemiologia , Estudos Retrospectivos
2.
PLoS One ; 15(11): e0240526, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33141833

RESUMO

In-person (face-to-face) data collection methods offer many advantages but can also be time-consuming and expensive, particularly in areas of difficult access. We take advantage of the increasing mobile phone penetration rate in rural areas to evaluate the feasibility of using cell phones to monitor the provision of key health and nutrition interventions linked to the first 1,000 days of life, a critical period of growth and development. We examine response rates to calendarized text messages (SMS) and phone calls sent to 1,542 households over a period of four months. These households have children under two years old and pregnant women and are located across randomly selected communities in Quiche, Guatemala. We find that the overall (valid) response rate to phone calls is over 5 times higher than to text messages (75.8% versus 14.4%). We also test whether simple SMS reminders improve the timely reception of health services but do not find any effects in this regard. Language, education, and age appear to be major barriers to respond to text messages as opposed to phone calls, and the rate of response is not correlated with a household's geographic location (accessibility). Moreover, response veracity is high, with an 84-91% match between household responses and administrative records. The costs per monitored intervention are around 1.12 US dollars using text messages and 85 cents making phone calls, with the costs per effective answer showing a starker contrast, at 7.76 and 1.12 US dollars, respectively. Our findings indicate that mobile phone calls can be an effective, low-cost tool to collect reliable information remotely and in real time. In the current context, where in-person contact with households is not possible due to the COVID-19 crisis, phone calls can be a valuable instrument for collecting information, monitoring development interventions, or implementing brief surveys.


Assuntos
Telefone Celular/estatística & dados numéricos , Infecções por Coronavirus/epidemiologia , Monitorização Fisiológica/estatística & dados numéricos , Estado Nutricional/fisiologia , Pandemias , Pneumonia Viral/epidemiologia , População Rural/estatística & dados numéricos , Adulto , Telefone Celular/economia , Pré-Escolar , Feminino , Guatemala/epidemiologia , Humanos , Lactente , Recém-Nascido , Masculino , Monitorização Fisiológica/economia , Gravidez , Sistemas de Alerta/economia , Sistemas de Alerta/estatística & dados numéricos , Inquéritos e Questionários , Telemedicina/economia , Telemedicina/estatística & dados numéricos , Envio de Mensagens de Texto/economia , Envio de Mensagens de Texto/estatística & dados numéricos
3.
PLoS One ; 15(10): e0239921, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33108379

RESUMO

Nutrition in pregnancy and early childhood affects later blood pressure and precursors of atherosclerosis, but its influence on arterial stiffness is unexplored. This study determines whether exposure to improved nutrition during early life influences Augmentation index (AI) and pulse wave velocity (PWV) in mid-adulthood. We included 1221 adults (37-54y) who participated in a cluster-randomized nutritional supplementation trial of a protein-energy beverage (Atole), conducted between 1969-1977 in Guatemala. The comparison group received Fresco, a low-calorie protein-free beverage. In 2015-17, we measured anthropometry (weight, height, and waist-to-height ratio); AI and PWV (using carotid-femoral tonometry); blood pressure; fasting plasma glucose and serum lipids; and sociodemographic characteristics. Based on patterns of exposure, we characterized participants as fully, partially or unexposed to the intervention from conception to their second birthday (the 'first 1000 days'). We fit pooled and sex-specific models using intention-to-treat, difference-in-difference regression analysis to test whether exposure to the supplement in the first 1000 days was associated with AI and PWV in adulthood adjusting for basal and current sociodemographic variables and current life-style and cardio-metabolic risk factors. Prevalence of obesity in men and women was 39.6% and 19.6%, and prevalence of hypertension was 44.0% and 36.0%, respectively. Women had higher AI (34.4±9.6%) compared to men (23.0± 9.8%), but had similar PWV (7.60±1.13 m/s and 7.60±1.31, respectively). AI did not differ significantly across intervention groups. PWV was lower in individuals with full exposure to the supplement during the first 1000 days (-0.39m/s, 95% CI -0.87, 0.09; p = 0.1) compared to unexposed individuals. This difference was similar after adjusting for cardio-metabolic risk factors (-0.45m/s; 95%C-0.93, 0.01; p = 0.06). Exposure to improved nutrition during the first 1000 days was marginally associated with lower PWV, but not with AI.


