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1.
Washington, D.C.; PAHO; 2021-06-08. (PAHO/FPL/IM/21-0018).
Não convencional em Inglês | PAHO-IRIS | ID: phr-54189

RESUMO

In response to concurrent measles, diphtheria, and yellow fever outbreaks in the Americas Region alongside increasing migratory movement, the Pan American Health Organization (PAHO) declared an emergency situation in Guyana (as well as Brazil, Colombia, and Venezuela) on March 22nd, 2018, offering guidance and technical support in assessing country situations and developing emergency response plans.


Assuntos
Programas de Imunização , Programas Nacionais de Saúde , Vacinas , Cobertura Vacinal , Equidade em Saúde , Emergências , Migrantes , Saúde na Fronteira , Áreas de Fronteira , Guiana
2.
Washington, D.C.; OPS; 2021-06-08. (OPS/FPL/IM/21-0018).
Não convencional em Espanhol | PAHO-IRIS | ID: phr-54188

RESUMO

En respuesta a los brotes simultáneos de enfermedades prevenibles por vacunación (EPV) tales como: sarampión, difteria y fiebre amarilla en la Región de las Américas y países vecinos, junto con el aumento de los movimientos migratorios, la Organización Panamericana de la Salud (OPS) declaró el 22 de marzo del 2018 situación de emergencia en Guyana (así como en el Brasil, Colombia y Venezuela), ofreciendo orientación y apoyo técnico para evaluar las situaciones de los países y elaborar planes de respuesta frente a la emergencia.


Assuntos
Cobertura Vacinal , Vacinação , Imunização , Migrantes , Saúde na Fronteira , Equidade em Saúde , Guiana
3.
Suicide Life Threat Behav ; 51(2): 189-196, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33876491

RESUMO

Studied mostly in developed countries, the increased prevalence of suicide among youth, worldwide, is a preventable public health concern. Guyana, a developing country in South America, has the highest rate of youth death by suicide. Based on the diathesis-stress model, this community-based study aimed to identify both psychiatric and biological factors associated with repeated suicide attempts among high-risk youth. OBJECTIVE: We measured psychiatric symptoms, childhood traumas, and cortisol to identify correlates with recurrent suicide attempts. METHOD: Poisson regression tested the association between psychiatric symptoms, trauma, and cortisol levels on number of suicide attempts among 50 youths from three child welfare orphanages in Guyana. Sixty-six percent were female, and the average age was 14 years. DSM-5 symptom measure was administered and saliva samples collected. RESULTS: Fifty percent of the youth endorsed suicide attempt. Within this subsample, a minimum of one and maximum of five suicide attempts were self-reported. Participants' number of suicide attempts was positively associated with number of past traumas, psychosis, and depression symptoms. CONCLUSION: Suicide prevention screening among at-risk youth should target severity of psychosis and depression reports and number of traumatic life experiences.


Assuntos
Pesquisa Participativa Baseada na Comunidade , Tentativa de Suicídio , Adolescente , Criança , Feminino , Guiana , Humanos , Masculino , Prevalência , Fatores de Risco
4.
Zootaxa ; 4950(2): zootaxa.4950.2.4, 2021 Mar 30.
Artigo em Inglês | MEDLINE | ID: mdl-33903439

RESUMO

Gymnophthalmids are a highly diverse group of Neotropical lizards and its species richness is still in process of discovery. The incorporation of molecular evidence and a noticeable increase in taxon and geographic sampling in systematic studies has led to the description of numerous new genera and species of gymnophthalmids (particularly in Cercosaurinae) in recent years. Herein we describe a new genus and species of cercosaurine lizard with crocodile-like morphology, from the Venezuelan Guiana Shield on the basis of molecular phylogenetic and morphological evidence. Kataphraktosaurus gen. nov. can be readily distinguished from all other genera of Cercosaurinae by a unique combination of morphological characters that includes heterogeneous dorsal scalation with enlarged and strongly keeled scales forming two paravertebral rows, ventral and subcaudal scales imbricated and strongly keeled, large and symmetrical cephalic scales, absence of postmental scale, palpebral disc translucent and divided, tail slightly compressed, all digits clawed, and only six femoral pores (three at each hindlimb) inserted in a clump of small scales. This genus is described as monotypic and only contains Kataphraktosaurus ungerhamiltoni sp. nov., which is known from one specimen and diagnosed by the same set of aforementioned characters. The secretive habits of this species and the remoteness of the locality may explain its singleton situation. Following the International Union for Conservation of Nature's criteria, we categorized the new species as Data Deficient.


