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2.
PLoS One ; 16(1): e0245025, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33411780

RESUMO

PURPOSE: COVID-19 pandemic has multifaceted presentations with rising evidence of immune-mediated mechanisms underplay. We sought to explore the outcomes of severe COVID-19 patients treated with a multi-mechanism approach (MMA) in addition to standard-of-care (SC) versus patients who only received SC treatment. MATERIALS AND METHODS: Data were collected retrospectively for patients admitted to the intensive care unit (ICU). This observational cohort study was performed at five institutions, 3 in the United States and 2 in Honduras. Patients were stratified for MMA vs. SC treatment during ICU stay. MMA treatment consists of widely available medications started immediately upon hospitalization. These interventions target immunomodulation, anticoagulation, viral suppression, and oxygenation. Primary outcomes included in-hospital mortality and length of stay (LOS) for the index hospitalization and were measured using logistic regression. RESULTS: Of 86 patients admitted, 65 (76%) who had severe COVID-19 were included in the study; 30 (46%) patients were in SC group, compared with 35 (54%) patients treated with MMA group. Twelve (40%) patients in the SC group died, compared with 5 (14%) in the MMA group (p-value = 0.01, Chi squared test). After adjustment for gender, age, treatment group, Q-SOFA score, the MMA group had a mean length of stay 8.15 days, when compared with SC group with 13.55 days. ICU length of stay was reduced by a mean of 5.4 days (adjusted for a mean age of 54 years, p-value 0.03) and up to 9 days (unadjusted for mean age), with no significant reduction in overall adjusted mortality rate, where the strongest predictor of mortality was the use of mechanical ventilation. CONCLUSION: The finding that MMA decreases the average ICU length of stay by 5.4 days and up to 9 days in older patients suggests that implementation of this treatment protocol could allow a healthcare system to manage 60% more COVID-19 patients with the same number of ICU beds.


Assuntos
/terapia , Unidades de Terapia Intensiva , Tempo de Internação , Adulto , Idoso , Idoso de 80 Anos ou mais , /epidemiologia , Feminino , Honduras/epidemiologia , Humanos , Fatores Imunológicos/administração & dosagem , Masculino , Pessoa de Meia-Idade , Respiração Artificial , Estudos Retrospectivos , Resultado do Tratamento
4.
PLoS One ; 15(8): e0236703, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32785284

RESUMO

Travelers' diarrhea (TD) is the most prevalent illness encountered by deployed military personnel and has a major impact on military operations, from reduced job performance to lost duty days. Frequently, the etiology of TD is unknown and, with underreporting of cases, it is difficult to accurately assess its impact. An increasing number of ailments include an altered or aberrant gut microbiome. To better understand the relationships between long-term deployments and TD, we studied military personnel during two nine-month deployment cycles in 2015-2016 to Honduras. To collect data on the prevalence of diarrhea and impact on duty, a total of 1173 personnel completed questionnaires at the end of their deployment. 56.7% reported reduced performance and 21.1% reported lost duty days. We conducted a passive surveillance study of all cases of diarrhea reporting to the medical unit with 152 total cases and a similar pattern of etiology. Enteroaggregative E. coli (EAEC, 52/152), enterotoxigenic E. coli (ETEC, 50/152), and enteropathogenic E. coli (EPEC, 35/152) were the most prevalent pathogens detected. An active longitudinal surveillance of 67 subjects also identified diarrheagenic E. coli as the primary etiology (7/16 EPEC, 7/16 EAEC, and 6/16 ETEC). Eleven subjects were recruited into a nested longitudinal substudy to examine gut microbiome changes associated with deployment. A 16S rRNA amplicon survey of fecal samples showed differentially abundant baseline taxa for subjects who contracted TD versus those who did not, as well as detection of taxa positively associated with self-reported gastrointestinal distress. Disrupted microbiota was also qualitatively observable for weeks preceding and following the incidents of TD. These findings illustrate the complex etiology of diarrhea amongst military personnel in deployed settings and its impacts on job performance. Potential factors of resistance or susceptibility can provide a foundation for future clinical trials to evaluate prevention and treatment strategies.