Assuntos
Suplementos Nutricionais , Hipertensão/epidemiologia , Desnutrição/epidemiologia , Obesidade/epidemiologia , Rigidez Vascular , Adulto , Pré-Escolar , Feminino , Seguimentos , Guatemala/epidemiologia , Humanos , Lactente , Fenômenos Fisiológicos da Nutrição do Lactente , Recém-Nascido , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Estado Nutricional , Fatores de Risco , Adulto Jovem
4.
Artigo em Inglês | MEDLINE | ID: mdl-32784623

RESUMO

BACKGROUND: Sugarcane workers in Central America experience a heavy burden of chronic kidney disease of unknown origin. We conducted a pilot study among worker proxies in Guatemala to characterize exposures to particulate matter, silica, heavy metals, and glyphosate, as well as to examine potential nephrotoxic exposures. METHODS: Air, soil, and ash samples were collected and analyzed using scanning electron microscopy, X-ray diffraction, inductively coupled plasma mass spectrometry, and an enzyme-linked immunosorbent assay. RESULTS: The average mass concentration for particulate matter (PM)2.5 and PM100 exposures were 360 µg/m3 (range: 32 to 1500 µg/m3) and 555 µg/m3 (range: 229 to 1170 µg/m3), respectively. The elemental composition of particles was largely silicon. The amount of crystalline silica was below 5 µg, yet the percentage of total silica was ~17% by weight. Putatively, the silica was in the amorphous form. Concentrations of aluminum and calcium ranged from 2-7 µg/m3. Glyphosate was not detectable in analyzed air samples but was detectable at concentrations ranging from 81-165 ppb in soil samples. CONCLUSION: Sugarcane workers are exposed to high concentrations of particulate matter. Future studies should investigate the potential role of silica, heavy metals, and agrochemicals in the etiology of chronic kidney disease in this population.


Assuntos
Doenças dos Trabalhadores Agrícolas/epidemiologia , Poluentes Atmosféricos/efeitos adversos , Monitoramento Ambiental , Exposição por Inalação/análise , Saccharum , Doenças dos Trabalhadores Agrícolas/induzido quimicamente , Poluentes Atmosféricos/análise , Guatemala/epidemiologia , Humanos , Exposição por Inalação/efeitos adversos , Material Particulado/análise , Projetos Piloto , Insuficiência Renal Crônica/induzido quimicamente , Insuficiência Renal Crônica/epidemiologia
5.
PLoS Negl Trop Dis ; 14(8): e0008535, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32813703

RESUMO

Dengue fever occurs worldwide and about 1% of cases progress to severe haemorrhage and shock. Dengue is endemic in Guatemala and its surveillance system could document long term trends. We analysed 17 years of country-wide dengue surveillance data in Guatemala to describe epidemiological trends from 2000 to 2016.Data from the national dengue surveillance database were analysed to describe dengue serotype frequency, seasonality, and outbreaks. We used Poisson regression models to compare the number of cases each year with subsequent years and to estimate incidence ratios within serotype adjusted by age and gender. 91,554 samples were tested. Dengue was confirmed by RT-qPCR, culture or NS1-ELISA in 7097 (7.8%) cases and was IgM ELISA-positive in 19,290 (21.1%) cases. DENV1, DENV2, DENV3, and DENV4 were detected in 2218 (39.5%), 2580 (45.9%), 591 (10.5%), and 230 (4.1%) cases. DENV1 and DENV2 were the predominant serotypes, but all serotypes caused epidemics. The largest outbreak occurred in 2010 with 1080 DENV2 cases reported. The incidence was higher among adults during epidemic years, with significant increases in 2005, 2007, and 2013 DENV1 outbreaks, the 2010 DENV2 and 2003 DENV3 outbreaks. Adults had a lower incidence immediately after epidemics, which is likely linked to increased immunity.


Assuntos
Dengue/diagnóstico , Dengue/epidemiologia , Adolescente , Adulto , Anticorpos Antivirais/imunologia , Criança , Pré-Escolar , Dengue/imunologia , Vírus da Dengue/imunologia , Surtos de Doenças , Ensaio de Imunoadsorção Enzimática , Feminino , Guatemala/epidemiologia , Humanos , Incidência , Lactente , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase , Sorogrupo , Sorotipagem/métodos , Adulto Jovem
6.
Am J Trop Med Hyg ; 103(2): 735-744, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32524965

RESUMO

Chagas disease is a lethal, neglected tropical disease. Unfortunately, aggressive insecticide-spraying campaigns have not been able to eliminate domestic infestation of Triatoma dimidiata, the native vector in Guatemala. To target interventions toward houses most at risk of infestation, comprehensive socioeconomic and entomologic surveys were conducted in two towns in Jutiapa, Guatemala. Given the exhaustively large search space associated with combinations of risk factors, traditional statistics are limited in their ability to discover risk factor interactions. Two recently developed statistical evolutionary algorithms, specifically designed to accommodate risk factor interactions and heterogeneity, were applied to this large combinatorial search space and used in tandem to identify sets of risk factor combinations associated with infestation. The optimal model includes 10 risk factors in what is known as a third-order disjunctive normal form (i.e., infested households have chicken coops AND deteriorated bedroom walls OR an accumulation of objects AND dirt floors AND total number of occupants ≥ 5 AND years of electricity ≥ 5 OR poor hygienic condition ratings AND adobe walls AND deteriorated walls AND dogs). Houses with dirt floors and deteriorated walls have been reported previously as risk factors and align well with factors currently targeted by Ecohealth interventions to minimize infestation. However, the tandem evolutionary algorithms also identified two new socioeconomic risk factors (i.e., households having many occupants and years of electricity ≥ 5). Identifying key risk factors may help with the development of new Ecohealth interventions and/or reduce the survey time needed to identify houses most at risk.


