Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 1.128
Filtrar
2.
Braz Oral Res ; 35(suppl 01): e052, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34076076

RESUMO

Robust epidemiological data allow for logical interventions taken in the interest of public health. Dental caries is a major public health problem driven by increased sugar consumption and various biological, behavioral, and psychosocial factors, and is known to strongly affect an individual's quality of life. This study aims to critically review epidemiological data on the prevalence of dental caries in Latin American and Caribbean countries (LACC) and its impact on the oral health-related quality of life (OHRQoL) of the population. Although the majority of national surveys did not include all age groups and several countries reported a reduction in the prevalence of cavitated carious lesions, most nations still exhibited a high burden of decayed teeth. OHRQoL evaluation was limited to children and older adults only, and was not included in any national survey. Study heterogeneity and methodological issues hindered comparison of evidence between studies and over time, and updating national level data on caries prevalence and its impact on OHRQoL should be prioritized in LACCs.


Assuntos
Cárie Dentária , Qualidade de Vida , Idoso , Região do Caribe/epidemiologia , Criança , Estudos Transversais , Cárie Dentária/epidemiologia , Humanos , América Latina/epidemiologia , Saúde Bucal , Prevalência
3.
Global Health ; 17(1): 55, 2021 05 10.
Artigo em Inglês | MEDLINE | ID: mdl-33971911

RESUMO

The coronavirus disease (Covid-19) crisis presents as human, social and economic challenges. The advent of Covid-19, unfortunate as it is, has highlighted the need for close medical cooperation between states. Medical cooperation is the key counter to fight against the Covid-19 pandemic.


Assuntos
COVID-19/prevenção & controle , Atenção à Saúde/organização & administração , Cooperação Internacional , COVID-19/epidemiologia , Região do Caribe/epidemiologia , Humanos
4.
Spat Spatiotemporal Epidemiol ; 37: 100416, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33980406

RESUMO

The novel COVID-19 disease has highlighted the vulnerability of small and developing economies in managing what is now a global health crisis. This study presents the preliminary overview of the dynamics of the spread and expansion of COVID-19 as the disease takes its footprint in the Caribbean. The study explored the spatial clusters of the disease and its variations in the Caribbean region. Data was gathered from the World Health Organization reports and collated into a cross sectional data set. Spatial mapping and spatial lag analysis were conducted to identify spread patterns and statistical relationships with several relevant socioeconomic variables. Models showed the prominence of cases and deaths in the Caribbean region have a spatial connection with mainland countries. The models also show the connection between COVID-19 cases and deaths and the availability of medical services within the country. Results also showed similar social distancing policies adopted in the region and the possible connection between prevalence of diabetes and hypertension regionally impacted the number of deaths. It is hoped that the findings presented here will be useful in planning for an epidemiological response for the region based on the differences in the patterns for possible interventions and actions.


Assuntos
COVID-19/epidemiologia , Controle de Doenças Transmissíveis/organização & administração , Pneumonia Viral/epidemiologia , Análise Espacial , Região do Caribe/epidemiologia , Humanos , Pandemias , Pneumonia Viral/virologia , Prevalência , SARS-CoV-2 , Fatores Socioeconômicos
6.
JMIR Public Health Surveill ; 7(4): e25728, 2021 04 27.
Artigo em Inglês | MEDLINE | ID: mdl-33852413

