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1.
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
2.
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
4.
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
5.
Zootaxa ; 4638(3): zootaxa.4638.3.5, 2019 Jul 17.
Artigo em Inglês | MEDLINE | ID: mdl-31712469

RESUMO

A revised, geo-referenced, and cross-referenced list of 270 termite type localities in South America is presented. A total of 543 nominal species-group extant taxa are listed, 442 of them valid and 97 synonyms. The type-locality comprising the greatest number of nominal taxa in South America is Kartabo, Guyana (A.E. Emerson study site), with 59 taxa, followed by Cuiabá, Brazil (F. Sivestri), with 34, and Ribeirão Cascalheira, Brazil (Xavantina-Cachimbo Expedition, A.G.A. Mathews) with 26.


Assuntos
Isópteros , Animais , Brasil , Guiana , América do Sul
6.
Zootaxa ; 4576(3): zootaxa.4576.3.2, 2019 Apr 03.
Artigo em Inglês | MEDLINE | ID: mdl-31715747

RESUMO

Anomaloglossus is a species-rich genus of frogs endemic to the Guiana Shield that still harbors several unnamed species. Within the A. stepheni species group (which includes four valid nominal species), A. baeobatrachus has an uncertain taxonomic status, notably because the holotype was an unvouchered specimen depicted in a popular journal. Another member of this group, A. leopardus, was only superficially described, lacking information on the sex of specimens in the type series and on advertisement call. Therefore, these two taxa need clarifications in order to allow the description of the extant undescribed species. In this paper, we redescribe A. baeobatrachus based on newly collected material from the species type locality and provide information about its reproductive ecology. We also provide an amended definition of A. leopardus using newly collected material from its type locality. These two species form a clade along with a third species from the Eastern Guiana Shield, which is also described herein. The reproductive biology of A. baeobatrachus and A. stepheni is very similar. Both species have endotrophic and nidicolous tadpoles, despite being distantly related, suggesting independent evolution of this breeding mode. The new species and A. leopardus, on the other hand, have exotrophic tadpoles.


Assuntos
Anuros , Reprodução , Animais , Guiana , Larva
7.
Zootaxa ; 4585(2): zootaxa.4585.2.2, 2019 Apr 12.
Artigo em Inglês | MEDLINE | ID: mdl-31716167

RESUMO

The fasciolariid fauna from two expeditions to French Guiana is examined and augmented with published records and material of other collections from the Guianas and northeastern Brazil. Twelve species of Fasciolaria and Aurantilaria (Fasciolariinae), Aristofusus, Lyonsifusus and Fusinus s.l. (Fusininae), and Lamellilatirus and Polygona (Peristerniinae) are reported and discussed. Nine species are represented in expedition collections, and reports of three other species are evaluated. Two morphologically distinct species of Lamellilatirus are described as new; type localities of both are off French Guiana, 114-118 m. Ten Guianan fasciolariids range variously northward to Caribbean South America and the Lesser Antilles and southward to Ceará, Brazil; one other extends into the northern Caribbean, and one extends southward to Rio de Janeiro, Brazil.


Assuntos
Gastrópodes , Animais , Brasil , Região do Caribe , Guiana Francesa , Guiana
8.
Zootaxa ; 4664(2): zootaxa.4664.2.4, 2019 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-31716678

RESUMO

A new species of Cetopsis is described from Guiana Shield drainages in Guyana and Suriname. The new species is found in the Konawaruk River and tributaries, Essequibo River basin, Guyana, and in the Mauritie Creek, tributary to the Tempati River, upper Commewijne River basin, Suriname. The new taxon can be distinguished from all congeners by a combination of features: dark spots on sides of the body eye-sized or larger, dark, bilobed patch at the base of the caudal fin, absence of a dark humeral spot, absence of dark pigmentation along the fin-membrane posterior to the first dorsal-fin ray, dark pigmentation at the base of the dorsal fin, dark spots extending ventrally to the bases of anal-fin rays, and 41 total vertebrae with 28 caudal vertebrae. Data on internal anatomy of the new species were incorporated into a previously-published phylogenetic analysis and resolves the position of the new species as the sister group of C. motatanensis, from Lago Maracaibo basin. The new Cetopsis is the first species of the genus known to occur exclusively in the Guiana Shield.