Assuntos
Animais Domésticos , Doença de Chagas/epidemiologia , Materiais de Construção/estatística & dados numéricos , Abrigo para Animais , Habitação/estatística & dados numéricos , Insetos Vetores , Triatoma , Algoritmos , Animais , Doença de Chagas/transmissão , Galinhas , Cães , Instalação Elétrica/estatística & dados numéricos , Características da Família , Guatemala/epidemiologia , Humanos , Higiene , Controle de Insetos , Inseticidas , Piretrinas , Fatores de Risco , Comportamento de Redução do Risco , Fatores Socioeconômicos
7.
PLoS One ; 15(6): e0234399, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32559225

RESUMO

BACKGROUND: Dengue, chikungunya, and Zika viruses are increasingly important public health problems. Burning vegetation, leaves, and other plant products have been shown to be effective mosquito repellents for their vector, Aedes spp., but there has been scant research on whether firewood cooking smoke in households influences mosquito populations or mosquito-borne diseases. About 2.9 billion people worldwide use biomass fuel for household cooking and heating, resulting in an estimated 1.6 million deaths annually from household air pollution (HAP)-related diseases. Global health agencies now encourage households to transition from biomass to clean fuels, but it is unclear whether such interventions may actually increase risk for mosquito-borne diseases. This retrospective case-control study evaluated associations between arboviral infections and cooking with firewood in Santa Rosa, Guatemala. METHOD: Vigilancia Integrada Comunitaria (VICo) was a prospective public health surveillance system for bacterial, parasitic, and viral causes of diarrheal, neurological, respiratory, and febrile illnesses in hospitals and clinics in the department of Santa Rosa, Guatemala. Enrolled VICo in-patients and out-patients during 2011-2018 were interviewed using standardized questionnaires on demographics and household characteristics. Blood and stool specimens were collected and tested to identify the etiologies presenting symptoms. Cases were defined as laboratory-positive for dengue, chikungunya, or Zika virus infections. Controls were laboratory-positive for bacterial and viral diarrheal illnesses (e.g., Salmonella, Shigella, Campylobacter, Escherichia coli, rotavirus, norovirus, sapovirus, or astrovirus). Cooking with firewood, kitchen location, stove type, and firewood cooking frequency were the independent exposure variables. Logistic regression models were used to analyze unadjusted and adjusted associations between arboviral infections and exposures of interest. RESULT: There were 311 arboviral cases and 1,239 diarrheal controls. Arboviral infections were inversely associated with cooking with firewood in the main house (AOR: 0.22; 95% CI: 0.08-0.57), cooking with firewood on an open hearth (AOR: 0.50; 95% CI: 0.33-0.78), and cooking with firewood ≥5 times per week (AOR: 0.54; 95% CI: 0.36-0.81), adjusting for age, sex, ethnicity, socioeconomic status index, number of people per household, community population density, community elevation, recruitment location, season, and admission year. CONCLUSION: Several primary determinants of HAP exposure were inversely associated with arboviral infections. Additional studies are needed to understand whether interventions to reduce HAP might actually increase risk for mosquito-borne infectious diseases, which would warrant improved education and mosquito control efforts in conjunction with fuel interventions.


Assuntos
Poluição do Ar em Ambientes Fechados/análise , Febre de Chikungunya/epidemiologia , Dengue/epidemiologia , Infecção por Zika virus/epidemiologia , Adolescente , Adulto , Aedes/virologia , Animais , Estudos de Casos e Controles , Criança , Culinária , Características da Família , Feminino , Fogo , Guatemala/epidemiologia , Humanos , Repelentes de Insetos/análise , Modelos Logísticos , Masculino , Mosquitos Vetores/virologia , Estudos Retrospectivos , Fatores de Risco , Fumaça/análise , Madeira , Adulto Jovem
8.
Am J Trop Med Hyg ; 103(1): 157-159, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32458782

RESUMO

Real-time reverse transcriptase PCR (rRT-PCR) is the most accurate method for the detection of dengue virus (DENV) and yellow fever virus (YFV) in acute illness. However, performing rRT-PCR is not feasible for many laboratories in regions of endemicity. The current study compared new reverse transcription-insulated isothermal PCRs (the POCKIT DENV and YFV reagent sets) with laboratory-developed rRT-PCRs for both viruses using clinical samples and viral strains from different endemic regions. Sensitivity and specificity of the POCKIT DENV Reagent Set were 87.2% (68/78 samples) and 98.2% of samples (54/55), respectively. The YFV reagent set demonstrated sensitive detection of YFV RNA from six viral strains down to an estimated concentration of 2.5 log10 copies/mL and proved to be specific for YFV. Although the POCKIT assays require RNA extraction, they may provide accurate and less-complex options for molecular testing in laboratory settings where rRT-PCR is not practical.