Assuntos
Lagartos , Rios , Distribuição Animal , Estruturas Animais , Animais , Guiana , Lagartos/classificação , Lagartos/genética , Filogenia , Venezuela
5.
Artigo em Inglês | PAHO-IRIS | ID: phr-53354

RESUMO

[ABSTRACT]. Objective. To determine predictors associated with physical violence during pregnancy, and to determine the relationship between exposure to intimate partner violence during pregnancy and women’s health and suicide ideation in Guyana. Methods. A secondary data analysis of a cross-sectional household survey. Multivariate logistic regression models were fitted to the data to estimate the association between physical violence during pregnancy, controlling partner behavior, and other predictors. Ordered logistic regression models were fitted to estimate the association between physical violence during pregnancy and women’s health, and lifetime physical partner violence and overall health. Logistic regression models were fitted to estimate associations between physical violence during pregnancy and lifetime physical partner violence and overall health and suicide ideation. Results. The prevalence of lifetime physical/sexual intimate partner violence was 38.8%, current physical/sexual intimate partner violence 11.1%, and violence during pregnancy 9.2%. Controlling partner behavior was significantly and positively associated with maternal experience of physical violence during pregnancy. Experiencing physical partner violence during pregnancy, but not lifetime physical partner violence, was associated with significantly increased odds of poor overall health. Physical violence during pregnancy and lifetime physical violence were both significantly associated with increased odds of suicide ideation. Conclusions. The prevalence of violence during pregnancy in Guyana is high and is associated with adverse health outcomes. These findings suggest the need for intimate partner violence prevention, and for integrating intimate partner violence screening and treatment into antenatal care, reproductive health services, and maternal and child health programs and services to identify and treat at-risk women.


[RESUMEN]. Objetivo. Determinar los factores predictivos relacionados con la violencia física durante el embarazo y determinar la relación entre la exposición a la violencia de pareja durante el embarazo y la ideación suicida y la salud de las mujeres en Guyana. Métodos. Se realizó un análisis secundario de los datos obtenidos de una encuesta domiciliaria transversal. Se adaptaron modelos multifactoriales de regresión logística a los datos para calcular la asociación entre la violencia física durante embarazo, comportamiento controlador de la pareja y otros factores predictivos. Se emplearon modelos ordenados de regresión logística para calcular la asociación entre la violencia física durante el embarazo y la salud de la mujer, y la violencia de pareja a lo largo de la vida y la salud en general. Se aplicaron modelos de regresión logística para calcular la asociación entre la violencia física durante el embarazo y la violencia de pareja a lo largo de la vida y la ideación suicida y la salud en general. Resultados. La prevalencia de la violencia física o sexual infligida por la pareja a lo largo de la vida fue 38,8%, la violencia física o sexual infligida por la pareja en la actualidad fue 11,1% y la violencia durante el embarazo fue 9,2%. El comportamiento controlador de la pareja mostró una asociación positiva y significativa con una experiencia materna de violencia física durante el embarazo. Sufrir violencia física durante el embarazo, aunque no a lo largo de la vida, se asoció significativamente con mayores probabilidades de un estado de salud general deficiente. Tanto la violencia física durante el embarazo como la violencia física a lo largo de la vida se asociaron significativamente con mayores probabilidades de ideación suicida. Conclusiones. La prevalencia de la violencia durante el embarazo en Guyana es alta y está relacionada con consecuencias adversas en materia de salud. Estos resultados ponen de manifiesto la necesidad de prevenir la violencia de pareja y de integrar su detección y tratamiento en la atención prenatal, los servicios de salud reproductiva y los programas y servicios de salud maternoinfantil para detectar y tratar a las mujeres en riesgo.


[RESUMO]. Objetivo. Determinar as variáveis preditivas associadas à violência física contra mulheres na gravidez e avaliar a relação entre exposição à violência por parceiro íntimo na gravidez e saúde e ideação suicida em mulheres na Guiana. Métodos. Foi realizada uma análise dos dados secundários de uma pesquisa transversal domiciliar. Modelos de regressão logística multivariada foram ajustados ao conjunto de dados para estimar a associação entre violência física na gravidez, controlando-se o efeito do comportamento do parceiro e outras variáveis preditivas. Modelos de regressão logística ordinal foram ajustados para estimar a associação entre violência física na gravidez e saúde das mulheres e violência física por parceiro íntimo ao longo da vida e saúde geral. Modelos de regressão logística foram ajustados para estimar a associação entre violência física na gravidez e violência física por parceiro íntimo ao longo da vida e saúde geral e ideação suicida. Resultados. Observou-se uma prevalência de 38,8% de violência física/sexual por parceiro íntimo ao longo da vida, 11,1% de violência física/sexual por parceiro íntimo no momento presente e 9,2% de violência física/sexual na gravidez. Controlando-se o efeito do comportamento do parceiro, verificou-se uma associação positiva significativa com experiência materna de violência física na gravidez. Sofrer violência física por parceiro íntimo na gravidez, mas não violência física por parceiro íntimo ao longo da vida, foi associado a uma chance significativamente maior de saúde geral ruim. Verificou-se uma associação significativa entre violência física na gravidez e violência física ao longo da vida e uma maior chance de ideação suicida. Conclusões. A prevalência da violência contra mulheres na gravidez na Guiana é alta e está associada a desfechos de saúde adversos. Esses resultados apontam para a necessidade de prevenir a violência por parceiro íntimo e integrar a avaliação da violência por parceiro íntimo e o tratamento das mulheres aos serviços de assistência pré-natal e de saúde reprodutiva e programas e serviços de saúde materno-infantil para identificar e tratar as mulheres em risco.