Assuntos
Peixes-Gato , Animais , Guiana , Filogenia , Rios , Suriname
9.
Zootaxa ; 4664(1): zootaxa.4664.1.4, 2019 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-31716689

RESUMO

Chrysomydas Wilcox, Papavero Pimentel, 1989 (Diptera, Mydidae, Mydinae, Stratiomydina), is a poorly known monotypic genus, with the type-species, C. nitidulus (Olivier, 1811), recorded from Brazil, French Guiana, Guyana, and Suriname. The present work aims to provide an updated diagnosis for the genus and type-species, C. nitidulus, along with the description of C. phoenix Calhau Lamas sp. nov. from the state of Rio de Janeiro, Brazil, based on a male imago and associated pupal exuviae. Additionally, the first bionomic data for the genus are reported, with the rearing of adult C. nitidulus in the laboratory from larvae collected under the decaying trunk of a coconut palm (Cocos nucifera L.) in the state of Amazonas, Brazil. The new species is easily distinguished from C. nitidulus by the predominantly black tergal and scutal setulae, which are golden in the type-species. They also differ by the male genitalia and shape of the proboscis.


Assuntos
Dípteros , Animais , Brasil , Guiana Francesa , Guiana , Masculino , Suriname
10.
Zootaxa ; 4608(1): zootaxa.4608.1.4, 2019 May 17.
Artigo em Inglês | MEDLINE | ID: mdl-31717161

RESUMO

The demosponge genus Endectyon is characterized by the presence of acanthostyles with recurved or clavulate spines. Two subgenera are recognized, Endectyon and Hemectyon, distinguished mainly by the acanthostyles being located only in the periphery of the axial skeleton in Endectyon, or forming the ectosomal brushes in Hemectyon. Sixteen species are known worldwide, of which only two were reported from the Western Atlantic Ocean. However, the type locality of Endectyon xerampelina is uncertain, and it could be located either in the Western Atlantic or in Australia. In the present study, we describe new records of E. xerampelina from the Brazilian coast and propose that Raspailia (R.) johnhooperi from the Guyana shelf is a junior synonym of E. xerampelina. Our results support the hypothesis that the type locality of E. xerampelina is located somewhere in the Tropical Western Atlantic Ocean and also that the species belongs to the subgenus Endectyon (Endectyon). We amended the diagnosis of the subgenus Endectyon (Endectyon) to account for the variability of acanthostyle shape in E. (E.) xerampelina, assigning greater taxonomic value to the position of the echinating megascleres than to their shape and pattern of spination.


Assuntos
Poríferos , Distribuição Animal , Animais , Oceano Atlântico , Austrália , Brasil , Guiana
11.
Diabetes Res Clin Pract ; 158: 107929, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31738996

RESUMO

Diabetes is an increasing challenge for low- and middle-income countries (LMIC) and access to HbA1c testing is limited. HbA1c, a measure of glycaemic control averaged over 3 months, provides both clinicians and policymakers with a tool to identify the risk of long-term diabetes comorbidity. We describe the steps used to implement standardised testing in Guyana South America and the initial results according to a locally developed protocol as part of a country-wide project to improve the care of people with all forms of diabetes The steps identified include: a standardised method traceable to a recognized international reference standard, participation in a quality control cycle with an international reference laboratory, a clinical pathway for testing to reduce inappropriate use and minimize resource wastage, training of technicians in operation and maintenance of equipment, identification of a suitable space with constant power supply, a reliable procurement system, education of healthcare professionals on interpretation and follow-up of results and feedback of programme results to improve clinical practice. Some steps for implementation of the national HbA1c testing program were initiated better than others. Initial unreliability of the service undermined confidence in the system. Failure to follow the testing protocol led to some patients being tested too soon and others too late. Cost of reagents was about 5.60 USD/test. We trained 340 people in diabetes care and knowledge was improved but were unable to assess whether it was appropriately applied. Over one third of people tested in the 30-70 age group had an HbA1c over 9% (75 mmol/mol) and this did not improve over the 5 years of testing. Despite the difficulties we think our unique experience of implementation of a nationwide HbA1c testing programme has important lessons for other LMICs.


Assuntos
Glicemia/metabolismo , Diabetes Mellitus/diagnóstico , Hemoglobina A Glicada/metabolismo , Adulto , Idoso , Feminino , Guiana , Humanos , Masculino , Pessoa de Meia-Idade , América do Sul
12.
Proc Natl Acad Sci U S A ; 116(49): 24492-24499, 2019 12 03.
Artigo em Inglês | MEDLINE | ID: mdl-31740591