Assuntos
Diarreia/epidemiologia , Disenteria/epidemiologia , Escherichia coli Enteropatogênica/isolamento & purificação , Infecções por Escherichia coli/epidemiologia , Adulto , Diarreia/genética , Diarreia/microbiologia , Disenteria/genética , Disenteria/microbiologia , Disenteria/patologia , Escherichia coli Enteropatogênica/genética , Escherichia coli Enteropatogênica/patogenicidade , Infecções por Escherichia coli/genética , Infecções por Escherichia coli/microbiologia , Infecções por Escherichia coli/patologia , Fezes/microbiologia , Feminino , Microbioma Gastrointestinal/genética , Honduras/epidemiologia , Humanos , Masculino , Militares , RNA Ribossômico 16S/genética , Fatores de Risco , Viagem , Doença Relacionada a Viagens
5.
Am J Trop Med Hyg ; 102(6): 1373-1375, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32189609

RESUMO

To determine whether the presence of Blastocystis is associated with other gastrointestinal parasite infections, stool samples from 95 Honduran rural children were analyzed using multi-parallel quantitative real-time polymerase chain reaction (PCR) and Kato-Katz. Combined results detected the following prevalence: Blastocystis, 71.6%; Trichuris trichiura, 63.2%; Giardia lamblia, 40.0%; Ascaris lumbricoides, 15.8%; and Necator americanus, 4.2%. Age was found associated with the quantity of both Blastocystis DNA (r s = 0.524, P < 0.001) and T. trichiura DNA in the stool (fg/µL) by quantitative PCR (r s = 0.272, P < 0.001). In addition, there was an association with T. trichiura and Blastocystis infection (odds ratio [OR] = 4.72; 95% CI = 1.83, 12.20; P < 0.001). These findings demonstrate a high prevalence of Blastocystis and other intestinal parasites in a rural location in Honduras.


Assuntos
Infecções por Blastocystis/parasitologia , Blastocystis , Coinfecção , Enteropatias Parasitárias/parasitologia , Reação em Cadeia da Polimerase em Tempo Real/métodos , População Rural , Infecções por Blastocystis/epidemiologia , Honduras/epidemiologia , Humanos , Enteropatias Parasitárias/epidemiologia , Prevalência , Sensibilidade e Especificidade
6.
Am J Emerg Med ; 38(5): 958-961, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-31839518

RESUMO

OBJECTIVES: Trauma is a leading cause of morbidity and mortality worldwide, with a disproportionate burden of illness in low- and middle- income countries. This study sought to provide a proof-of-concept pilot study to evaluate the feasibility of a trauma registry in the Western Honduras Hospital. METHODS: A cross-sectional, observation study was performed that included all admitted, transferred, or deceased trauma patients presenting to the Western Honduras Hospital from February 4, 2019 until April 4, 2019. Descriptive statistics were utilized to describe patient demographics and injury characteristics. RESULTS: 268 patients were enrolled. The average age was 27.5 years (SD ±21.3). 10% of injuries were due to interpersonal violence. The most common mechanisms of injury were falls (33.6%) and motor vehicle collisions (MVCs) (22.4%). The mean Modified Kampala Trauma Score (M-KTS) was 12 (SD ±1.4). The mortality rate was 1.1% (N = 3). 94.5% of data points were complete. CONCLUSIONS: A continuous injury surveillance system in the Western Honduras Hospital is feasible and provides valuable information. The data completeness was suboptimal, but the current data collection system may be improved via modifying and utilizing the registry form as both a clinical and data collection instrument.