Assuntos
Violência por Parceiro Íntimo , Gravidez , Violência Doméstica , Abuso Físico , Saúde Mental , COVID-19 , Infecções por Coronavirus , Coronavirus , Betacoronavirus , Guiana , Violência por Parceiro Íntimo , Gravidez , Violência Doméstica , Abuso Físico , Saúde Mental , Infecções por Coronavirus , Violência por Parceiro Íntimo , Gravidez , Violência Doméstica , Saúde Mental , Violência contra a Mulher , Violência contra a Mulher , Violência contra a Mulher , Delitos Sexuais , Delitos Sexuais , Delitos Sexuais , Guiana
6.
Anthropol Med ; 28(1): 78-93, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33441023

RESUMO

This paper examines bodily transformation and well-being within the context of a millenarian movement that emerged during the 1840s in the area surrounding Mount Roraima at the periphery of Brazil, Guyana (British Guiana at the time), and Venezuela. The site of this movement was Beckeranta - meaning 'Land of the Whites' - where up to 400 Amerindians were reportedly killed in a quest that is described in its sole historical account as centred around a goal of bodily transformation into white people. In examining this movement, the paper engages with longstanding debates in medical anthropology concerning the body, as well as conversations among Amazonianists concerning the social formation of bodies, and examines sorcery and shamanism as practices that go 'beyond the body'. Notions of bodily transformation in Amazonia, which are often activated by strong emotions, facilitate conceptual expansions of the body in medical anthropology. The paper suggests that bodily transformations tied to sorcery and shamanism are in some contexts, such as at Beckeranta, associated with desires for well-being.Supplemental data for this article is available online at https://doi.org/10.1080/13648470.2020.1807726.


Assuntos
Índios Sul-Americanos/etnologia , Bruxaria , Antropologia Médica , Cristianismo/história , Guiana/etnologia , História do Século XIX , História do Século XX , História do Século XXI , Humanos
7.
PLoS One ; 15(12): e0244454, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33373407

RESUMO

Despite being a priority population in malaria elimination, there is scant literature on malaria-related behavior among gold miners. This study explores the prevalence and factors influencing malaria prevention, care seeking and treatment behaviors in Guyana gold mining camps. A cross sectional survey was conducted among adult gold miners living in mining camps in the hinterland Regions 1 (Barima-Waini), 7 (Cuyuni-Mazaruni), and 8 (Potaro-Siparuni). Multivariable logistic regressions explored factors associated with miners' self-report of mosquito net use, prompt care-seeking; self-medication; and testing for malaria. A third of miners used a mosquito net the night preceding the survey and net use was higher among those who believed that net use was the norm in their camp (aOR: 3.11; 95% CI:1.65, 5.88). Less than half (45%) of miners had a fever in the past 12 months, among whom 36% sought care promptly, 48% tested positive for malaria while 54% self-medicated before seeking care. Prompt care-seeking was higher among miners with high malaria knowledge (aOR: 1.44; 95% CI: 1.01, 2.05). Similarly, testing rates increased with secondary education (aOR: 1.71; 95% CI: (1.16, 2.51), high malaria knowledge (aOR: 1.45; 95% CI: 1.02, 2.05), positive beliefs regarding malaria transmission, threat, self-diagnosis, testing and treatment, and, trust in government services (aOR: 1.59; 95% CI (1.12, 2.27) and experience of a prior malaria episode (aOR: 2.62; 95% CI: 1.71, 4.00). Self-medication was lower among male miners (aOR: 0. 52; 95% CI: 0.32, 0.86). Malaria prevention and care seeking behaviors among miners are somewhat low and influenced by mosquito net usage, perceived norms, malaria knowledge and prior episode of confirmed malaria. Study findings have implications for malaria interventions in the hinterland regions of Guyana such as the mass and continuous distribution of insecticide treated nets as well as community case management initiatives using trained malaria testing and treatment volunteers to curb malaria transmission among remote gold mining populations. These include efforts to identify and address gaps in distributing mosquito nets to miners and address miners' barriers to prompt care seeking, malaria testing and treatment adherence. Targeted social and behavior change messaging is needed on net acquisition, use and care, prompt care-seeking, malaria testing and treatment adherence. Additional efforts to ensure the overall sustainability of the community case management initiative include increased publicity of the community case management initiative among miners, use of incentives to promote retention rates among the community case management volunteer testers and public private partnerships between the Guyana Ministry of Health and relevant mining organizations.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Malária/prevenção & controle , Mineradores/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Adolescente , Adulto , Serviços de Saúde Comunitária/organização & administração , Estudos Transversais , Feminino , Ouro , Guiana , Humanos , Malária/tratamento farmacológico , Malária/parasitologia , Malária/transmissão , Masculino , Pessoa de Meia-Idade , Mineradores/estatística & dados numéricos , Mineração/organização & administração , Mosquiteiros/estatística & dados numéricos , Motivação , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Parcerias Público-Privadas , Automedicação/psicologia , Automedicação/estatística & dados numéricos , Autorrelato/estatística & dados numéricos , Adulto Jovem
8.
Can J Surg ; 63(5): E418-E421, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33009901