RESUMO

Reducing emissions from deforestation and forest degradation (REDD+) is a climate change mitigation policy in which rich countries provide payments to developing countries for protecting their forests. In 2009, the countries of Norway and Guyana entered into one of the first bilateral REDD+ programs, with Norway offering to pay US$250 million to Guyana if annual deforestation rates remained below 0.056% from 2010 to 2015. To quantify the impact of this national REDD+ program, we construct a counterfactual times-series trajectory of annual tree cover loss using synthetic matching. This analytical approach allows us to quantify tree cover loss that would have occurred in the absence of the Norway-Guyana REDD+ program. We found that the Norway-Guyana REDD+ program reduced tree cover loss by 35% during the implementation period (2010 to 2015), equivalent to 12.8 million tons of avoided CO2 emissions. Our analysis indicates that national REDD+ payments attenuated the effect of increases in gold prices, an internationally traded commodity that is the primary deforestation driver in Guyana. Overall, we found strong evidence that the program met the additionality criteria of REDD+. However, we found that tree cover loss increased after the payments ended, and therefore, our results suggest that without continued payments, forest protection is not guaranteed. On the issue of leakage, which is complex and difficult to quantify, a multinational REDD+ program for a region could address leakage that results from differences in forest policies between neighboring countries.


Assuntos
Conservação dos Recursos Naturais/métodos , Modelos Teóricos , Árvores , Conservação dos Recursos Naturais/estatística & dados numéricos , Política Ambiental , Florestas , Guiana , Cooperação Internacional , Noruega
13.
PLoS One ; 14(10): e0222835, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31574098

RESUMO

BACKGROUND: Guyana expanded its HIV response in 2005 but the epidemiology of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections has not been characterized. METHODS: The 2011 Seroprevalence and Behavioral Epidemiology Risk Survey for HIV and STIs collected biologic specimens with demographic and behavioral data from a representative sample of Guyana military personnel. Diagnostics included commercial serum: HIV antibody; total antibody to hepatitis B core (anti-HBc); IgM anti-HBc; hepatitis B surface antigen (HBsAg); anti-HBs; antibody to HCV with confirmatory testing; and HBV DNA sequencing with S gene fragment phylogenetic analysis. Chi-square, p-values and prevalence ratios determined statistical significance. RESULTS: Among 480 participants providing serologic specimens, 176 (36.7%) tested anti-HBc-positive. Overall, 19 (4.0%) participants tested HBsAg-positive; 17 (89.5%) of the HBsAg-positive participants also had detectable anti-HBc, including 1 (5.3%) IgM anti-HBc-positive male. Four (6.8%) females with available HBV testing were HBsAg-positive, all aged 23-29 years. Sixteen (16, 84.2%) HBsAg-positive participants had sufficient specimen for DNA testing. All 16 had detectable HBV DNA, 4 with viral load >2x104IU/ml. Sequencing found: 12 genotype (gt) A1 with 99.9% genetic identity between 1 IgM anti-HBc-positive and 1 anti-HBc-negative; 2 gtD1; and 2 with insufficient specimen. No statistically significant associations between risk factors and HBV infection were identified. CONCLUSIONS: Integrated HIV surveillance identified likely recent adult HBV transmission, current HBV infection among females of reproductive age, moderate HBV infection prevalence (all gtA1 and D1), no HCV infections and low HIV frequency among Guyana military personnel. Integrated HIV surveillance helped characterize HBV and HCV epidemiology, including probable recent transmission, prompting targeted responses to control ongoing HBV transmission and examination of hepatitis B vaccine policies.


Assuntos
Infecções por HIV/sangue , HIV-1/isolamento & purificação , Hepatite B/sangue , Hepatite C/sangue , Adolescente , Adulto , Região do Caribe/epidemiologia , Feminino , Guiana/epidemiologia , Anticorpos Anti-HIV/sangue , Infecções por HIV/epidemiologia , Infecções por HIV/transmissão , Infecções por HIV/virologia , HIV-1/patogenicidade , Hepatite B/epidemiologia , Hepatite B/transmissão , Hepatite B/virologia , Anticorpos Anti-Hepatite B/sangue , Antígenos do Núcleo do Vírus da Hepatite B/sangue , Antígenos de Superfície da Hepatite B/sangue , Vírus da Hepatite B/isolamento & purificação , Vírus da Hepatite B/patogenicidade , Hepatite C/epidemiologia , Hepatite C/transmissão , Hepatite C/virologia , Humanos , Masculino , Militares , Fatores de Risco , Estudos Soroepidemiológicos , Carga Viral , Adulto Jovem
14.
An Acad Bras Cienc ; 91(suppl 3): e20190325, 2019 Aug 26.
Artigo em Inglês | MEDLINE | ID: mdl-31460594

RESUMO

The West Indian (Trichechus manatus) and Amazonian (T. inunguis) manatees have a sympatric occurrence at the mouth of the Amazon River. A result of this interspecific encounter is the occurrence of hybrids, which are frequently found along the coasts of Amapá state in Brazil, French Guiana and Guyana. Here we present new genetic evidence indicating the occurrence of a hybrid swarm along the Guianas Shield coastline, which is an interspecific hybrid zone that also separates T. manatus populations located east (Brazil) and west (Caribbean, Gulf of Mexico, Florida and Antilles). In addition, we suggest that this hybrid population occupies a peculiar mangrove-rich environment under strong influence of the Amazon River plume, which requires an independent management and should be considered a special conservation area.


