Compliance with eye and foot preventive care in people with self-reported diabetes in Latin America and the Caribbean: Pooled, cross-sectional analysis of nine national surveys.

AIMS: To estimate the proportion of people with self-reported diabetes receiving eye and foot examinations in Latin America and the Caribbean (LAC). METHODS: Cross-sectional analysis of national health surveys in nine countries. Adults aged 25-64 years with self-reported diabetes. We quantified the proportion who reported having an eye examination in the last two years or a foot examination in the last year. We fitted multilevel Poisson regressions to assess socio-demographic (age and sex) and clinical (oral hypoglycemic medication and insulin treatment) variables associated with having had examinations. RESULTS: There were 7435 people with self-reported diabetes included in the analysis. In three countries (Chile [64%; 95% CI: 56%-71%], British Virgin Islands [58%; 95% CI: 51%-65%], and Brazil [54%; 95% CI: 50%-58%]), >50% of people with diabetes reported having had an eye examination in the last two years. Fewer participants (<50% across all countries) reported having had a foot examination in the last year, with Ecuador having the lowest proportion (12%; 95% CI: 8%-17%). Older people, and those taking oral medication or insulin, were more likely to have eye/foot examinations. CONCLUSIONS: The proportion of eye and foot examinations in people with self-reported diabetes across nine countries in LAC is low.

Cardiovascular Disease in the Caribbean: Risk Factor Trends, Care and Outcomes Still Far From Expectations.

Cardiovascular diseases (CVD) are a major public health concern in the Caribbean. Cardiovascular care in the Caribbean revealed encouraging improvements but still less than expectations. This study aims to gain insight into CVD and identify gaps in cardiovascular care in the Caribbean compared to high-income countries. More specifically, this review reports on the epidemiology, CVD risk factors, management practices, and patient outcomes (quality of life (QOL) and mortality). A systematic review of peer-reviewed articles was conducted to assess the CVD of individuals in the Caribbean from 1959 to 2022.Using multiple search engines and keywords, a systematic review of relevant peer-reviewed CVD articles was conducted using the necessary inclusion and exclusion criteria. Relevant data of studies were classified by title, publication year, location, type and size of samples, and results. Further analysis grouped patients by epidemiological profile, CVD risk, management, and selected outcomes (quality of life and inpatient mortality).  From the initial review of 1,553 articles, 36 were analyzed from Trinidad and Tobago (20), Barbados (4), Jamaica (7), along with the Bahamas (2), British Virgin Islands (1), Bonaire (1), and one article from a Caribbean study. The social environment of fast food, sedentary jobs, and stress determinants are postulated to be precursors for an increase in CV risks. CVD in the Caribbean reveals a high prevalence of CV risks, suboptimal care, poor compliance, and high inpatient mortality compared with high-income countries. Greater efforts are required to improve CVD care at all stages, including in the social environment.

CO2 emissions in Latin America: a time series perspective based on fractional integration.

This article deals with the analysis of [Formula: see text] emissions in Latin America by using a long memory process based on fractional integration. Using data of [Formula: see text] emission and [Formula: see text] emissions per capita, for 32 Latin American and Caribbean countries, the results show significant differences according to the variable examined, the model used, and the country under examination. In particular, for the [Formula: see text] emissions, mean reversion is found in Belize and also under some circumstances in Antigua and Barbuda, Colombia, Dominica, Dominican Republic, Ecuador, Grenada, Honduras, Nicaragua, Panama, Peru, and Uruguay. Thus, shocks in these series have a transitory effect. With respect to the time trends, only for some Caribbean countries, namely, Antigua and Barbuda, Aruba, Bahamas, Cuba, and Jamaica, the trend is insignificant; on the other hand, large countries like Brazil, Mexico, and Argentina display the highest time trend coefficients; for the [Formula: see text] emissions per capita, there are eleven countries where mean reversion is detected, and there are ten that share a lack of significance for the trend. The most significant trends now take place in Trinidad and Tobago, British Virgin Islands, Barbados, and Guyana. Policy implications of the results obtained are reported at the end of the paper.