RESUMO

BACKGROUND: The COVID-19 pandemic has placed unprecedented stress on economies, food systems, and health care resources in Latin America and the Caribbean (LAC). Existing surveillance provides a proxy of the COVID-19 caseload and mortalities; however, these measures make it difficult to identify the dynamics of the pandemic and places where outbreaks are likely to occur. Moreover, existing surveillance techniques have failed to measure the dynamics of the pandemic. OBJECTIVE: This study aimed to provide additional surveillance metrics for COVID-19 transmission to track changes in the speed, acceleration, jerk, and persistence in the transmission of the pandemic more accurately than existing metrics. METHODS: Through a longitudinal trend analysis, we extracted COVID-19 data over 45 days from public health registries. We used an empirical difference equation to monitor the daily number of cases in the LAC as a function of the prior number of cases, the level of testing, and weekly shift variables based on a dynamic panel model that was estimated using the generalized method of moments approach by implementing the Arellano-Bond estimator in R. COVID-19 transmission rates were tracked for the LAC between September 30 and October 6, 2020, and between October 7 and 13, 2020. RESULTS: The LAC saw a reduction in the speed, acceleration, and jerk for the week of October 13, 2020, compared to the week of October 6, 2020, accompanied by reductions in new cases and the 7-day moving average. For the week of October 6, 2020, Belize reported the highest acceleration and jerk, at 1.7 and 1.8, respectively, which is particularly concerning, given its high mortality rate. The Bahamas also had a high acceleration at 1.5. In total, 11 countries had a positive acceleration during the week of October 6, 2020, whereas only 6 countries had a positive acceleration for the week of October 13, 2020. The TAC displayed an overall positive trend, with a speed of 10.40, acceleration of 0.27, and jerk of -0.31, all of which decreased in the subsequent week to 9.04, -0.81, and -0.03, respectively. CONCLUSIONS: Metrics such as new cases, cumulative cases, deaths, and 7-day moving averages provide a static view of the pandemic but fail to identify where and the speed at which SARS-CoV-2 infects new individuals, the rate of acceleration or deceleration of the pandemic, and weekly comparison of the rate of acceleration of the pandemic indicate impending explosive growth or control of the pandemic. Enhanced surveillance will inform policymakers and leaders in the LAC about COVID-19 outbreaks.


Assuntos
COVID-19/epidemiologia , Vigilância em Saúde Pública , Região do Caribe/epidemiologia , Humanos , América Latina/epidemiologia , Estudos Longitudinais
7.
Travel Med Infect Dis ; 41: 102059, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33848692

RESUMO

BACKGROUND: Determinants of vaccine acceptance are multifactorial, complex, and in most cases, context-dependent. We determined the prevalence of COVID-19 vaccination intention (VI) and fear of its adverse effects (FAE) as well as their associated factors in Latin America and the Caribbean (LAC). METHODS: We conducted a secondary cross-sectional analysis of a database collected by the University of Maryland and Facebook. We included participants aged 18 and over from LAC surveyed, January 15 to February 1, 2021. We evaluated VI, FAE, sociodemographic characteristics, COVID-19 symptomatology, compliance with community mitigation strategies, food and economic insecurity, mental health evaluation and the influence in VI when recommended by different stakeholders. We calculated crude and adjusted prevalence ratios with their 95%CIs. RESULTS: We analyzed 472,521 responses by Latin American adults, finding a VI and FAE prevalence of 80.0% and 81.2%, respectively. We found that female and non-binary genders were associated with a lower probability of VI and a higher probability of FAE. Besides, living in a town, village or rural area and economic insecurity was associated with a higher FAE probability. The fears of becoming seriously ill, a family member becoming seriously ill from COVID-19 and having depressive symptoms were associated with a higher probability of VI and FAE. CONCLUSION: Eight out of 10 adults in LAC have VI and FAE. The factors identified are useful for the development of communication strategies to reduce FAE frequency. It is necessary to guarantee mass vaccination and support the return of economic activities.