RESUMO

SUMMARY: The Canadian Network for International Surgery (CNIS) hosted a workshop in May of 2020 with a goal of critically evaluating Trauma Team Training courses. The workshop was held virtually because of the coronavirus disease 2019 (COVID-19) pandemic. Twenty-three participants attended from 8 countries: Canada, Guyana, Kenya, Nigeria, Switzerland, Tanzania, Uganda and the United States. More participants were able to attend the virtual meeting than the traditional in-person meetings. Web-based videoconference software was used, participants presented prerecorded PowerPoint videos, and questions were raised using a written chat. The review proved successful, with discussions and recommendations for improvements surrounding course quality, lecture content, skills sessions, curriculum variations and clinical practical scenarios. The CNIS's successful experience conducting an online curriculum review involving international participants may prove useful to others proceeding with collaborative projects during the COVID-19 pandemic.


Assuntos
Congressos como Assunto/organização & administração , Infecções por Coronavirus/prevenção & controle , Currículo , Cirurgia Geral/educação , Cooperação Internacional , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Betacoronavirus/patogenicidade , Canadá/epidemiologia , Congressos como Assunto/normas , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Cirurgia Geral/métodos , Guiana/epidemiologia , Humanos , Controle de Infecções/organização & administração , Controle de Infecções/normas , Quênia/epidemiologia , Nigéria/epidemiologia , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Pneumonia Viral/virologia , Suíça/epidemiologia , Tanzânia/epidemiologia , Uganda/epidemiologia , Estados Unidos/epidemiologia , Comunicação por Videoconferência/organização & administração , Comunicação por Videoconferência/normas , Ferimentos e Lesões/cirurgia
9.
PLoS One ; 15(10): e0238499, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33119591

RESUMO

INTRODUCTION: Great strides in responding to the HIV epidemic have led to improved access to and uptake of HIV services in Guyana, a lower-middle-income country with a generalized HIV epidemic. Despite efforts to scale up HIV treatment and adopt the test and start strategy, little is known about costs of HIV services across the care cascade. METHODS: We collected cost data from the national laboratory and nine selected treatment facilities in five of the country's ten Regions, and estimated the costs associated with HIV testing and services (HTS) and antiretroviral therapy (ART) from a provider perspective from January 1, 2016 to December 31, 2016. We then used the unit costs to construct four resource allocation scenarios. In the first two scenarios, we calculated how close Guyana would currently be to its 2020 targets if the allocation of funding across programs and regions over 2017-2020 had (a) remained unchanged from latest-reported levels, or (b) been optimally distributed to minimize incidence and deaths. In the next two, we estimated the resources that would have been required to meet the 2020 targets if those resources had been distributed (a) according to latest-reported patterns, or (b) optimally to minimize incidence and deaths. RESULTS: The mean cost per test was US$15 and the mean cost per person tested positive was US$796. The mean annual cost per of maintaining established adult and pediatric patients on ART were US$428 and US$410, respectively. The mean annual cost of maintaining virally suppressed patients was US$648. Cost variation across sites may suggest opportunities for improvements in efficiency, or may reflect variation in facility type and patient volume. There may also be scope for improvements in allocative efficiency; we estimated a 28% reduction in the total resources required to meet Guyana's 2020 targets if funds had been optimally distributed to minimize infections and deaths. CONCLUSIONS: We provide the first estimates of costs along the HIV cascade in the Caribbean and assessed efficiencies using novel context-specific data on the costs associated with diagnostic, treatment, and viral suppression. The findings call for better targeting of services, and efficient service delivery models and resource allocation, while scaling up HIV services to maximize investment impact.