West Indies

Islands lying between southeastern North America and northern South America, enclosing the Caribbean Sea. They comprise the Greater Antilles (CUBA; DOMINICAN REPUBLIC; HAITI; JAMAICA; and PUERTO RICO), the Lesser Antilles (ANTIGUA AND BARBUDA and the other Leeward Islands, BARBADOS; MARTINIQUE and the other Windward Islands, NETHERLANDS ANTILLES; VIRGIN ISLANDS OF THE UNITED STATES, BRITISH VIRGINI ISLANDS, and the islands north of Venezuela which include TRINIDAD AND TOBAGO), and the BAHAMAS. (From Webster's New Geographical Dictionary, 1988, p1330)

Islas que se extienden entre el sudeste de América del Norte y el norte de América del Sur, que encierra el mar Caribe. Comprenden las Antillas Mayores (CUBA; REPÚBLICA DOMINICANA; HAITÍ; JAMAICA y PUERTO RICO), las Antillas Menores (ANTIGUA y BARBUDA y las demás islas de Sotavento, BARBADOS, MARTINICA y el resto de las Islas de Barlovento, ANTILLAS HOLANDESAS; ISLAS VÍRGENES DE LOS ESTADOS UNIDOS, ISLAS VÍRGENES BRITÁNICAS, y las islas del norte de Venezuela que incluyen TRINIDAD Y TOBAGO), y las BAHAMAS. (Traducción libre del original: Webster's New Geographical Dictionary, 1988, p1330)

Ilhas que se situam entre o sudeste da América do Norte e norte da América do Sul, incluindo o Mar do Caribe. Compreendem as Grandes Antilhas (CUBA, REPÚBLICA DOMINICANA, HAITI, JAMAICA e PORTO RICO), as Pequenas Antilhas (ANTÍGUA E BARBUDA e as outras Ilhas de Sotavento, BARBADOS, MARTINICA e as outras Ilhas de Barlavento, ANTILHAS HOLANDESAS, ILHAS VIRGENS AMERICANAS, e as ilhas ao norte da Venezuela que incluem TRINIDAD E TOBAGO) e as BAHAMAS. (Tradução livre do original: Webster's New Geographical Dictionary, 1988, p1330)

British Virgin Islands

A British overseas territory, part of the British West Indies, lying about 60 miles east of Puerto Rico. Tortola is the main island, other islands include Virgin Gorda, Jost Van Dyke and Anegada.

Un territorio ultramar británico, parte de las Indias Occidentales Británicas, situadas a unos 60 kilómetros al este de Puerto Rico. Tortola es la isla principal, otras islas que se incluyen son Virgen Gorda, Jost Van Dyke y Anegada.

Território britânico ultramarino, parte das Índias Britânicas Orientais, situando-se a aproximadamente 60 milhas a oeste de Porto Rico. Tortola é a principal ilha; outras ilhas incluem Virgem Gorda, Jost van Dyke e Anegada.

Caribbean People

People native to or inhabitants of islands in the Caribbean Sea or CARIBBEAN including ANTIGUA AND BARBUDA; ARUBA; BAHAMAS; BARBADOS; BRITISH VIRGIN ISLANDS; CARIBBEAN NETHERLANDS; CUBA; CURACAO; DOMINICA; DOMINICAN REPUBLIC; GRENADA; GUADELOUPE; HAITI; JAMAICA; MARTINIQUE; PUERTO RICO; SAINT KITTS AND NEVIS; SAINT LUCIA; SAINT VINCENT AND THE GRENADINES; SINT MAARTEN; TRINIDAD AND TOBAGO; and UNITED STATES VIRGIN ISLANDS.

Personas nativas o habitantes de islas en el Mar Caribe o CARIBE incluyendo ANTIGUA Y BARBUDA, ARUBA, BAHAMAS, BARBADOS, ISLAS VIRGENES BRITÁNICAS, PAÍSES BAJOS DEL CARIBE, CUBA, CURAZAO, DOMINICA, REPÚBLICA DOMINICANA, GRANADA, GUADALUPE, HAITÍ, JAMAICA, MARTINICA, PUERTO RICO, SAN CRISTÓBAL Y NIEVES, SANTA LUCÍA, SAN VICENTE Y LAS GRANADINAS, SAN MAARTÉN, TRINIDAD Y TOBAGO e ISLAS VIRGENES DE LOS ESTADOS UNIDOS.