Assuntos
Vírus da Dengue/genética , Dengue/diagnóstico , RNA Viral/genética , Reação em Cadeia da Polimerase em Tempo Real/métodos , Febre Amarela/diagnóstico , Vírus da Febre Amarela/genética , Dengue/epidemiologia , Dengue/virologia , Doenças Endêmicas/estatística & dados numéricos , Guatemala/epidemiologia , Humanos , Paraguai/epidemiologia , Kit de Reagentes para Diagnóstico , Reação em Cadeia da Polimerase em Tempo Real/normas , Sensibilidade e Especificidade , Sri Lanka/epidemiologia , Carga Viral/genética , Febre Amarela/epidemiologia , Febre Amarela/virologia
10.
J Parasitol ; 106(3): 341-345, 2020 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-32227228

RESUMO

Rodents are reservoirs and hosts of several pathogens around the world, including zoonotic parasite species. This study aimed to determine the occurrence of zoonotic gastrointestinal helminths in rodents captured inside households in a rural community from southern Guatemala. Sixty-nine rodents were captured in 33% (49/148) of the surveyed households, including Rattus rattus, Rattus norvegicus, Mus musculus, and Sigmodon hispidus. Thirty-six percent (25/69) of these rodents (3 Rattus and 22 Mus musculus), from 45% (22/49) of the households, were parasitized with at least 1 gastrointestinal helminth species. Helminths from 6 species were identified: Hymenolepis diminuta, Moniliformis moniliformis, Heterakis spumosa, Nippostrongylus sp., Strongyloides sp., and Syphacia sp. Two zoonotic species were found in Rattus, H. diminuta in R. rattus (1/6), and M. moniliformis in R. norvegicus (1/1). Coinfection with other non-zoonotic helminth parasites, such as He. spumosa and Strongyloides sp., also was observed in the Rattus genus. Mus musculus had only non-zoonotic helminths: He. spumosa, Nippostrongylus sp., and Syphacia sp. being the most common, and He. spumosa (96%) followed by Nippostrongylus sp. (48%), with a higher presence in males than females, with a similar proportion in adult and young individuals. This is the first report of zoonotic and non-zoonotic helminths parasites in rodents from Guatemala.


Assuntos
Helmintíase Animal/parasitologia , Camundongos/parasitologia , Ratos/parasitologia , Doenças dos Roedores/parasitologia , Zoonoses/parasitologia , Animais , Reservatórios de Doenças/parasitologia , Características da Família , Feminino , Guatemala/epidemiologia , Helmintíase Animal/epidemiologia , Humanos , Masculino , Doenças dos Roedores/epidemiologia , População Rural
11.
Am J Trop Med Hyg ; 103(1): 260-265, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32314688

RESUMO

Infection by Helicobacter pylori is a major risk factor for gastric cancer (GC), the second leading cause of cancer-related death worldwide. Although biomarkers such as pepsinogens (PGs) and soluble urokinase plasminogen activator receptor (suPAR) may have diagnostic and/or prognostic value in patients with GC, their levels may be affected by H. pylori infection. The aim of this study was to investigate the association of the presence of antibodies to H. pylori and cytotoxin-associated gene A (CagA) with plasma levels of PGs and suPAR in a cohort of Guatemalan GC patients and controls. To this end, levels of suPAR, Pepsinogens I and II (PGI and PGII), and antibodies to H. pylori and CagA toxin were determined by ELISA in plasma samples from 67 GC patients and 136 matched healthy controls. Seropositivity for CagA was significantly higher in patients with GC than in controls. Pepsinogens II and suPAR levels were higher and PGI/PGII ratios were lower in GC patients than in controls. There was a significant association of H. pylori seropositivity status with increased levels of PGII and lower PGI/PGII ratios, particularly in the control (non-GC) population. The levels of suPAR were not significantly affected by H. pylori or CagA seropositivity status. These results suggest that the seropositivity status for H. pylori and CagA need to be taken into account during the GC diagnostic process.