Assuntos
Vacinas contra COVID-19/administração & dosagem , COVID-19/prevenção & controle , Vacinação/psicologia , Vacinação/estatística & dados numéricos , Adolescente , Adulto , Idoso , COVID-19/epidemiologia , COVID-19/psicologia , Região do Caribe/epidemiologia , Estudos Transversais , Feminino , Humanos , Intenção , América Latina/epidemiologia , Masculino , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Percepção , SARS-CoV-2 , Inquéritos e Questionários , Recusa de Vacinação/estatística & dados numéricos , Adulto Jovem
8.
Drug Alcohol Depend ; 221: 108621, 2021 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-33636598

RESUMO

BACKGROUND: To estimate the prevalence of changes in the frequency of self-reported heavy episodic drinking (HED) among drinkers in Latin America and Caribbean countries on alcohol consumption during the COVID-19 pandemic, and to assess self-reported factors associated with the increased frequency of HED. METHODS: Data from 12,328 adults who responded to the cross-sectional survey conducted in 33 countries of Latin America and the Caribbean by Pan American Health Organization were used. Logistic regression analyses were performed to estimate the effect of the sociodemographic characteristics, quarantine practices, and anxiety symptoms on the increase in frequency of HED among the 2019 drinkers. RESULTS: 65 % of drinkers in 2019 self-reported HED during the COVID-19 pandemic with 13.8 % of the drinkers reporting an increase in HED compared to a 33.38 % decrease in HED. Multivariable analysis indicated that male gender (aOR 1.29, 95 %CI 1.13; 1.49), higher income (aOR 1.64, 95 %CI 1.35; 1.99) and higher level of quarantine practices (aOR 1.10, 95 %CI 1.04; 1.16) were positively associated with increased frequency of HED; unemployment (aOR 0.78, 95 %CI 0.64; 0.96), student status (aOR 0.53, 95 %CI 0.43; 0.64) and living with children (aOR 0.91, 95 %CI 0.84; 0.99) were negatively associated with increased frequency of HED. A gradient of association was found between generalized anxiety disorder and an increase in HED frequency during the pandemic. CONCLUSION: Along with other measures to decrease the spread of COVID-19, it is important to include measures to reduce alcohol consumption and address mental health conditions in the national response to the pandemic.


Assuntos
Consumo Excessivo de Bebidas Alcoólicas/epidemiologia , COVID-19/epidemiologia , Adolescente , Adulto , Ansiedade/psicologia , Região do Caribe/epidemiologia , Estudos Transversais , Feminino , Humanos , América Latina/epidemiologia , Masculino , Pessoa de Meia-Idade , Organização Pan-Americana da Saúde , Prevalência , Quarentena/psicologia , Autorrelato , Fatores Socioeconômicos , Adulto Jovem
10.
Acta Trop ; 215: 105788, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33338465

RESUMO

Dengue fever has become one of the most outstanding infectious diseases in the world. Besides, the incidence and prevalence of dengue are increasing in the endemic areas of the tropical and subtropical regions. Space and time disease mapping models are common instruments to explain the patterns of disease counts, where hierarchical Bayesian models constitute a suitable framework for their formulation. These random events reflect interactions between nearby geographic locations, as well as correlations between close temporary instants. Functional data analysis techniques can better describe the evolution of disease mapping. In this paper, the risk of dengue in Mexico, Central and South America is studied from a Functional approach through a Bayesian estimation model focused on Hilbert-valued autoregressive processes combined with the Kalman filtering algorithm. Thus, the temporal functional evolution of spatial geographic patterns of incidence risk in disease mapping during 1998-2018 is approximated. Applying this methodology, the excess of smoothing that occurs with traditional models is avoided and the heterogeneity is conserved across the years. It improves the number of false positives created by noise and the number of false negatives as well. The results obtained with the application of this model are compared with those of previous models, corroborating the preceding statements and obtaining better results in the relative risk estimates, providing greater robustness and stability of disease risk estimates.