Assuntos
Acidentes por Quedas/estatística & dados numéricos , Acidentes de Trânsito/estatística & dados numéricos , Serviço Hospitalar de Emergência , Violência/estatística & dados numéricos , Ferimentos e Lesões/epidemiologia , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Estudos Transversais , Feminino , Honduras/epidemiologia , Humanos , Escala de Gravidade do Ferimento , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Estudo de Prova de Conceito , Sistema de Registros , Ferimentos e Lesões/etiologia , Ferimentos e Lesões/mortalidade , Adulto Jovem
7.
Int J Environ Health Res ; 30(2): 160-173, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30760020

RESUMO

Household air pollution from combustion of solid fuels is an important risk factor for morbidity and mortality, causing an estimated 2.6 million premature deaths globally in 2016. Self-reported health symptoms are a meaningful measure of quality of life, however, few studies have evaluated symptoms and quantitative measures of exposure to household air pollution. We assessed the cross-sectional association of self-reported symptoms and exposures to household air pollution among women in rural Honduras using stove type (traditional [n = 76]; cleaner-burning Justa [n = 74]) and 24-hour average personal and kitchen fine particulate matter (PM2.5) concentrations. The odds of prevalent symptoms were higher among women using traditional stoves vs Justa stoves (e.g. headache: odds ratio = 2.23; 95% confidence interval = 1.13-4.39). Associations between symptoms and measured PM2.5 were generally consistent with the null. These results add to the evidence suggesting reduced exposures and better health-related quality of life among women using cleaner-burning biomass stoves.


Assuntos
Poluentes Atmosféricos/efeitos adversos , Poluição do Ar em Ambientes Fechados/efeitos adversos , Culinária , Exposição Ambiental/efeitos adversos , Material Particulado/efeitos adversos , Doenças Respiratórias/epidemiologia , População Rural/estatística & dados numéricos , Transtornos da Visão/epidemiologia , Adulto , Estudos Transversais , Feminino , Honduras/epidemiologia , Humanos , Pessoa de Meia-Idade , Prevalência , Doenças Respiratórias/induzido quimicamente , Autorrelato , Transtornos da Visão/induzido quimicamente
8.
Nutr. clín. diet. hosp ; 40(2): 32-38, 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-198967

RESUMO

La alimentación poco saludable representa un problema de salud grave en todo el mundo. Las dietas altas en grasas y bajas en productos y granos enteros son comunes. OBJETIVO: caracterizar el consumo de comida chatarra en la población escolar de Honduras, en junio de 2018. Material y MÉTODOS: Estudio no experimental, descriptivo, transversal. El universo estaba constituido por todos los niños en edad escolar de 5 a 15 años, que cursaban los grados de primero a sexto, en las escuelas públicas de Honduras. Mediante una técnica de muestreo estratificada; los centros de educación primaria se obtuvieron por técnica aleatoria simple, y la población a estudiar mediante técnica aleatoria probabilística. Se obtuvo una muestra de 7020 escolares. Se tomaron 10 escolares, por cada uno de los 6 grados. RESULTADOS: La comida chatarra más consumida fue el churro con un 92.9% de escolares, seguido por las bebidas carbonatadas con 80.4% escolares y el pollo frito con 76.6% de los escolares. DISCUSIÓN: Para Palenzuela et al. más de la mitad de los adolescentes consumen refrescos de forma diaria y la ingesta de golosinas se hace en más de una ocasión al día en el 18% de los adolescentes estudiados. Lo que discrepa de los datos de este estudio. CONCLUSIONES: Se encontró que la mayor parte de encuestados fueron de primer grado, del sexo femenino, con un ingreso menor a 6 dólares diarios. Hay un número importante de escolares que consumen algún tipo de comida chatarra con frecuencia. El mayor consumo fue de churros, bebidas carbonatadas y pollo frito y, tanto en raciones por día, como veces por semana; consumiendo en con mayor frecuencia la comida chatarra en sus casas