Assuntos
Variação Genética/genética , Hibridização Genética , Especificidade da Espécie , Trichechus inunguis/genética , Trichechus manatus/genética , Animais , Teorema de Bayes , Brasil , Região do Caribe , Guiana , Filogenia , Dinâmica Populacional , Rios , Trichechus inunguis/fisiologia , Trichechus manatus/fisiologia
15.
Plant Dis ; 103(9): 2204-2211, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31355735

RESUMO

One hundred and one rice genotypes were evaluated for response to sheath blight disease under greenhouse and lowland irrigated field conditions in Guyana. The level of resistance varied from highly resistant to resistant in 14 genotypes over five experimental trials. These genotypes were also observed with low area under the disease progress curve values and slow blighting reactions against artificial inoculation of the pathogen. Genotypes GR1568-31-9-1-1-2-1 and cultivar Rustic had susceptible reactions in all experiments. Additive main effect and multiplicative interaction analysis was used to study the genotype and environment interactions. The analysis revealed that 52.98% of the total sum of square was attributed to genotype effect, 7.50% was attributable to environment effect, and 39.52% was attributable to genotype by environment interaction (G × E) effects. The G × E was almost as large as the genotype effect, thus indicating significant differences of genotypes across the testing environments. This revealed that resistance was slightly influenced by the G × E. The genotypes that showed stable resistance in all environments in this study could be used for breeding the sheath blight resistance in rice.


Assuntos
Resistência à Doença , Interação Gene-Ambiente , Modelos Estatísticos , Oryza , Cruzamento , Resistência à Doença/genética , Fungos/fisiologia , Genótipo , Guiana , Oryza/genética , Oryza/microbiologia
16.
Diabetes Metab Syndr ; 13(2): 905-912, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31336544

RESUMO

BACKGROUND: Diabetes mellitus signifies a major public health threat worldwide. Type 2 diabetes has been reported as the fourth leading cause of death and has affected 15.5% of the adult population in Guyana, South America. Diabetes has also led to major lower extremity amputation at the only referral public hospital in Guyana. Diabetic foot and related complications are known to be multifactorial. CONCLUSION: In this review, we highlight the information on the diabetic foot and related complications with an emphasis on Guyanese background.


Assuntos
Amputação/estatística & dados numéricos , Complicações do Diabetes/epidemiologia , Diabetes Mellitus Tipo 2/complicações , Pé Diabético/epidemiologia , Complicações do Diabetes/etiologia , Pé Diabético/etiologia , Guiana/epidemiologia , Humanos , Incidência , Fatores de Risco
17.
Am J Hum Biol ; 31(5): e23291, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31287207

RESUMO

OBJECTIVES: Chronic sleep loss among youth is a worldwide health problem. Since research on its predictors is often limited to high-income countries, it is unclear if these findings are generalizable to all populations. To address this gap from an ecological perspective, we evaluated the associations between adolescents' sleep behaviors and several factors at the community, household, and individual levels in a middle-income country. METHODS: This was a cross-sectional study of 73 girls (mean age = 14.5 y; range = 11-18 y) in rural and urban communities in Guyana. Sleep behaviors (nap-duration, bedtime, rise-time, night-bed-duration, and sleep-duration) were assessed with interviews and monitored up to 7 consecutive days using waist-worn accelerometers. RESULTS: Similar to other settings, Guyanese urban youth reported significantly later bedtimes than rural youth, and increasing age was associated with later bedtime and shorter night-bed-duration. In contrast to the association observed in high-income countries, increasing household poverty scores in Guyana were associated with longer night-bed-duration. CONCLUSIONS: Although the relationships between locale, age, and sleep in Guyana paralleled patterns seen in high-income countries, the positive relationship between poverty and sleep diverges from previous reports. These findings suggest that predictors of chronic sleep loss seen in high-income countries are likely to differ from those in middle- and low-income countries. More sleep studies in underrepresented populations are needed to gain a comprehensive understanding of adolescent sleep behavior and its correlates.