Assuntos
Teorema de Bayes , Dengue/epidemiologia , Região do Caribe/epidemiologia , Dengue/etiologia , Humanos , Incidência , América Latina/epidemiologia , Risco
11.
PLoS Med ; 17(12): e1003443, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33373361

RESUMO

BACKGROUND: Adolescents and young people (10-24 years old) in the Latin America and the Caribbean (LAC) region represent approximately 25% of the region's population. Since the 2008 global economic crisis, the pace of reduction in poverty and income inequality in the LAC region has stalled. The region is characterised by high levels of inequities and is also vulnerable to many natural disasters. Food systems are changing with increased availability and marketing of packaged and fast foods and sugar-sweetened drinks. Adolescence is a formative phase of the life course with multiple physical, emotional and social changes which can make them vulnerable to health problems. We assess the potential impact of macro-determinants, human and economic development as well as income inequality, on 2 top-ranking regional priorities for adolescent nutrition and mental health, using measures of overweight and suicidal ideation and planning which some have shown to be associated. METHODS AND FINDINGS: The Global School-based Health Survey (GSHS) is a nationally representative self-administered, school-based survey. We examined overweight/obesity and suicidal ideation with planning by gross domestic product (GDP) per capita or human development index (HDI) in 10-19-year-old adolescents from 21 LAC countries between 2009 and 2013. Sample sizes varied from 943 in Anguilla to 27,988 in Argentina. A total of 55,295 adolescents had a measure of overweight/obesity status, and 59,061 adolescents reported about suicidal ideation with planning. There was equal representation by sex in the surveys (52% girls and 48% boys). A total of 28.8% of boys and 28.1% of girls had overweight/obesity, and 7.5% of boys and 17.5% of girls reported suicidal ideation with planning over the last 12 months. Adjusted for individual socioeconomic and risk behaviours, and relative to the highest GDP per capita tertile, the middle tertile was associated with 42% (95% confidence interval (CI) 59% to 17%, p = 0.003) and 32% (95% CI 60% to 5%, p = 0.023), and the lowest tertile with 40% (95% CI 55% to 19%, p = 0.001) and 46% (95% CI 59% to 29%, p < 0.001) lower chances of overweight/obesity for girls and boys, respectively. A similar positive effect was seen with HDI, with lowest chances of overweight in the lowest tertile compared with the highest tertile for both sexes. Overweight/obesity was positively related with suicidal ideation with planning for girls (odds ratio (OR) 1.12, 95% CI 1.02 to 1.22, p = 0.009) and weakly related for boys (OR 1.09, 95% CI 0.96 to 1.24, p = 0.182). In contrast to overweight/obesity status, suicidal ideation with planning was not related to macro-level indices despite both outcomes sharing common individual socioeconomic and risk behaviour correlates. Limitations include the dominance of Argentinians in the sample (40%), the exclusion of vulnerable adolescents who dropped out of school, and reporting bias due to stigma of mental health-related issues. CONCLUSIONS: This study shows that economic and human development were positively associated with adolescent overweight/obesity but not with suicidal ideation with planning. We also observed an interconnectedness between overweight/obesity and suicide ideation with planning among girls. These findings highlight the importance of strategies that engage with both upstream and downstream determinants to improve adolescent nutrition and mental health.


Assuntos
Comportamento do Adolescente , Comportamento Infantil , Obesidade Pediátrica/psicologia , Ideação Suicida , Adolescente , Fatores Etários , Região do Caribe/epidemiologia , Criança , Estudos Transversais , Feminino , Inquéritos Epidemiológicos , Humanos , América Latina/epidemiologia , Masculino , Saúde Mental , Obesidade Pediátrica/diagnóstico , Obesidade Pediátrica/epidemiologia , Medição de Risco , Fatores de Risco , Fatores Sexuais , Adulto Jovem
12.
Sci Rep ; 10(1): 22275, 2020 12 17.
Artigo em Inglês | MEDLINE | ID: mdl-33335156