Pessoas nativas ou habitantes de ilhas no Mar do Caribe ou CARIBE, incluindo ANTIGUA E BARBUDA, ARUBA, BAHAMAS, BARBADOS, ILHAS VIRGENS BRITÂNICAS, PAÍSES BAIXOS CARIBENHOS, CUBA, CURAÇAO, DOMINICA, REPÚBLICA DOMINICANA, GRANADA, GUADALUPE, HAITI, JAMAICA, MARTINICA, PORTO RICO, SÃO CRISTÓVÃO E NÉVIS, SANTA LÚCIA, SÃO VICENTE E GRANADINAS, SÃO MARTINHO (PAÍSES BAIXOS), TRINIDAD E TOBAGO, e ILHAS VIRGENS AMERICANAS.

Host-parasite Interactions between a Copepod (Pharodes tortugensis) and Small Reef-associated Gobies (Coryphopterus) in the British Virgin Islands.

The effects of parasitic copepods on free-living hosts are infrequently documented, and the copepod Pharodes tortugensis has remained virtually unstudied since described. For the first time, we document its host range in the British Virgin Islands (BVI), the prevalence and intensity of infections on wild hosts, and its impacts on host morphology and performance. Infections were observed on four benthic gobies in the BVI (Coryphopterus glaucofraenum, C. venezuelae, C. dicrus and C. eidolon) but not on other host species previously reported from other parts of the western Atlantic. Infected gobies were widespread in the BVI (detected at 33 of 52 sites, prevalence from 1-25%) but extremely rare elsewhere in the Caribbean (detected at 2 of 16 sites, prevalence < 0.006%). As is typical of macroparasite infections, P. tortugensis was over-dispersed in BVI host populations (mean intensity = 4.7, range = 1-17). Infections were most common in juvenile and female hosts, and rarely found in larger male hosts. The copepods attach in the branchial chamber of the goby; female copepods show high attachment fidelity to the ventral surface of the chamber, while male copepods attached most often to the first two gill arches and in the branchial chamber adjacent to the female. Infections caused substantial damage to the host's branchial chamber and gill filaments. Parasitized gobies also had larger livers and smaller gonads than unparasitized individuals of similar length. The changes in organ mass of infected gobies were not sizeable enough to affect total body mass, and host condition (the body-length vs. body-mass relationship) was similar for gobies with and without infections. Parasitized gobies were, however, significantly smaller in body mass at a given age, reflecting slower overall growth. Effects of P. tortugensis on individual hosts were broadly similar to those of other parasitic copepods that infect fish gills and, for unknown reasons, the BVI appears to be a persistent hotspot of infections on these goby hosts.

Mental health systems in six Caribbean small island developing states: a comparative situational analysis.

BACKGROUND: Small island developing states (SIDS) have particular mental health system needs due to their remoteness and narrow resource base. We conducted situational analyses to support mental health system strengthening in six SIDS: Anguilla, Bermuda, British Virgin Islands, Cayman Islands, Montserrat and Turks and Caicos Islands. METHODS: The situational analyses covered five domains: 1. Socio-economic context and burden of mental disorders, 2. Leadership and governance for mental health 3. Mental health and social care services 4. Strategies for promotion and prevention in mental health and 5. Information systems, evidence and research for mental health. First, a desk-based exercise was conducted, in which data was drawn from the public domain. Second, a field visit was conducted at each site, comprising visits to facilities and consultation meetings with key stakeholders. RESULTS: Our key findings were 1. Despite most of these SIDS being high-income economies, social inequalities within states exist. There was no population-level data on mental health burden. 2. All SIDS have a mental health policy or plan, but implementation is typically limited due to lack of funds or staff shortages. There was minimal evidence of service user involvement in policy or service development. 3. All SIDS have a specialist, multi-disciplinary mental health workforce, however Montserrat and Anguilla rely on visiting psychiatrists. Child and adolescent and dedicated crisis intervention services were found in only two and one SIDS respectively. A recovery-oriented ethos was not identified in any SIDS. 4. Mental illness stigma was prevalent in all SIDS. Promotion and prevention were objectives of mental health strategies for all SIDS, however activities tended to be sporadic. No mental health non-Governmental organisations were identified in three SIDS. 5. Health information systems are generally underdeveloped, with paper-based systems in three SIDS. There has been no rigorous local mental health research. CONCLUSION: Cross-cutting recommendations include: to develop mental health action plans that include clear implementation indicators; to facilitate community surveys to ascertain the prevalence of mental disorders; to explore task-sharing approaches to increase access to primary mental health care; and to develop programmes of mental health promotion and prevention.