Unhealthy eating represents a serious health problem worldwide. Diets high in fat and low in products and whole grains are common. OBJECTIVE: to characterize the consumption of junk food in the school population of Honduras, in June 2018. MATERIAL AND METHODS: Non-experimental, descriptive, cross-sectional study. The universe was made up of all schoolage children from 5 to 15 years old, who were in grades one to six, in public schools in Honduras. Through a stratified sampling technique; Primary education centers were obtained using a simple random technique, and the population to be studied using a probabilistic random technique. A sample of 7020 schoolchildren was obtained. 10 schoolchildren were taken for each of the 6 grades. RESULTS: The most consumed junk food was churro with 92.9% of schoolchildren, followed by carbonated drinks with 80.4% schoolchildren and fried chicken with 76.6% of schoolchildren. DISCUSSION: For Palenzuela et al. more than half of the adolescents consume soft drinks daily and the ingestion of sweets is done more than once a day in 18% of the adolescents studied. This is disagrees with the data from this study. CONCLUSIONS: It was found that most of the respondents were first grade, female, with an income of less than 6 dollars a day. There are a significant number of schoolchildren who consume some form of junk food frequently. The highest consumption was churros, carbonated drinks and fried chicken and, both in portions per day and times per week; consuming junk food more frequently at home


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Alimentação Escolar/classificação , Fast Foods/estatística & dados numéricos , Inquéritos Nutricionais/estatística & dados numéricos , Bebidas Gaseificadas/análise , Estudos Transversais , Honduras/epidemiologia , Indústria de Processamento de Alimentos/estatística & dados numéricos
10.
Int J Gynaecol Obstet ; 146(3): 296-301, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31152595

RESUMO

OBJECTIVE: To assess the association between intimate partner violence (IPV) and pregnancy termination in Latin America. METHODS: Demographic and Health Survey (DHS) data were analyzed for Honduras, the Dominican Republic, Colombia, Peru, and Guatemala. Women were asked about their experiences with violence by partners and pregnancy termination. The association between IPV and risk for termination was assessed using adjusted odds ratios (OR) with correction for intracluster correlations. RESULTS: The average prevalence of IPV across the five countries was 31.8%. Women who reported IPV had 1.4 times the odds of experiencing pregnancy termination OR 1.41 (95% CI, 1.32-1.50). A positive dose-response relationship was observed between IPV and termination; a woman who reported three types of IPV showed three times the odds of experiencing pregnancy termination compared with a woman who did not report IPV. Elimination of exposure to IPV in all five countries was associated with 167 743 fewer pregnancy terminations. CONCLUSION: IPV is a risk factor for pregnancy termination. Reduction or elimination of IPV is associated with substantial decline in pregnancy terminations in Latin America. Routine prenatal screening for IPV and counseling could potentially avert a substantial number of pregnancy terminations in these settings.


Assuntos
Aborto Induzido/estatística & dados numéricos , Violência por Parceiro Íntimo/estatística & dados numéricos , Adolescente , Adulto , Colômbia/epidemiologia , Estudos Transversais , República Dominicana/epidemiologia , Feminino , Guatemala/epidemiologia , Inquéritos Epidemiológicos , Honduras/epidemiologia , Humanos , Pessoa de Meia-Idade , Razão de Chances , Peru/epidemiologia , Gravidez , Prevalência , Fatores de Risco , Adulto Jovem
11.
Rev. esp. nutr. comunitaria ; 25(2): 0-0, abr.-jun. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-191442

RESUMO

FUNDAMENTOS: Existe una deuda social por disminuir las desigualdades, particularmente relacionada con los grupos étnicos. La información que se dispone es escasa para orientar estos esfuerzos. El objetivo del presente estudio fue evaluar la situación nutricional y la seguridad alimentaria de la población lenca (Intibucá, Honduras). MÉTODOS: Estudio descriptivo con modelo de muestras independientes y análisis de datos a través de la prueba "T de Student", frecuencias y correlación de Pearson. La seguridad alimentaria fue valorada aplicando una encuesta socioeconómica, la Escala Latinoamericana y Caribeña de Seguridad Alimentaria; la situación nutricional fue valorada con un recordatorio de consumo de 24 horas, antropometría, composición corporal, indicadores bioquímicos y presión arterial. RESULTADOS: El 95% de las personas se encontraban en inseguridad alimentaria. Los hombres se encontraron afectados mayormente con sobrepeso (49,2%), grasa visceral (41,25%), pre hipertensión (50,79%) y glucosa alterada (18,24%), y las mujeres presentaron mayor problema de obesidad (27,27%), grasa corporal (60,6%) y anemia (42,42%). CONCLUSIONES: La población lenca sufre de inseguridad alimentaria y nutricional. Su alimentación presentó exceso de carbohidratos, azúcar y sodio, con altas deficiencias de proteína, hierro, calcio y vitamina C, reflejando deficiencias nutricionales y manifestaciones metabólicas