RESUMO

Chile has become a popular destination for migrants from South America and the Caribbean (low- and middle-income countries migration). Close to 200.000 Haitian migrants have arrived in Chile. Infectious and non-infectious disease burden among the Haitian adult population living in Chile is unknown. This study aimed to acquire the basic health information (selected transmissible and non-transmissible conditions) of the Haitian adult population living in Chile. A cross-sectional survey was performed, inviting Haitian-born residents in Chile older than 18 years old. Common conditions and risk factors for disease were assessed, as well as selected transmissible conditions (HIV, HBV, and HCV). 498 participants (60.4% female) from 10 communities in two regions of Chile were surveyed. Most subjects had never smoked (91.5%), and 80% drank less than one alcohol unit per month. The mean BMI was 25.6, with 45% of participants having a normal BMI (20-25). Hypertension was present in 31.5% (33% in the 25-44 age group). Prevalence of HIV was 2.4% (95 CI 1.3-4.2%), hepatitis B (HBsAg positive) was 3.4% (95 CI 2.1-5.5%), and hepatitis C was 0% (95 CI 0.0-0.9%). Quality of life showed a significant prevalence of depression and anxiety markers, particularly in those arriving in Chile less than 1 year ago. Low prevalence of obesity, diabetes, smoking, and drinking and estimated cardiovascular risk were found. Nonetheless, hypertension at a younger age, disproportionately higher prevalence of HIV and HBV infection and frequent markers of anxiety and depression were also found. Public policies for detecting and treating hypertension, HIV, and HBV screening, offering HBV vaccination, and organizing mental health programs for Haitian immigrants, are urgently needed.


Assuntos
Infecções por HIV/enzimologia , Hepatite B/epidemiologia , Hepatite C/epidemiologia , Infecções/epidemiologia , Adolescente , Adulto , Região do Caribe/epidemiologia , Chile/epidemiologia , Feminino , Carga Global da Doença , Infecções por HIV/genética , Infecções por HIV/virologia , Hepacivirus/patogenicidade , Hepatite B/virologia , Vírus da Hepatite B/patogenicidade , Hepatite C/virologia , Humanos , Infecções/virologia , Masculino , Pessoa de Meia-Idade , Doenças não Transmissíveis/epidemiologia , Qualidade de Vida , Fatores de Risco , Adulto Jovem
13.
BMJ Open ; 10(12): e035307, 2020 12 15.
Artigo em Inglês | MEDLINE | ID: mdl-33323426

RESUMO

INTRODUCTION: Zika virus (ZIKV) infection in pregnancy has been associated with microcephaly and severe neurological damage to the fetus. Our aim is to document the risks of adverse pregnancy and birth outcomes and the prevalence of laboratory markers of congenital infection in deliveries to women experiencing ZIKV infection during pregnancy, using data from European Commission-funded prospective cohort studies in 20 centres in 11 countries across Latin America and the Caribbean. METHODS AND ANALYSIS: We will carry out a centre-by-centre analysis of the risks of adverse pregnancy and birth outcomes, comparing women with confirmed and suspected ZIKV infection in pregnancy to those with no evidence of infection in pregnancy. We will document the proportion of deliveries in which laboratory markers of congenital infection were present. Finally, we will investigate the associations of trimester of maternal infection in pregnancy, presence or absence of maternal symptoms of acute ZIKV infection and previous flavivirus infections with adverse outcomes and with markers of congenital infection. Centre-specific estimates will be pooled using a two-stage approach. ETHICS AND DISSEMINATION: Ethical approval was obtained at each centre. Findings will be presented at international conferences and published in peer-reviewed open access journals and discussed with local public health officials and representatives of the national Ministries of Health, Pan American Health Organization and WHO involved with ZIKV prevention and control activities.