Assuntos
Antígenos de Bactérias/imunologia , Proteínas de Bactérias/imunologia , Infecções por Helicobacter/epidemiologia , Helicobacter pylori/imunologia , Pepsinogênio A/sangue , Receptores de Ativador de Plasminogênio Tipo Uroquinase/sangue , Neoplasias Gástricas/microbiologia , Anticorpos Antibacterianos/sangue , Anticorpos Antibacterianos/imunologia , Estudos de Casos e Controles , Ensaio de Imunoadsorção Enzimática , Feminino , Guatemala/epidemiologia , Infecções por Helicobacter/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Soroepidemiológicos , Neoplasias Gástricas/sangue
12.
AIDS Behav ; 24(10): 2906-2917, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32277308

RESUMO

A dearth of empirical research exists on female sex workers in Central America who begin selling sex under age 18. Data were collected from adult female sex workers (N = 1216) sampled using census and modified time-location sampling in three urban centers of Guatemala. In adjusted analyses, female sex workers who entered the sex trade under age 16 years were more likely to be HIV positive (AOR = 4.6, 95% CI 1.6, 13.2), have not received HIV education in their first year of sex trade (AOR = 2.8, 95% CI 1.5, 5.5), have experienced violence to force commercial sex (AOR = 4.6, 95% CI 2.2, 9.8) and have not used condoms in their first month (AOR = 2.8, 95% CI 1.3, 6.1) , relative to those who entered as adults. An interaction between age at entry and foreign migration at entry was found for HIV risk. Efforts to prevent adolescent sex trade entry are needed and may also help to reduce HIV rates in Guatemala.


Assuntos
Preservativos/estatística & dados numéricos , Infecções por HIV/diagnóstico , Trabalho Sexual/estatística & dados numéricos , Profissionais do Sexo , Adolescente , Adulto , Estudos Transversais , Feminino , Guatemala/epidemiologia , Infecções por HIV/epidemiologia , Infecções por HIV/transmissão , Humanos , Comportamento Sexual , Migrantes
13.
PLoS One ; 15(4): e0225022, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32267848

RESUMO

Population size estimation is performed for several reasons including disease surveillance and control, for example to design adequate control strategies such as vaccination programs or to estimate a vaccination campaign coverage. In this study, we aimed at investigating the possibility of using Unmanned Aerial Vehicles (UAV) to estimate the size of free-roaming domestic dog (FRDD) populations and compare the results with two regularly used methods for population estimations: foot-patrol transect survey and the human: dog ratio estimation. Three studies sites of one square kilometer were selected in Petén department, Guatemala. A door-to-door survey was conducted in which all available dogs were marked with a collar and owner were interviewed. The day after, UAV flight were performed twice during two consecutive days per study site. The UAV's camera was set to regularly take pictures and cover the entire surface of the selected areas. Simultaneously to the UAV's flight, a foot-patrol transect survey was performed and the number of collared and non-collared dogs were recorded. Data collected during the interviews and the number of dogs counted during the foot-patrol transects informed a capture-recapture (CR) model fit into a Bayesian inferential framework to estimate the dog population size, which was found to be 78, 259, and 413 in the three study sites. The difference of the CR model estimates compared to previously available dog census count (110 and 289) can be explained by the fact that the study population addressed by the different methods differs. The human: dog ratio covered the same study population as the dog census and tended to underestimate the FRDD population size (97 and 161). Under the conditions within this study, the total number of dogs identified on the UAV pictures was 11, 96, and 71 for the three regions (compared to the total number of dogs counted during the foot-patrol transects of 112, 354 and 211). In addition, the quality of the UAV pictures was not sufficient to assess the presence of a mark on the spotted dogs. Therefore, no CR model could be implemented to estimate the size of the FRDD using UAV. We discussed ways for improving the use of UAV for this purpose, such as flying at a lower altitude in study area wisely chosen. We also suggest to investigate the possibility of using infrared camera and automatic detection of the dogs to increase visibility of the dogs in the pictures and limit workload of finding them. Finally, we discuss the need of using models, such as spatial capture-recapture models to obtain reliable estimates of the FRDD population. This publication may provide helpful directions to design dog population size estimation methods using UAV.


Assuntos
Cães , Animais de Estimação , Animais , Teorema de Bayes , Doenças do Cão/epidemiologia , Cães/fisiologia , Guatemala/epidemiologia , Humanos , Animais de Estimação/fisiologia , Densidade Demográfica , Tecnologia de Sensoriamento Remoto
14.
Guatemala; MSPAS, Unidad de Gestion de Riesgos; 07 abr 2020. 28 p. graf.
Não convencional em Espanhol | LILACS, LIGCSA | ID: biblio-1096398

RESUMO

Establece los lineamientos a seguir durante en el proceso del manejo de cadáveres infectados con el Coronavirus COVID-19 en todo el territorio nacional. Describe procedimientos para servicios de salud y funerarias, en el trato de los cuerpos.