BACKGROUND: There is a social debt to reduce inequalities, particularly related to ethnic groups. The information that is available is scarce to address these efforts. The objective of the present study was to evaluate the nutritional situation and food security of the Lenca population (Intibucá, Honduras). METHODS: Descriptive study with model of independent samples and analysis of data through the "Student T-test", frequencies and Pearson correlation. Food security was valued by applying a socioeconomic survey, the Latin American and Caribbean Scale of Food Security; the nutritional situation was assessed with a reminder of 24-hour consumption, anthropometry, body composition, biochemical indicators and blood pressure. RESULTS: 95% of people were in food insecurity. Men were affected mostly by overweight (49.2%), visceral fat (41.25%), pre hypertension (50.79%) and altered glucose (18.24%), and women showed greatest obesity problem (27.27%), body fat (60.6%) and anemia (42.42%); their food had excess of carbohydrates, sugar and sodium, with high deficiencies of protein, iron, calcium and vitamin C, reflecting nutritional and metabolic problems. CONCLUSIONS: Lenca population suffers from food and nutritional insecurity. Their diet presented excess carbohydrates, sugar and sodium, with high deficiencies of protein, iron, calcium and vitamin C, reflecting nutritional deficiencies and metabolic manifestations


Assuntos
Humanos , Masculino , Feminino , Comportamento Alimentar/etnologia , Avaliação Nutricional , Estado Nutricional/fisiologia , Obesidade/epidemiologia , Pesos e Medidas Corporais/estatística & dados numéricos , Desnutrição/epidemiologia , Hipertensão/epidemiologia , Composição Corporal/fisiologia , Segurança Alimentar e Nutricional , Honduras/epidemiologia , 50227 , Nutrição de Grupos de Risco , Política Nutricional , Distribuição por Sexo , Antropometria/métodos , Análise por Conglomerados , Inquéritos Nutricionais/estatística & dados numéricos
12.
J Glob Oncol ; 5: JGO1800233, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-31050922

RESUMO

PURPOSE: Low- and middle-income countries have high incidences of cervical cancer linked to human papillomavirus (HPV), and without resources for cancer screenings these countries bear 85% of all cervical cancer cases. To address some of these needs, brigade-style screening combined with sensitive polymerase chain reaction-based HPV testing to detect common high-risk HPV genotypes may be necessary. METHODS: We deployed an inexpensive DNA extraction technique and a real-time polymerase chain reaction-based HPV genotyping assay, as well as Papanicolaou testing, in a factory in San Pedro Sula, Honduras, where 1,732 women were screened for cervical cancer. RESULTS: We found that 28% of participants were positive for high-risk HPV, with 26% of HPV-positive participants having more than one HPV infection. Moreover, the most common HPV genotypes detected were different than those routinely found in the United States. CONCLUSION: This work demonstrates a deployable protocol for HPV screening in low- and middle-income countries with limited resources to perform cytopathology assessment of Pap smears.