Assuntos
Infecções por HIV/economia , Infecções por HIV/terapia , Custos de Cuidados de Saúde , Alocação de Recursos , Adolescente , Adulto , Fármacos Anti-HIV/economia , Fármacos Anti-HIV/uso terapêutico , Criança , Pré-Escolar , Feminino , Guiana/epidemiologia , Infecções por HIV/epidemiologia , Instalações de Saúde , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Retrospectivos , Adulto Jovem
10.
Artigo em Inglês | PAHO-IRIS | ID: phr-52946

RESUMO

[ABSTRACT]. Objectives. To analyze progress in organizational structures, mechanisms, strategies, and enabling factors and barriers towards gender mainstreaming (GM) in health in Guatemala, Guyana, and Peru, given GM’s role in addressing gender inequalities in health as a key structural driver of health equity. Methods. Data was obtained through a grey literature review of laws, policies, and/or program documents and semi-structured qualitative interviews with 37 informants. Analysis was based on a theoretical framework including 7 categories considered essential to advance GM in the health sector. Results. Despite significant efforts and accumulated experiences of GM in health, structural barriers include: wider societal challenges of transforming gender unequal power relations; health system complexity combined with the low technical, political, and financial capacity of institutional structures tasked with GM; and limited coordination with (often weak) National Women’s Machineries (NWMs). In some contexts, barriers are compounded by limited understanding of basic concepts underlying GM (at times exacerbated by misunderstandings related to intersectionality and/or engagement with men) and the absence of indicators to measure GM’s concrete results and impact. Conclusions. Successful GM requires a more strategic and transformational agenda, developed and implemented in coordination with NWMs and civil society and with reference to external bodies (e.g. Committee on the Elimination of Discrimination against Women) to go beyond process, with clearer distinction between gender sensitivity and gender transformation, and definition of expected results and indicators to measure advances. These then could be better documented and systematized, enabling GM to be more broadly understood and operationalized as a concrete instrument towards health equity.


[RESUMEN]. Objetivos. Analizar el progreso en las estructuras, mecanismos y estrategias organizativas, así como los factores y las barreras, que favorecen la incorporación de la perspectiva de género en la salud en Guatemala, Guyana y Perú, dado el papel que ello desempeña en el abordaje de las desigualdades de género en la salud como un motor estructural clave de la equidad en salud. Métodos. Se obtuvieron datos a partir de la literatura gris de leyes, políticas o documentos de programas y entrevistas cualitativas semiestructuradas con 37 informantes. El análisis se basó en un marco teórico que incluía 7 categorías consideradas esenciales para avanzar la incorporación de la perspectiva de género en el sector de la salud. Resultados. A pesar de los importantes esfuerzos y las experiencias acumuladas respecto de la incorporación de la perspectiva de género en el sector de la salud persisten obstáculos estructurales, como desafíos sociales más amplios para transformar las relaciones de poder desiguales entre los géneros; la complejidad del sistema de salud combinada con una baja capacidad técnica, política y financiera de las estructuras institucionales encargadas de abordar el tema; y la limitada coordinación con las instituciones nacionales dedicadas a la promoción de la mujer (a menudo débiles). En algunos contextos, los obstáculos se ven agravados por la limitada comprensión de los conceptos básicos subyacentes a la perspectiva de género (a veces exacerbada por una comprensión limitada de la interseccionalidad o el compromiso con los hombres) y la ausencia de indicadores para medir los resultados y el impacto concreto de la incorporación de la perspectiva de género. Conclusiones. Para que la incorporación de la perspectiva de género en la salud sea satisfactoria se requiere una agenda más estratégica y transformadora, elaborada e implementada en coordinación con las instituciones nacionales de promoción de la mujer y la sociedad civil y vinculada a instancias externas (p. ej., el Comité para la Eliminación de la Discriminación contra la Mujer). Es necesario, asimismo, una distinción más clara entre los enfoques sensibles al género y aquellos transformativos de las relaciones desiguales de género, y una definición de los resultados previstos y los indicadores para medir los avances. Estos podrían entonces documentarse y sistematizarse mejor, lo que permitiría que la perspectiva de género se comprendiera más ampliamente y se pusiera en práctica como instrumento concreto para lograr la equidad en salud.