COVID-19 Situation Update, n. 149 (30 January 2022)

The situation in some countries and territories (hitherto referred to as countries) follows the trend from last week of peaks in the current Omicron wave having been reached and declining cases & hospitalizations. This week, Antigua & Barbuda, Guadeloupe, Montserrat, St. Lucia and St. Vincent and the Grenadines have joined British Virgin Islands, French Guiana, Grenada and St. Kitts and Nevis in showing a declining 7 day moving incidence rates as well as a decline in the 7 day average of test positivity. Both these indicators are converging in these nine countries. In St. Vincent & the Grenadines, information for total RDTs tested, albeit partial, has recently been published so estimates of test positivity aren't sufficiently reliable. Nonetheless including RDTs, the test positivity in last 3 days is around 16%, comparable to other countries who consider RDT results to be confirmatory and are showing declining trend (Grenada). In Barbados and Martinique, 7 day case incidence shows a slight dip in the last 2-3 days but it is too early to say that a peak has been reached. The new Minister of Health of Barbados mentioned that the country is at "...halfway point in Omicron surge" on Jan 29, 2022. Currently the rate of increase in total tests conducted in seven days in that country is higher than than the increase in cases, which shows that health authorities are prioritizing the right areas even when one of every four people tested in the last week in Barbados had Barbados. Anguilla, on the other hand, shows a clear decline in incidence but in the absence of testing information, a decline in COVID-19 is plausible for now.

COVID-19 Situation Update, n. 148 (20 January 2022)

The situation in some countries and territories (hitherto referred to as countries) is already showing that the current Omicron wave has peaked and cases are now declining. Especially British Virgin Islands, French Guiana, Grenada and St. Kitts and Nevis show declining 7 day moving incidence rates in the last week as well as a decline in the 7 day average of test positivity. Both these indicators are converging in these four countries. Cases continue to steadily increase in other countries although the situation varies widely. Incidence in both children (<18 years) and adults in Barbados shows a near equal rate of increase in incidence, however the test positivity has somewhat steadied and hovers around 20-25% - a rate relatively lower compared to other ECC countries. On the other hand, test positivity rate in Antigua & Barbuda, and St. Lucia hover upwards of 30-40% - reflecting a near saturation of lab capacity and consequently cases may not show an increase owing to ceiling effect. Data from Dominica is patchy but test positivity rates in that country are also rising, albeit near 100% of suspected cases are tested with RDTs and as such comparison with other countries can't be done. St. Vincent and the Grenadines has adopted RDT to be confirmatory diagnosis for COVID-19, but the statistics reflect only PCR positive cases leading to false low incidence rate. When RDTs are summed up with PCR cases, the incidence rate is near 16 times high.

Using DNA barcoding to identify host-parasite interactions between cryptic species of goby (Coryphopterus: Gobiidae, Perciformes) and parasitic copepods (Pharodes tortugensis: Chondracanthidae, Cyclopoida).