Assuntos
Características da Família , Individualidade , Sono , Fatores Socioeconômicos , Adolescente , Criança , Estudos Transversais , Feminino , Guiana , Humanos
18.
PLoS One ; 14(7): e0219250, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31291297

RESUMO

The study examines the potential influence of sub-regional variations in climate, and specifically heavy rain events, in determining relative vulnerabilities of locations in twelve Caribbean countries. An aggregate vulnerability index, referred to as the Caribbean Vulnerability Score (CVS), is created using historical demographic and socioeconomic data and climate data representing extreme rain events. Four scenarios are explored. Firstly, comparative vulnerabilities are determined when heavy rainfall is incorporated in CVS versus when it is excluded. The impact of climate change is also investigated using future climate data derived from statistical downscaling but holding demographic and socioeconomic sub-indices constant. The analysis is repeated with projections of future demographic structure from the Shared Socioeconomic Pathway data (SSP3), future climate projections and constant socioeconomic. Finally, the sensitivity of the results is examined with respect to applying different weights i.e. versus using equal weights for the climate and non-climatic components of CVS as is done for the first three scenarios. Results suggest that the inclusion of historical susceptibility to rainfall extremes influences relative vulnerabilities within the Caribbean when compared to the rankings of vulnerability derived using only socioeconomic and demographic inputs. In some cases significant increases in relative rankings are noted. Projected changes in the intensity of rain events across the Caribbean region in the 2030s and 2050s, do not significantly alter the top and lowest ranked vulnerable locations when demographic and socioeconomic indices are held constant. Changes may however occur in the order of the top ranked locations dependent on scenario and time slice. In general, future shifts in relative vulnerabilities were found to be dependent on (i) changes in both future climate and demographic scenarios, (ii) the time horizons being considered, and (iii) the weighting assigned to climate in the future.


Assuntos
Mudança Climática , Demografia , Fatores Socioeconômicos , Belize/epidemiologia , Região do Caribe/epidemiologia , Cuba/epidemiologia , República Dominicana/epidemiologia , Guiana/epidemiologia , Humanos , Umidade , Jamaica/epidemiologia , Chuva
20.
Diabetes Metab Syndr ; 13(3): 1871-1876, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31235108

RESUMO

Diabetic foot infection is a global epidemic and a major public health concern. Development of microbial resistance to many antimicrobial agents in foot ulcer leads to serious complications. Therefore, the study aims to identify the microbiological profile and the potential risk factors among diabetic and non-diabetic foot ulcer patients. A prospective cross sectional study was carried out among 183 ulcer patients from diabetic foot clinic and wound dressing clinic at the public health hospital, Guyana. A total of 254 bacteria were isolated from the study with an average of 1.4 organism per lesion. Gram negative bacteria (63.0%) were prevalent than gram positive bacteria (37.0%) in this study. Among DF patients, Pseudomonas aeruginosa (18.8%) was the most common isolate followed by Escherichia coli (13.9%) among gram negative group. Were as MRSA (12.1%) followed by MSSA (7.9%) dominated among gram positive group in diabetic foot patients. Almost 42.1% (95% CI 34.8-49.6) of the infections were caused by poly-microbial. Interestingly, a stepwise logistic regression model determined increasing age and lack of health education as independent risk factor identified for acquiring an MDR wound infection (OR = 1.1; p ≥ 0.05; 95% CI 1.0-1.1). Mild, moderate and severe infection among MDR and NMDR patients were recorded as 45.3% (95% CI 32.8-58.3), 26.5% (95% CI 16.3-39.1), 28.1% (95% CI 17.6-40.8) and 51.3% (95% CI 41.9-60.5), 32.8% (95% CI 24.4-42.0), 16.0% (95% CI 9.9-23.8). Therefore, it is concluded that there's an urgent need for surveillance of resistant bacteria in diabetic foot infections to reduce the risk of major complications.


Assuntos
Biomarcadores/análise , Diabetes Mellitus Tipo 2/fisiopatologia , Pé Diabético/epidemiologia , Infecções por Pseudomonas/complicações , Pseudomonas aeruginosa/patogenicidade , Glicemia/análise , Estudos de Casos e Controles , Estudos Transversais , Pé Diabético/microbiologia , Feminino , Seguimentos , Hemoglobina A Glicada/análise , Guiana/epidemiologia , Humanos , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Prognóstico , Estudos Prospectivos , Infecções por Pseudomonas/microbiologia , Pseudomonas aeruginosa/isolamento & purificação , Fatores de Risco
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