Assuntos
Humanos , Masculino , Feminino , Pneumonia Viral/mortalidade , Pneumonia Viral/prevenção & controle , Cadáver , Infecções por Coronavirus/mortalidade , Infecções por Coronavirus/prevenção & controle , Betacoronavirus , Autopsia , Saneamento/métodos , Cemitérios/normas , Necrotério/métodos , Funerárias/normas , Guatemala/epidemiologia
15.
Gac. sanit. (Barc., Ed. impr.) ; 34(2): 127-132, mar.-abr. 2020. tab, mapas, graf
Artigo em Inglês | IBECS | ID: ibc-196048

RESUMO

OBJECTIVE: To assess the impact of introducing Xpert as a follow-on test after smear microscopy on the total number pulmonary TB notifications. METHOD: Genexpert systems were installed in six departments across Guatemala, and Xpert was indicated as a follow-on test for people with smear-negative results. We analyzed notifications to national tuberculosis (TB) programmes (NTP) and the project's laboratory data to assess coverage of the intervention and case detection yield. Changes in quarterly TB notifications were analyzed using a simple pre/post comparison and a regression model controlling for secular notification trends. Using a mix of project and NTP data we estimated the theoretical yield of the intervention if testing coverage achieved 100%. RESULTS: Over 18,000 smear-negative individuals were eligible for Xpert testing during the intervention period. Seven thousand, one hundred and ninety-three people (39.6% of those eligible) were tested on Xpert resulting in the detection of 199 people with smear-negative, Xpert positive results (2.8% positivity rate). In the year before testing began 1098 people with smear positive and 195 people with smear negative results were notified in the six intervention departments. During the intervention, smear-positive notification remained roughly stable (1090 individuals, 0.7%), but smear-negative notifications increased by 167 individuals (85.6%) to an all-time high of 362. After controlling for secular notifications trends over an eight-quarter pre-intervention period, combined pulmonary TB notifications (both smear positive and negative) were 19% higher than trend predictions. If Xpert testing coverage approached 100% of those eligible, we estimate there would have been a+41% increase in TB notifications. CONCLUSIONS: We measured a large gain in pulmonary notifications through the introduction of Xpert testing alone. This indicates a large number of people with TB in Guatemala are seeking health care and being tested, yet are not diagnosed or treated because they lack bacteriological confirmation. Wider use of more sensitive TB diagnostics and/or improvements in the number of people clinically diagnosed with TB have the potential to significantly increase TB notifications in this setting, and potentially in other settings where a low proportion of pulmonary notifications are clinically diagnosed


OBJETIVO: Evaluar el impacto en la notificación de casos de tuberculosis pulmonar de la introducción de Xpert como prueba de continuación después del análisis microscópico. MÉTODO: Se instalaron sistemas Genexpert es seis departamentos de Guatemala y se indicó como prueba consecutiva en todos los resultados negativos en la baciloscopia microscópica. Se analizaron los datos del Programa Nacional y los del laboratorio del proyecto para medir la cobertura y la productividad en detección de casos. Las notificaciones trimestrales se compararon con los valores anteriores a la intervención y se adoptó un modelo de regresión para controlar por las tendencias temporales. Se estimó la contribución teórica de la intervención en términos de notificación si se obtuviera una cobertura del 100%. RESULTADOS: Durante el período de intervención, más de 18.000 personas con baciloscopia negativa fueron elegibles en los seis departamentos. El esputo de 7193 (36,9%) de ellos fue analizado también por Xpert y se detectaron 199 personas con baciloscopia negativa y Xpert positivo (positividad: 2,8%). En el año anterior a la intervención se notificaron 1098 casos de tuberculosis pulmonar y baciloscopia positiva, y 195 con baciloscopia negativa. Durante la intervención, la notificación de casos con baciloscopia positiva se mantuvo estable (1090 personas, 0,7%), pero las notificaciones con baciloscopia negativa, que incluía los casos con baciloscopia negativa y Xpert positivo, aumentó en 167 casos (85,6%), llegando a los 362 casos. Después de controlar por la tendencia temporal de notificación en los ocho trimestres anteriores, la notificación de tuberculosis pulmonar (con baciloscopia positiva o no) fue un 19% mayor que las predicciones de la tendencia. Si la cobertura de Xpert se acercase al 100%, se estima que se habría producido un incremento del 41% en las notificaciones. CONCLUSIONES: Se identifica un importante aumento de las notificaciones de tuberculosis pulmonar solo con la introducción de Xpert. Ello indica que un número importante de personas con tuberculosis en Guatemala son atendidos por los servicios de salud y son sometidos a bacteriología microscópica, pero no son diagnosticados ni tratados porque no disponen de confirmación bacteriológica. La utilización de técnicas diagnósticas más sensibles o la mejora en el diagnóstico clínico tienen potencial para aumentar significativamente las notificaciones de tuberculosis pulmonar en esta zona y en cualquier otro lugar donde exista una proporción baja de diagnósticos clínicos no confirmados por microscopía


Assuntos
Humanos , Tuberculose Pulmonar/diagnóstico , Mycobacterium tuberculosis/isolamento & purificação , Escarro/microbiologia , Sensibilidade e Especificidade , Guatemala/epidemiologia , Erros de Diagnóstico/prevenção & controle
16.
PLoS One ; 15(3): e0229413, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32142520