Assuntos
Complicações Infecciosas na Gravidez , Infecção por Zika virus , Zika virus , Região do Caribe/epidemiologia , Estudos de Coortes , Feminino , Humanos , América Latina/epidemiologia , Gravidez , Complicações Infecciosas na Gravidez/epidemiologia , Estudos Prospectivos , Risco , Infecção por Zika virus/epidemiologia
15.
Rev. bioét. derecho ; (50): 221-237, nov. 2020.
Artigo em Espanhol | IBECS | ID: ibc-191355

RESUMO

Los avances de las Tecnologías de la Información y la Comunicación (TIC) permiten acceder en tiempo real a una cantidad ingente de datos, a través de los cuales es posible conocer el comportamiento de hechos sociales. En este escenario, la actual pandemia por SARS-CoV-2 ha permitido, bajo cuestionables criterios de inmediatez y urgencia, circular información que genera realidad e impacta en la toma de decisiones; y, además, ha favorecido la apropiación del dato, exponiendo a las personas a violaciones de sus derechos fundamentales. Ambos asuntos son sensibles para América Latina y el Caribe, región que hoy se presenta no sólo como el epicentro de la pandemia sino también de las desigualdades. La contribución que desde la reflexión y deliberación bioética puede realizarse en esta materia, adquiere especial relevancia con vistas a generar un nuevo pacto para el tratamiento de los datos


Advances in Information and Communication Technologies (ICT) provide real-time access to a vast amount of data, through which it is possible to know the behavior of social facts. In this scenario, the current SARS-CoV-2 pandemic has allowed, under questionable criteria of immediacy and urgency, to circulate information that generates reality and impacts on decision-making; and has also favored the appropriation of the data, exposing people to violations of their fundamental rights. Both issues are sensitive to Latin America and the Caribbean, a region that today is presented itself not only as the epicenter of the pandemic but also of inequalities. The contribution that bioethical reflection and deliberation can make in this matter, acquires special relevance with a view to generating a new covenant for the treatment of data


Els avenços de les Tecnologies de la Informació I la Comunicació (TIC) permeten accedir en temps real a una quantitat ingent de dades, a través dels quals és possible conèixer el comportament de fets socials. En aquest escenari, l'actual pandèmia per SARS-CoV-2 ha permès, sota qüestionables criteris d'immediatesa I urgència, circular informació que genera realitat I impacta en la presa de decisions; i, a més, ha afavorit l'apropiació de la dada, exposant a les persones a violacions dels seus drets fonamentals. Tots dos assumptes són sensibles per a Amèrica Llatina I el Carib, regió que avui es presenta no només com l'epicentre de la pandèmia sinó també de les desigualtats. La contribució que des de la reflexió I deliberació bioètica pot realitzarse en aquesta matèria, adquireix especial rellevància amb vistes a generar un nou pacte per al tractament de les dades


Assuntos
Humanos , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Pandemias , Acesso à Internet , Tecnologia da Informação , América Latina/epidemiologia , Região do Caribe/epidemiologia
16.
PLoS One ; 15(10): e0239797, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33027272

RESUMO

The current coronavirus pandemic is an unprecedented public health challenge that is having a devastating economic impact on households. Using a sample of 230,540 respondents to an online survey from 17 countries in Latin America and the Caribbean, the study shows that the economic impacts are large and unequal: 45 percent of respondents report that a household member has lost their job and, among households owning small businesses, 59 percent of respondents report that a household member has closed their business. Among households with the lowest income prior to the pandemic, 71 percent report that a household member lost their job and 61 percent report that a household member has closed their business. Declines in food security and health are among the disproportionate impacts. The findings provide evidence that the current public health crisis will exacerbate economic inequality and provides some of the first estimates of the impact of the pandemic on the labor market and well-being in developing countries.


Assuntos
Betacoronavirus , Infecções por Coronavirus/economia , Infecções por Coronavirus/epidemiologia , Países em Desenvolvimento/economia , Pandemias/economia , Pneumonia Viral/economia , Pneumonia Viral/epidemiologia , Fatores Socioeconômicos , Adulto , Região do Caribe/epidemiologia , Infecções por Coronavirus/virologia , Características da Família , Feminino , Abastecimento de Alimentos , Humanos , Renda , América Latina/epidemiologia , Masculino , Pneumonia Viral/virologia , Pobreza , Inquéritos e Questionários , Desemprego
18.
Medwave ; 20(8): e8025, 2020 Sep 16.
Artigo em Espanhol | MEDLINE | ID: mdl-32956342