Assuntos
Papillomaviridae , Infecções por Papillomavirus/epidemiologia , Infecções por Papillomavirus/virologia , Países em Desenvolvimento , Detecção Precoce de Câncer , Feminino , Frequência do Gene , Genótipo , Honduras/epidemiologia , Humanos , Programas de Rastreamento , Tipagem Molecular , Papillomaviridae/genética , Infecções por Papillomavirus/complicações , Vigilância em Saúde Pública , Neoplasias do Colo do Útero/epidemiologia , Neoplasias do Colo do Útero/etiologia
13.
Injury ; 50(4): 883-889, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30935746

RESUMO

BACKGROUND: Honduras is one of the most violent countries in the world and it has limited epidemiological data that describes the extent of intentional and unintentional injuries. This research is needed to develop and inform prevention programs in Honduras, as well as to spread international awareness. METHODS: A cross-sectional study was carried out on a paper-based injury surveillance system (InSS) with the help of Honduras' University Medical School Hospital (UMSH), the main referral medical center in Tegucigalpa-Honduras. Descriptive statistics and bivariate analysis were carried out using data from all registered injuries in 2013. RESULTS: Of the 17,971 injuries reported, intentional injuries made up 18.14% of all injuries. Interpersonal violence from gun violence, robberies, and physical altercations accounted for 14.68%. Self-inflicted injuries made up 3.46% of injuries, with suicide falls and poison intoxications being the most frequent (1.9% and 1.2%, respectively). Sexual harassment was minimally reported (0.27%, n = 48). Unintentional injuries made up 81.79% of the total injuries. The most common causes of unintentional injuries were falls (38.01%) and road traffic injuries (16.65%). Motorocyclists made up 35.4% of those injured by road traffic accidents. In general, injuries occured during the weekend and mainly affected men during the ages when they would be most likely to work and maintain jobs. The modified Kampala trauma score (M-KTS) showed that most of the injuries were mild (range 3-11), with 59.59% of the patients with a M-KTS of 9, and an overall mortality rate of 0.65% (n = 117). CONCLUSION: The description of injuries provides the basis for prevention. The disproportionate number of unintentional injuries (4:1) seen in Honduras' referral hospital calls for further research in: 1) trauma care logistics and emergency systems, 2) mortality and lethality of intentional injuries, and 3) analysis of the types of unintentional injuries. Further research is necessary to evaluate interventions and identify the socioeconomic effects of injuries in the region.


Assuntos
Acidentes/estatística & dados numéricos , Serviço Hospitalar de Emergência , Encaminhamento e Consulta/estatística & dados numéricos , Sistema de Registros/estatística & dados numéricos , Suicídio/estatística & dados numéricos , Violência/estatística & dados numéricos , Ferimentos e Lesões/epidemiologia , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Estudos Transversais , Feminino , Promoção da Saúde , Honduras/epidemiologia , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Ferimentos e Lesões/etiologia , Adulto Jovem
15.
Folia Parasitol (Praha) ; 662019 Mar 14.
Artigo em Inglês | MEDLINE | ID: mdl-30919825

RESUMO

Mites of the family Pterygosomatidae are usually infesting lizards, geckos and iguanas. In this family, the genus Geckobiella Hirst, 1917 comprises 12 species including Geckobiella donnae Paredes-León, Klompen et Pérez, 2012. We collected 48 mites of G.donnae from 10 captive iguanas Ctenosaura bakeri Stejneger (Reptilia: Iguanidae) out of 23 examined individuals (prevalence 43% ) in Iguana Research and Breeding Station on Isla de Utila, Islas de la Bahía, Honduras on 1 September 2014. Males of G. donnae occurred together with females. The male of G. donnae is described here for the first time. We speculated that G. donnae is autochthonous on Isla de Utila with C. bakeri as a natural host or that it was transmitted to C. bakeri from Iguana iguana (Linnaeus) native to Utila or introduced to Utila from the North American/Central American mainland by a host kept as a pet.