Previous work, using morphological characters, identified a generalist copepod parasite (Pharodes tortugensis) at high prevalence on two common gobies (Coryphopterus glaucofraenum and C. dicrus) in the British Virgin Islands (BVI). DNA barcoding subsequently revealed C. glaucofraenum to be three morphologically similar species (C. glaucofraenum, C. venezuelae and C. tortugae), casting doubt on host identities in the BVI and the classification of the parasite as a single species. Mitochondrial cytochrome c oxidase subunit I (COI) data from 67 gobies in the BVI showed that, in addition to C. dicrus, host gobies were a mix of C. glaucofraenum and C. venezuelae, while C. tortugae was unexpectedly absent from the study area. COI data (n = 70) indicated that the copepod infecting all three hosts was a single species, almost certainly P. tortugensis. The pharodes-coryphopterus interaction has a strong impact on host dynamics in the BVI, and a revised understanding of these dynamics must account for any differences among the three newly confirmed hosts in transmission of, and susceptibility to, the shared parasite. No other infected hosts were discovered at our sites, but P. tortugensis is reportedly widespread and infects 12 additional host species elsewhere. Further DNA barcoding is thus needed to test whether P. tortugensis is truly a widespread generalist, or instead represents a group of more specialized cryptic species.

Subclinical Burkholderia pseudomallei Infection Associated with Travel to the British Virgin Islands.

Phylogenetic analysis of a clinical isolate associated with subclinical Burkholderia pseudomallei infection revealed probable exposure in the British Virgin Islands, where reported infections are limited. Clinicians should consider this geographic distribution when evaluating possible infection among persons with compatible travel history.

Range extension and conservation status of the rare Solanaceae shrub, Solanum conocarpum.

BACKGROUND: The British Virgin Islands and the US Virgin Islands, two island groups located in the Caribbean archipelago, hold unique plant diversity and high endemism. Until recently, Solanum conocarpum was considered a rare plant species endemic to the island of St. John in the US Virgin Islands. Ongoing botanical surveys in this region are revealing new populations and refining our understanding of the distribution of these narrow endemic plant species. The objective of this paper is to assess the conservation status of S. conocarpum, including a review of its geographic range, population numbers, threats and conservation actions needed for its long-term survival. NEW INFORMATION: In this paper, we present new occurrences for S. conocarpum, extending its geographic range to a new island, Tortola and new territory, the British Virgin Islands. Despite this range expansion, this species is evaluated as Endangered (EN), based on Criteria B1b(iii,v)+2b(iii,v)+C2a(i), according to the IUCN Red List Categories and Criteria. The extent of occurrence (EOO = 46 km2) and area of occupancy (AOO = 20 km2) are highly restricted. On St. John (US Virgin Islands), the historically recorded individuals at Reef Bay, Europa Ridge and Sabbat Point are now considered extirpated due to disturbance from development compounded by invasive species, as well as the impact of feral ungulates and drought stress. These threats are impacting the species across the whole island of St. John and contributing to a continuing decline of suitable habitat, despite the island being a National Park. On the island of Tortola, the species occurs on unprotected lands subject to development and habitat modification and decline by feral ungulates. Based on these threats acting separately across the two islands, two locations were defined. The estimated total number of mature individuals ranges between 150 and 250, with the largest subpopulation at Nanny Point in the US Virgin Islands, containing 108 mature individuals. Conservation action, focused on protecting this species' habitat, is urgently needed.

Conservation status of native plant hybrids in the British Virgin Islands.