Assuntos
Equidade em Saúde , Equidade de Gênero , Transversalidade de Gênero , Políticas Inclusivas de Gênero , Guiana , Peru , Guatemala , Equidade em Saúde , Equidade de Gênero , Transversalidade de Gênero , Políticas Inclusivas de Gênero , Peru
11.
Mem Inst Oswaldo Cruz ; 115: e200043, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32667459

RESUMO

BACKGROUND The number of malaria cases in Roraima nearly tripled from 2016 to 2018. The capital, Boa Vista, considered a low-risk area for malaria transmission, reported an increasing number of autochthonous and imported cases. OBJECTIVES This study describes a spatial analysis on malaria cases in an urban region of Boa Vista, which sought to identify the autochthonous and imported cases and associated them with Anopheles habitats and the potential risk of local transmission. METHODS In a cross-sectional study at the Polyclinic Cosme e Silva, 520 individuals were interviewed and diagnosed with malaria by microscopic examination. Using a global positional system, the locations of malaria cases by type and origin and the breeding sites of anopheline vectors were mapped and the risk of malaria transmission was evaluated by spatial point pattern analysis. FINDINGS Malaria was detected in 57.5% of the individuals and there was a disproportionate number of imported cases (90.6%) linked to Brazilian coming from gold mining sites in Venezuela and Guyana. MAIN CONCLUSIONS The increase in imported malaria cases circulating in the west region of Boa Vista, where there are positive breeding sites for the main vectors, may represent a potential condition for increased autochthonous malaria transmission in this space.


Assuntos
Anopheles/parasitologia , Malária/diagnóstico , Malária/transmissão , Mineradores/estatística & dados numéricos , Mosquitos Vetores/parasitologia , Plasmodium/isolamento & purificação , Viagem , Adulto , Animais , Anopheles/classificação , Brasil/epidemiologia , Estudos Transversais , Feminino , Sistemas de Informação Geográfica , Ouro , Guiana , Humanos , Malária/epidemiologia , Malária/parasitologia , Masculino , Pessoa de Meia-Idade , Plasmodium/classificação , Análise Espacial , População Urbana , Venezuela
12.
PLoS One ; 15(5): e0233379, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32442197

RESUMO

INTRODUCTION: Point-of-care ultrasound (POCUS) is physician-performed at the bedside, and it is a powerful diagnostic tool, especially in resource-limited emergency medicine healthcare settings. This study aims to quantify both the use of ultrasound and its impact on patient care at the Accident and Emergency Department at the Georgetown Public Hospital Corporation (GPHC). METHODS: This is a cross-sectional observational descriptive analysis of data collected for quality assessment in the GPHC Accident and Emergency Department. Over the course of two months, physicians were asked to record each ultrasound exam performed and record whether the ultrasound results changed patient disposition or the medication used in management. RESULTS: During the study period, there were 173 ultrasound data sheets collected representing 426 ultrasound studies. 196 studies were positive with pathologic findings (46.0%). The use of ultrasound in patient care either changed the patient's final disposition or medication 78.6% of the time. CONCLUSION: Ultrasound is used frequently at the Georgetown Public Hospital Corporation for a wide variety of applications. When utilized, POCUS frequently influenced patient care.


Assuntos
Tomada de Decisão Clínica/métodos , Serviços Médicos de Emergência/métodos , Serviço Hospitalar de Emergência , Ultrassonografia/métodos , Estudos Transversais , Feminino , Guiana , Humanos , Masculino , Sistemas Automatizados de Assistência Junto ao Leito , Gravidez
13.
PLoS Negl Trop Dis ; 14(4): e0008149, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32251455

RESUMO

BACKGROUND: Individual behavior, particularly choices about prevention, plays a key role in infection transmission of vector-borne diseases (VBDs). Since the actual risk of infection is often uncertain, individual behavior is influenced by the perceived risk. A low risk perception is likely to diminish the use of preventive measures (behavior). If risk perception is a good indicator of the actual risk, then it has important implications in a context of disease elimination. However, more research is needed to improve our understanding of the role of human behavior in disease transmission. The objective of this study is to explore whether preventive behavior is responsive to risk perception, taking into account the links with disease knowledge and controlling for individuals' socioeconomic and demographic characteristics. More specifically, the study focuses on malaria, dengue fever, Zika and cutaneous leishmaniasis (CL), using primary data collected in Guyana-a key country for the control and/or elimination of VBDs, given its geographic location. METHODS AND FINDINGS: The data were collected between August and December 2017 in four regions of the country. Questions on disease knowledge, risk perception and self-reported use of preventive measures were asked to each participant for the four diseases. A structural equation model was estimated. It focused on data collected from private households only in order to control for individuals' socioeconomic and demographic characteristics, which led to a sample size of 497 participants. The findings showed evidence of a bidirectional association between risk perception and behavior. A one-unit increase in risk perception translated into a 0.53 unit increase in self-reported preventive behavior for all diseases, while a one-unit increase in self-reported preventive behavior (i.e. the use of an additional measure) led to a 0.46 unit decrease in risk perception for all diseases (except CL). This study also showed that higher education significantly improves knowledge and that better knowledge increases the take up of preventive measures for malaria and dengue, without affecting risk perception. CONCLUSIONS: In trying to reach elimination, it appears crucial to promote awareness of the risks and facilitate access to preventive measures, so that lower risk perception does not translate into lower preventive behavior.