Assuntos
Iguanas , Infestações por Ácaros/veterinária , Ácaros/anatomia & histologia , Ácaros/fisiologia , Animais , Honduras/epidemiologia , Masculino , Infestações por Ácaros/epidemiologia , Infestações por Ácaros/parasitologia , Prevalência
16.
Travel Med Infect Dis ; 31: 101382, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30721779

RESUMO

BACKGROUND: Zika virus (ZIKV) infection has significantly affected Latin America in 2015-2017. Most studies have been reported from Brazil and Colombia, and only a few from Central America. For these reasons, we analyzed the incidence, incidence rates and evolution of cases in Honduras from 2016 to 2017. METHODS: Using epidemiological weeks (EW) surveillance data on the ZIKV epidemics in Honduras, we estimated incidence rates (cases/100,000 population), and developed maps at national, departmental and municipal levels. RESULTS: From 1 January 2016 to 31 December 2017, a total of 32,607 cases of ZIKV were reported (98.5% in 2016 for an incidence rate of 36.85 cases/100,000 pop; 1% confirmed by RT-PCR). The highest peak was reached on the EW 6°, 2016 (2559 cases; 29.34 cases/100,000 pop). The department with the highest number of cases and incidence rate was Cortés (13,128 cases, 791.08 cases/100,000 pop in 2016). DISCUSSION: The pattern and evolution of ZIKV infection in Honduras have been similar to that which occurred for chikungunya in 2015. As previously reported, infection with chikungunya involved predominantly the central and capital area of the country, reaching incidences there >750 cases/100,000 pop. Studies using geographical information systems linked with clinical disease characteristics are necessary to attain accurate epidemiological data for public health systems. Such information is also useful for assessment of risk for travelers who visit specific areas in a destination country.


Assuntos
Sistemas de Informação Geográfica , Saúde Pública/métodos , Medicina de Viagem/métodos , Infecção por Zika virus/epidemiologia , Evolução Biológica , Demografia , Honduras/epidemiologia , Humanos , Incidência , Infecção por Zika virus/virologia
17.
Microb Drug Resist ; 25(5): 690-695, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30614762

RESUMO

Although Acinetobacter baumannii has become one of the most important nosocomial pathogens worldwide, very little is known about the genetic identity of isolates from less developed countries in Latin America. To alleviate this, we sequenced the genomes of 16 A. baumannii isolates from Honduras. Whole-genome sequencing was conducted on 16 isolates from five Honduran Hospitals. With the sequences of these Honduran isolates and other 42 publically available genomes, a maximum likelihood phylogeny was constructed to establish the relationship between the Honduran isolates and those belonging to the International Clones (ICs). In addition, sequence type (ST) assignation was conducted by the PubMLST, and antibiotic resistance genes were identified using ResFinder. The Honduran isolates are highly diverse and contain new allele combinations under the Bartual multilocus sequence typing scheme. The most common STs were STB447/STP10 and STB758/STP156. Furthermore, none of these isolates belongs to clonal complexes related to the ICs. Antibiotic susceptibility profiles of these isolates showed that they are multidrug resistant (MDR) or extensively drug resistant (XDR). In addition, the Honduran isolates had genes involved in resistance to seven antibiotic families. For instance, several blaOXA alleles were found, including blaOXA-23 and a gene encoding the metallo-beta-lactamase NDM-1. Notably, nine of the Honduran isolates have antibiotic resistance genes to three or more antibiotic families. In summary, in this study, we unveiled an untapped source of genetic diversity of MDR and XDR isolates; notably, these isolates did not belong to the well-known ICs.


Assuntos
Infecções por Acinetobacter/epidemiologia , Acinetobacter baumannii/genética , Farmacorresistência Bacteriana Múltipla/genética , Genes Bacterianos , Genoma Bacteriano , beta-Lactamases/genética , Infecções por Acinetobacter/tratamento farmacológico , Infecções por Acinetobacter/microbiologia , Acinetobacter baumannii/classificação , Acinetobacter baumannii/efeitos dos fármacos , Acinetobacter baumannii/isolamento & purificação , Antibacterianos/farmacologia , Células Clonais , Monitoramento Epidemiológico , Expressão Gênica , Variação Genética , Honduras/epidemiologia , Humanos , Testes de Sensibilidade Microbiana , Tipagem de Sequências Multilocus , Filogenia , Plasmídeos/química , Plasmídeos/metabolismo , Centros de Atenção Terciária , Sequenciamento Completo do Genoma , beta-Lactamases/metabolismo
19.
Torture ; 29(3): 46-58, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31984943