RESUMO

INTRODUCTION: Chronic kidney disease of unknown origin (CKDu) is an epidemic concentrated in agricultural communities in Central and South America, including young, male sugarcane harvesters. The purpose of this analysis is to understand early changes in kidney function among a cohort of first-time sugarcane harvesters and to determine risk factors for kidney function decline. METHODS: Joint latent class mixed models were used to model sub-population kidney function trajectory over the course of 4 years (2012-2016). Probability weighted logistic regression was used to determine personal health, community, and individual behavior risk factors associated with sub-population assignment. Data analysis occurred in 2019. RESULTS: Of 181 new workers median age 19 years old (IQR: 4), 39 (22%) were identified as having non-stable kidney function with an annual age-adjusted decline of estimated glomerular filtration rate (eGFR) of -1.0 ml/min per 1.73 m2 (95% CI: -3.4, 1.3). Kidney function (OR: 0.96; 95% CI: 0.93, 0.98), mild hypertension (OR: 5.21; 95% CI: 2.14, 13.94), and having a local home of residence (OR: 7.12; 95% CI: 2.41, 26.02) prior to employment in sugarcane were associated with non-stable eGFR sub-population assignment. CONCLUSIONS: Mild hypertension may be an early indicator of the development of CKDu. A better understanding of preexisting risk factors is needed to determine why individuals are entering the workforce with reduced kidney function and elevated blood pressure and increased risk of renal function decline.


Assuntos
Doenças dos Trabalhadores Agrícolas/fisiopatologia , Agricultura/métodos , Taxa de Filtração Glomerular , Hipertensão/complicações , Insuficiência Renal Crônica/epidemiologia , Saccharum , Adulto , Creatinina/sangue , Guatemala/epidemiologia , Humanos , Estudos Longitudinais , Masculino , Insuficiência Renal Crônica/etiologia , Fatores de Risco , Adulto Jovem
17.
BMC Womens Health ; 20(1): 58, 2020 03 21.
Artigo em Inglês | MEDLINE | ID: mdl-32199448

RESUMO

BACKGROUND: Despite Guatemala's large indigenous population, indigenous health is often neglected in reported health data and interventions. Although this data is limited in scope, it shows that indigenous people have poorer health outcomes. Sexually transmitted infections (STIs) are now a growing threat in Guatemala and pose great risk to the wellbeing of its indigenous population. METHODS: This qualitative pilot study assessed the knowledge, attitudes, and beliefs of STIs through semi-structured interviews among a previously unstudied population of indigenous Maya women (n = 35, ages 18-50) in the six municipalities of Santa Cruz La Laguna, Guatemala. RESULTS: Four key themes were identified: 1) indigenous Maya women have limited factual knowledge about sex and STIs; 2) widespread partner infidelity minimizes women's control over preventing STI contraction; 3) close-knit communities and the resulting heightened fear of gossip prevents communication and hinders care seeking; and 4) lack of quality medical care and inaccessibility of biomedical healthcare systems pose barriers to seeking care for potential STIs. CONCLUSIONS: To address these findings, we suggest methods to improve sexual education, combat male infidelity, promote condom use, and improve health services to reduce the incidence of STIs in Maya Guatemala.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Doenças Sexualmente Transmissíveis/epidemiologia , Adolescente , Adulto , Feminino , Guatemala/epidemiologia , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Pesquisa Qualitativa , Comportamento Sexual , Doenças Sexualmente Transmissíveis/prevenção & controle , Adulto Jovem
18.
Guatemala; Universidad del Valle de Guatemala. Programa Regional Centroamericano de VIH, MSPAS, CDC, PEPFAR, The University Norht Caroline; mar 2020. 99 p. ilus.
Monografia em Inglês | LILACS, LIGCSA | ID: biblio-1147330

RESUMO

In a qualitative study with both MSM and TW living with HIV in Guatemala City, Barrington et al (2016) again found that intersecting stigma and discrimination created fear of HIV testing and linkage to HIV care and barriers to knowledge about HIV. Retention-specific determinants included HIV clinic dynamics and limited employment opportunities, which affected economic stability. These multiple levels of factors driving linkage and retention in care and treatment require multi-level, integrated responses (AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Infecções por HIV/diagnóstico , HIV , Fármacos Anti-HIV/uso terapêutico , Saúde Sexual , Apoio Social , Aplicações da Informática Médica , Estudos Prospectivos , Medo/psicologia , Estigma Social , Guatemala/epidemiologia
19.
Reprod Health ; 17(1): 19, 2020 Jan 30.
Artigo em Inglês | MEDLINE | ID: mdl-32000798