Assuntos
Comportamento , Conhecimentos, Atitudes e Prática em Saúde , Doenças Transmitidas por Vetores/prevenção & controle , Doenças Transmitidas por Vetores/transmissão , Demografia , Dengue/prevenção & controle , Dengue/transmissão , Características da Família , Feminino , Guiana , Humanos , Leishmaniose Cutânea/prevenção & controle , Leishmaniose Cutânea/transmissão , Malária/prevenção & controle , Malária/transmissão , Masculino , Fatores de Risco , Autorrelato , Fatores Socioeconômicos , Inquéritos e Questionários , Infecção por Zika virus/prevenção & controle , Infecção por Zika virus/transmissão
14.
Int J Infect Dis ; 95: 32-37, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32251804

RESUMO

OBJECTIVES: This study aimed to verify the frequency, genotypes, and etiological role of Human Bocavirus (HBoV) in younger Amazonian children with either acute gastroenteritis (AGE) or respiratory infections (ARI). The influence of Rotarix™ vaccination and co-infection status was also investigated. DESIGN: HBoV quantitative polymerase chain reaction (qPCR) testing was done on both fecal and saliva (1468 samples) from 734 children < 5 months old living in the Amazon (Brazil, Guyana, and Venezuela). High and median HBoV viral load samples were used for extraction, nested PCR amplification, and sequencing for genotyping. HBoV mRNA detection was done by reverse transcription following DNA amplification. RESULTS: The overall HBoV frequencies were 14.2% (69/485; AGE) and 14.1% (35/249; ARI) (p = 0.83). HBoV exclusively infected 4.5% (22/485; AGE) and 4% (10/249) of the Amazonian children (Odds ratios 1.13, 95% confidence interval= 2.42-0.52). HBoV 1 was mainly detected in feces and saliva from AGE children; and HBoV2, from ARI children. HBoV mRNA was detected only in feces. The Rotarix™ vaccination status did not affect the HBoV frequencies. CONCLUSIONS: We suggest that, after entry into the air/oral pathways, HBoV1 continues infecting toward the intestinal tract causing AGE. HBoV2 can be a causative agent of AGE and ARI in younger Amazonian children.


Assuntos
Gastroenterite/virologia , Bocavirus Humano/genética , Infecções por Parvoviridae/virologia , Infecções Respiratórias/virologia , Doença Aguda , Brasil , Coinfecção/virologia , Fezes/virologia , Feminino , Genótipo , Guiana , Bocavirus Humano/isolamento & purificação , Humanos , Lactente , Masculino , Reação em Cadeia da Polimerase , Saliva/virologia , Venezuela , Carga Viral
16.
Biomed Res Int ; 2020: 9063808, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32047818

RESUMO

Abstract. Persistent urban-rural disparity in subjective health and quality of life is a growing concern for healthcare systems across the world. In general, urban population performs better on most health indicators compared with their rural counterparts. However, research evidence on the urban-rural disparity on perceived health, happiness, and quality of life among the young adult population is scarce in South American countries like Guyana. Therefore, in the present study we aimed to investigate whether subjective health, happiness, and quality of life differ according to place of residence among the young adult population in Guyana. Methods: Cross-sectional data on 2,434 men and women aging between 15 and 24 years were collected from the most recent Guyana Multiple Indicator Cluster Survey conducted in 2014. Outcome variables were perceived: satisfaction about health, life, and happiness, as well as life satisfaction before and after one year from the time of the survey. The urban-rural disparity in reporting satisfaction for these indicators was assessed by multivariate regression methods and by adjusting for relevant sociodemographic factors. Results: More than four-fifth of the respondents reported satisfaction with health (82.4%) and life (81.4%) and 77.9% reported being happy. A vast majority expressed improvement in life situation compared with a year ago (81.4%), and nearly all of the participants (95.4%) expect to have better life situation a year later. Multivariate analysis revealed an inverse association between rural residence and subjective health among men [OR = 0.518, 95%CI = 0.297, 0.901], and happiness [OR = 0.662, 95%CI = 0.381, 0.845] and life satisfaction [OR = 3.722, 95%CI = 1.502, 9.227] among women. Women having secondary [OR = 2.219, 95%CI = 1.209, 3.720] and higher [OR = 1.600, 95%CI = 1.041, 3.302] education also had higher odds of satisfaction with happiness. Conclusions: Our findings demonstrate the existence of significant urban-rural disparities in perceived health and quality of life among the young adult population in Guyana, especially among women. National health promotion projects should therefore take proper policy actions to address the underlying factors contributing to the urban-rural gaps in order to establish a more equitable healthcare system. Further researches are necessary to explore the underlying causes behind such disparities.