BACKGROUND: Hybridization is an evolutionary event present in the natural world. Several studies suggest that natural hybridization is an important process in plant evolution, creating new genetic combinations which can play a vital role in speciation (Soltis and Soltis 2009, Soltis 2013, Neri et al. 2017, Taylor and Larson 2019). Therefore, it is important to understand and protect naturally occurring hybrids, conserving their ecological novelties and new traits, such as the ability to explore new niches, different from those of the parental species (Soltis 2013, Supple and Shapiro 2018).The British Virgin Islands (BVI) is a UK Overseas Territory situated in the Caribbean biodiversity hotspot (Myers et al. 2000). To date, three natural hybrids are known to occur within this territory: Tillandsia × lineatispica Mez, Anthurium × selloanum K.Koch and Coccoloba krugii × C. uvifera R.A.Howard (Howard 1957, Acevedo-Rodriguez and Strong 2005, Acevedo-Rodriguez and Strong 2012).Tillandsia × lineatispica is endemic to the Puerto Rican Bank, occurring in Puerto Rico, the US Virgin Islands (USVI) and the British Virgin Islands with an extent of occurrence estimated to be 3,390 km2 and a limited number of locations. The suitable habitat for this hybrid is declining mainly due to the negative impacts of feral ungulates, development for tourism and residential infrastructure and the impact of human-induced wildfires. In addition, it is suspected that the global population does not exceed 10,000 individuals with the largest subpopulation on Beef Island in the BVI thought to have no more than 1,000 mature individuals. This hybrid is therefore evaluated as Vulnerable, based on IUCN Red List Criteria, B1a(iii)+2b(iii) + C2a(i).Anthurium × selloanum is an endemic hybrid to BVI and USVI with a very restricted extent of occurrence which was estimated to range between 103 km2 and 207 km2 and an area of occupancy which was estimated to range between 56 km2 and 188 km2 and a limited number of locations. The suitable habitat of this species is declining mainly due to the negative impacts of feral ungulates, development for tourism and residential infrastructure and the negative impact of recreation activities in protected areas. This species is therefore evaluated as Endangered, based on IUCN Red List Criteria B1a+ b(iii) + B2a+b(iii).Coccoloba krugii × C. uvifera is native to the BVI, USVI, Puerto Rico, Dominican Republic, Haiti and Anguilla. It is estimated to have an extent of occurrence of 89,412 km2. This value exceeds the threshold for any threatened category. Despite an observed continuing decline of suitable habitat for this species, which is being degraded mainly through ongoing development pressures, this species occurs in more than 10 locations. It is therefore assessed as Least Concern (LC). NEW INFORMATION: In this paper, we discuss the conservation status of all the known, naturally occurring, native hybrids in the the British Virgin Islands and we provide distribution data, including new records, from across these hybrid species ranges. Although conservation assessments of hybrids are out of the scope of the published IUCN Red List of Threatened Species (IUCN Standards and Petitions Committee 2019), we use the IUCN Red List Criteria and Categories (version 3.1) to establish an equivalent conservation status of these hybrids and discuss conservation action due to the potential evolutionary importance of these naturally occurring hybrids. These assessments provide the necessary baseline information for prioritising species conservation and making informed management decisions, such as establishing the BVI's Tropical Important Plant Areas (TIPAS) network (Sanchez et al. 2019).

Epidemiological surveillance of chikungunya fever in Mexico since its introduction in 2014-2016 and identification of circulating genotypes.

In 2014, the chikungunya virus (CHIKV) was detected for the first time in Mexico, the identified strain was the one corresponding to the Asian genotype which was phylogenetically grouped with the strains that circulated in the British Virgin Islands outbreak and was later classified with lineages of Caribbean strains. In three years, 13,569 cases of chikungunya were registered in Mexico. Although the transmission and spread of the virus are now considered a moderate risk, the danger that the virus reemerges is not ruled out due to the infestation of Aedes mosquitoes. In this study, we reviewed the chikungunya fever (CHIKF) cases reported between 2014 and 2016 to reanalyze the data. Seventeen cases were selected from different states where the circulation of the virus had been reported. Statistical data were analyzed and a retrospective analysis was carried out. Nucleic acid sequences were determined of these 17 samples. 2015 was the year with the highest number of cases (92.8%) and they were detected in 28 states of the country. There is a predominance of females, and the most affected age group was between 25 and 44 years. In 2016, CHIKV genotypes were not known, in this study the presence of the Asian genotype of Caribbean lineage was confirmed. The presence of the West African and ECSA genotypes was phylogenetically ruled out. The sequences obtained were deposited in GeneBank.