RESUMO

BACKGROUND: Oligohydramnios is a condition of abnormally low amniotic fluid volume that has been associated with poor pregnancy outcomes. To date, the prevalence of this condition and its outcomes has not been well described in low and low-middle income countries (LMIC) where ultrasound use to diagnose this condition in pregnancy is limited. As part of a prospective trial of ultrasound at antenatal care in LMICs, we sought to evaluate the incidence of and the adverse maternal, fetal and neonatal outcomes associated with oligohydramnios. METHODS: We included data in this report from all pregnant women in community settings in Guatemala, Pakistan, Zambia and the Democratic Republic of Congo (DRC) who received a third trimester ultrasound as part of the First Look Study, a randomized trial to assess the value of ultrasound at antenatal care. Using these data, we conducted a planned secondary analysis to compare pregnancy outcomes of women with to those without oligohydramnios. Oligohydramnios was defined as measurement of an Amniotic Fluid Index less than 5 cm in at least one ultrasound in the third trimester. The outcomes assessed included maternal morbidity and fetal and neonatal mortality, preterm birth and low-birthweight. We used pairwise site comparisons with Tukey-Kramer adjustment and multivariable logistic models using general estimating equations to account for the correlation of outcomes within cluster. RESULTS: Of 12,940 women enrolled in the clusters in Guatemala, Pakistan, Zambia and the DRC in the First Look Study who had a third trimester ultrasound examination, 87 women were diagnosed with oligohydramnios, equivalent to 0.7% of those studied. Prevalence of detected oligohydramnios varied among study sites; from the lowest of 0.2% in Zambia and the DRC to the highest of 1.5% in Pakistan. Women diagnosed with oligohydramnios had higher rates of hemorrhage, fetal malposition, and cesarean delivery than women without oligohydramnios. We also found unfavorable fetal and neonatal outcomes associated with oligohydramnios including stillbirths (OR 5.16, 95%CI 2.07, 12.85), neonatal deaths < 28 days (OR 3.18, 95% CI 1.18, 8.57), low birth weight (OR 2.10, 95% CI 1.44, 3.07) and preterm births (OR 2.73, 95%CI 1.76, 4.23). The mean birth weight was 162 g less (95% CI -288.6, - 35.9) with oligohydramnios. CONCLUSIONS: Oligohydramnos was associated with worse neonatal, fetal and maternal outcomes in LMIC. Further research is needed to assess effective interventions to diagnose and ultimately to reduce poor outcomes in these settings. TRIAL REGISTRATION: NCT01990625.


Assuntos
Países em Desenvolvimento/estatística & dados numéricos , Feto/patologia , Mortalidade Infantil/tendências , Recém-Nascido de Baixo Peso , Oligo-Hidrâmnio/epidemiologia , Resultado da Gravidez/epidemiologia , Cuidado Pré-Natal/estatística & dados numéricos , Adulto , Feminino , Feto/diagnóstico por imagem , Guatemala/epidemiologia , Humanos , Lactente , Recém-Nascido , Masculino , Oligo-Hidrâmnio/diagnóstico por imagem , Paquistão/epidemiologia , Gravidez , Estudos Prospectivos , Ultrassonografia Pré-Natal , Adulto Jovem , Zâmbia/epidemiologia
20.
Am J Trop Med Hyg ; 102(5): 971-981, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32100677

RESUMO

Zika virus, which is transmitted by Aedes aegypti mosquitoes and through sexual transmission, disproportionally affects the human fetus. Guatemala experienced a surge of Zika cases beginning in 2016. We conducted a qualitative study of community perceptions of the seriousness of Zika, as well as the effectiveness, feasibility, and collective efficacy of Zika prevention actions. Free listing elicited the preventive actions salient for 68 participants comprising pregnant women, men with a pregnant partner, and women likely to become pregnant; 12 focus group discussions in a highland and a lowland town explored other concepts through rank orderings of prevention practices depicted on cards. Participants' initial concern about Zika, based on recent experience with chikungunya and high media coverage, diminished because of its mild symptoms and reduced media coverage. Participants identified more than 32 salient preventive actions, many of which are considered effective by programs. Participants ranked water storage container cleaning and regular unspecified cleaning of the house and its surroundings as highly effective, feasible, and of high collective efficacy; however, the actions lacked the specificity needed to effectively destroy mosquito eggs. Community-level removal of tires and discarded containers had lower collective efficacy than household-level implementation because of the municipal and community cooperation needed. Condom use, although salient for Zika prevention, was hindered by gender roles. The findings indicate space for increasing self-efficacy for condom use among fathers-to-be, abandoning nonspecific terms such as "cleaning" and "standing water," increasing people's skills in using bleach as an ovicide, and promoting antenatal care and family planning counseling.


Assuntos
Atitude Frente a Saúde , Infecção por Zika virus/prevenção & controle , Zika virus , Adolescente , Adulto , Aedes/virologia , Animais , Feminino , Guatemala/epidemiologia , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Controle de Mosquitos , Mosquitos Vetores/virologia , Gravidez , Pesquisa Qualitativa , Adulto Jovem , Infecção por Zika virus/epidemiologia , Infecção por Zika virus/transmissão
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...