RESUMO

INTRODUCTION: Every year, thousands of women flee gender-based violence in Honduras, El Salvador, and Guatemala (sometimes collectively referred to as the Northern Triangle) in an attempt to seek asylum in the United States. Once in the United States, their legal teams may refer them for a psychological evaluation as part of their application for asylum. Licensed clinicians conduct in-depth interviews in order to document the psychological impact of the reported human rights violations. METHOD: Using archival de-identified data from a human rights program, this study gathered the experiences of gender-based violence reported by 70 asylum-seeking women from Honduras, El Salvador, and Guatemala who participated in pro bono psychological evaluation. Descriptive data were analyzed using a modified consensual qualitative research (CQR-M) method. RESULTS: These asylum seekers reported exposure to systemic violence, including severe intimate partner violence, as well as physical and sexual assaults, and threats of death by organized criminal groups in their communities. Additionally, over a third of women reported experiences of violence during their migration. The majority of asylum seekers endorsed symptoms associated with anxiety (80%) and depression (91%), as well as trauma-and stressor-related symptoms (80%). DISCUSSION: The results of this study elucidate the many forms of gender-based violence experienced by women in this region, the physical and psychological sequelae of this persecution, and the systemic forces that prevent them from remaining in their countries of origin. The research results also highlight the potential impact of trauma on the women's ability to testify effectively during asylum legal hearings, elucidate factors that may contribute to their resilience in light of the human rights violations they survived, and suggest implications for clinical practice.


Assuntos
Mulheres Maltratadas/psicologia , Violência de Gênero/psicologia , Refugiados/psicologia , Adulto , El Salvador/epidemiologia , Feminino , Guatemala/epidemiologia , Honduras/epidemiologia , Humanos , Entrevista Psicológica , Masculino , Estados Unidos
20.
Indoor Air ; 29(1): 130-142, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30195255

RESUMO

Growing evidence links household air pollution exposure from biomass cookstoves with elevated blood pressure. We assessed cross-sectional associations of 24-hour mean concentrations of personal and kitchen fine particulate matter (PM2.5 ), black carbon (BC), and stove type with blood pressure, adjusting for confounders, among 147 women using traditional or cleaner-burning Justa stoves in Honduras. We investigated effect modification by age and body mass index. Traditional stove users had mean (standard deviation) personal and kitchen 24-hour PM2.5 concentrations of 126 µg/m3 (77) and 360 µg/m3 (374), while Justa stove users' exposures were 66 µg/m3 (38) and 137 µg/m3 (194), respectively. BC concentrations were similarly lower among Justa stove users. Adjusted mean systolic blood pressure was 2.5 mm Hg higher (95% CI, 0.7-4.3) per unit increase in natural log-transformed kitchen PM2.5 concentration; results were stronger among women of 40 years or older (5.2 mm Hg increase, 95% CI, 2.3-8.1). Adjusted odds of borderline high and high blood pressure (categorized) were also elevated (odds ratio = 1.5, 95% CI, 1.0-2.3). Some results included null values and are suggestive. Results suggest that reduced household air pollution, even when concentrations exceed air quality guidelines, may help lower cardiovascular disease risk, particularly among older subgroups.


Assuntos
Poluição do Ar em Ambientes Fechados/efeitos adversos , Pressão Sanguínea/fisiologia , Hipertensão/induzido quimicamente , Adulto , Biomassa , Índice de Massa Corporal , Culinária , Estudos Transversais , Fontes Geradoras de Energia , Monitoramento Ambiental , Feminino , Honduras/epidemiologia , Humanos , Hipertensão/epidemiologia , Pessoa de Meia-Idade , Material Particulado/efeitos adversos , Material Particulado/análise , População Rural
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