RESUMO

Introduction: Coronavirus disease 2019 has been reported in the pediatric population; however, there is limited information in Latin American and the Caribbean countries. Objectives: To describe the frequency of cases, deaths, incidence, and case fatality rate attributed to COVID-19 in children and adolescents from Latin American and the Caribbean countries. Methods: An observational study was carried-out using COVID-19 case registries in children and adolescents published by the Ministries of Health of 19 countries in Latin American and the Caribbean countries until May 20, 2020. Cases and deaths were classified by sex and age group. Also, incidence and case fatality rates were calculated for each country. Results: A total of 20,757 (4.2% of all patients) cases of COVID-19 were reported in children from 0 to 19 years of age. 52.4% was in the group aged 10 to 19 years. 50.6% were male. 139 (0.26%) deaths were reported in children from 0 to 19 years. The accumulated incidence was higher in Chile, Panama, and Peru. The cumulative incidence per 100,000 inhabitants ranged from 1.26 to 77.55 in the population from 0 to 9 years old, 1.57 to 98.84 from 10 to 19 years old, and 0.91 to 88.34 from 0 to 19 years old. The case fatality rate in children from 0 to 19 years old ranged from 0 to 9.09%. Conclusion: In 19 Latin American and the Caribbean countries, the frequency of cases, cumulative incidence, case fatality rate in children and adolescents was heterogeneous. These results contribute to understanding the epidemiological behavior of this disease in children and adolescents of the countries included in the study.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Adolescente , Distribuição por Idade , Região do Caribe/epidemiologia , Criança , Pré-Escolar , Infecções por Coronavirus/mortalidade , Humanos , Incidência , Lactente , Recém-Nascido , América Latina/epidemiologia , Pandemias , Pneumonia Viral/mortalidade , Distribuição por Sexo , Adulto Jovem
19.
PLoS One ; 15(9): e0237542, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32886663

RESUMO

BACKGROUND: Given that most evidence-based recommendations for managing type 2 diabetes mellitus (T2DM) are generated in high-income settings, significant challenges for their implementation exist in Latin America and the Caribbean region (LAC), where the rates of T2DM and related mortality are increasing. The aim of this study is to identify the facilitators and barriers to successful management of T2DM in LAC, from the perspectives of patients, their families or caregivers, healthcare professionals, and/or other stakeholders. METHODS: We conducted a systematic review in MEDLINE, Web of Science, SciELO, and LILACS. We included studies of disease management, prevention of complications and risk factor management. We qualitatively synthesized the verbatim text referring to barriers and/or facilitators of diabetes management according to the Theoretical Domain Framework and described their relative frequencies. FINDINGS: We included 60 studies from 1,595 records identified. 54 studies (90%) identified factors related to the environmental context and resources, highlighting the importance of questions related to health care access or lack of resources in the health system, and the environmental context and living conditions of the patients. Issues related to "social influences" (40 studies) and "social/professional role and identity" (37 studies) were also frequently addressed, indicating the negative impact of lack of support from family and friends and clinicians' paternalistic attitude. 25 studies identified patients beliefs as important barriers, identifying issues such as a lack of patients' trust in the effectiveness of the medication and/or the doctor's advice, or preferences for alternative therapies. CONCLUSIONS: Successful diabetes management in LAC is highly dependent on factors that are beyond the control of the individual patients. Successful disease control will require emphasis on public policies to reinforce health care access and resources, the promotion of a patient-centred care approach, and health promoting infrastructures at environmental level.


Assuntos
Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/terapia , Região do Caribe/epidemiologia , Diabetes Mellitus Tipo 2/prevenção & controle , Gerenciamento Clínico , Acesso aos Serviços de Saúde , Humanos , América Latina/epidemiologia , Assistência Centrada no Paciente , Fatores de Risco
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...