Assuntos
Autoavaliação Diagnóstica , Felicidade , Satisfação Pessoal , Adolescente , Estudos Transversais , Atenção à Saúde , Feminino , Guiana , Humanos , Masculino , Análise Multivariada , Qualidade de Vida , Análise de Regressão , População Rural , Fatores Socioeconômicos , Inquéritos e Questionários , População Urbana , Adulto Jovem
17.
Mycologia ; 112(1): 39-51, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31825746

RESUMO

We report on the discovery and characterization of a novel Fusarium species that produced yellow-orange pseudoflowers on Xyris spp. (yellow-eyed grass; Xyridaceae) growing in the savannas of the Pakaraima Mountains of western Guyana. The petaloid fungal structures produced on infected plants mimic host flowers in gross morphology. Molecular phylogenetic analyses of full-length RPB1 (RNA polymerase largest subunit), RPB2 (RNA polymerase second largest subunit), and TEF1 (elongation factor 1-α) DNA sequences mined from genome sequences resolved the fungus, described herein as F. xyrophilum, sp. nov., as sister to F. pseudocircinatum within the African clade of the F. fujikuroi species complex. Results of a polymerase chain reaction (PCR) assay for mating type idiomorph revealed that single-conidial isolates of F. xyrophilum had only one of the MAT idiomorphs (MAT1-1 or MAT1-2), which suggests that the fungus may have a heterothallic sexual reproductive mode. BLASTn searches of whole-genome sequence of three strains of F. xyrophilum indicated that it has the genetic potential to produce secondary metabolites, including phytohormones, pigments, and mycotoxins. However, a polyketide-derived pigment, 8-O-methylbostrycoidin, was the only metabolite detected in cracked maize kernel cultures. When grown on carnation leaf agar, F. xyrophilum is phenotypically distinct from other described Fusarium species in that it produces aseptate microconidia on erect indeterminate synnemata that are up to 2 mm tall and it does not produce multiseptate macroconidia.


Assuntos
Mimetismo Biológico , Flores , Fusarium/classificação , Poaceae/microbiologia , DNA Fúngico/genética , Proteínas Fúngicas/genética , Fusarium/citologia , Fusarium/genética , Genes Fúngicos Tipo Acasalamento/genética , Genoma Fúngico/genética , Guiana , Filogenia , Análise de Sequência de DNA , Esporos Fúngicos/classificação , Esporos Fúngicos/citologia , Esporos Fúngicos/genética
18.
Ambio ; 49(6): 1241-1255, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31606885

RESUMO

REDD+ remains a critical tool for dealing with increasing levels of atmospheric carbon dioxide. Like other global-level initiatives, REDD+ has strong supporters and critics. Despite the division over its merits, little has been done to understand how a national-level audience responds to the program's arrival in a partner country and which players drive a program's implementation. Here we coded the archives of two Guyanese newspapers to identify the policy actors, institutions, and concepts (players) that drove the implementation of the country's Low Carbon Development Strategy (LCDS). Two groups of players-super-key and key-dictated the direction of the LCDS implementation. Super-key players used the state-owned media to advocate their positions, while players who felt they would be punished by the LCDS implementation published their positions in the privately-owned media. Therefore, like responses to other global-level environmental challenges, views around the LCDS were divided.


Assuntos
Dióxido de Carbono , Conservação dos Recursos Naturais , Emoções , Guiana
19.
Int J Psychol ; 55(4): 618-628, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31621908

RESUMO

Guyana, a low-to-middle-income country (LMIC) in South America, leads the world in youth suicide. As an understanding of risk and protective factors is critical to the development of culturally informed suicide prevention efforts, research exploring these factors among youth in Guyana is needed. The current study expands on current research on adolescent suicide in Guyana and LMICs broadly by using qualitative focus groups and interviews to explore adult stakeholders' and youth's perspectives. Participants included 17 adult stakeholders and 40 adolescents in Guyana. Data were analysed using a grounded theory approach. Themes related to participants' perceptions of risk factors for suicide included demographic characteristics, pressure and expectations, adults' responses to youth, limited coping with stressful life events and exposure to suicide. Themes related to protective factors for suicide included positive social support and involvement in community activities. Findings have implications for the development and tailoring of suicide prevention efforts for Guyanese youth.


Assuntos
Fatores de Proteção , Suicídio/prevenção & controle , Adulto , Feminino , Guiana , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Adulto Jovem
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