Epidemiological Update: Coronavirus disease (COVID-19) (15 October 2020)

All 54 countries and territories in the Region of the Americas have reported COVID-19 cases and deaths. Since the 18 September 2020 PAHO/WHO Epidemiological Update on COVID-19 and as of 13 October 2020, 3,018,295 additional confirmed cases of COVID-19, including 77,525 deaths, have been reported in the Region of the Americas, representing a 17% increase in cases and a 13% increase in deaths. Across all subregions, a relative increase was observed, both in the number of cases and number of deaths. The highest increase in cases was observed in the Caribbean and the Atlantic Ocean Islands subregion, with a 20% increase in cases and an 18% increase in deaths, followed by the Central America subregion, with a 20% increase in cases and a 16% increase in deaths; the South America subregion, with a 17% increase in cases and a 16% increase in deaths; and the North America subregion, with a 16% increase in cases and a 12% increase in deaths. In the last 60 days, 10 of the 54 countries/territories in the Region reported increased intensity of COVID-19 transmission and modified their COVID-19 transmission classifications accordingly: Aruba, Belize, the British Virgin Islands, Curacao, Guadeloupe, Jamaica, Martinique, Saint Barthelemy, Saint Martin, and Trinidad and Tobago. Five of these had a relative increase in confirmed cases of greater than 90% (range 94% to 97%): Aruba, Belize, Curacao, Guadeloupe, and Trinidad and Tobago. During the same period, 7 of these 10 countries/territories also presented with a relative increase in deaths, ranging from 29% to 93%: Aruba, Belize, Guadeloupe, Jamaica, Martinique, Saint Martin, and Trinidad and Tobago. [...]

Los 54 países y territorios de la Región de las Américas han notificado casos y defunciones de COVID-19. Desde la última actualización epidemiológica publicada por la OPS/OMS el 18 de septiembre de 2020 hasta el 13 de octubre de 2020, fueron notificados 3.018.295 casos confirmados de COVID-19, incluidas 77.525 defunciones adicionales en la región de las Américas, lo que representa un aumento de 17% de casos y de 13% de defunciones. En todas las subregiones se observó un incremento relativo, tanto en el número de casos como en el número de defunciones, siendo el mayor en las Islas del Caribe y del Océano Atlántico con 20% de aumento en casos y 18% de aumento en defunciones. El resto de las subregiones, incrementaron de la siguiente manera, en orden decreciente: América Central con 20 % de aumento en casos y 16% de aumento en defunciones, América del Sur con 17% de aumento en casos y 16% aumento en defunciones y América del Norte8 con 16 % de incremento en casos y 12% de incremento en defunciones (Figuras 2 y 3). Con relación a la intensidad de la transmisión del virus SARS CoV-2, 10 de los 54 países y territorios de la región notificaron un incremento de casos y defunciones de COVID-19 en los últimos 60 días, modificando su escenario de transmisión de menor a mayor intensidad: Aruba, Belice, Curazao, Guadalupe, Jamaica, Martinica, San Bartolomé, San Martín, Trinidad y Tobago e Islas Vírgenes Británicas. En este período, Aruba, Belice, Curazao, Guadalupe y Trinidad y Tobago presentaron un incremento relativo de casos confirmados mayor a 90% (rango 94% a 97%). Respecto de las defunciones, el incremento relativo se observó en 7 de estos 10 países y territorios: Aruba, Belice, Guadalupe, Jamaica, Martinica, San Martín y Trinidad y Tobago en un rango de 29% a 93%. [...]

Epidemiological Alert: Recurring waves and outbreaks of COVID-19 (9 October 2020)

Since the confirmation of the first COVID-19 cases and until 5 October 2020, a total of 35,109,317 COVID-19 cases have been reported globally, including 1,035,341 deaths. The Region of the Americas accounts for 49% of the total cases and 55% of the total deaths reported globally. The analysis of trends in COVID-19 cases at the global level, by WHO Region, shows a new increase in cases in the WHO European Region and the WHO Western Pacific Region In the Region of the Americas, 10 of the 54 countries and territories reported an increase in COVID-19 cases and deaths in the last 60 days. The countries/territories that modified their COVID-19 transmission classifications due to increased intensity of COVID-19 transmission are Aruba, Belize, the British Virgin Islands, Curaçao, Guadeloupe, Jamaica, Martinique, Saint Barthelemy, Saint Martin, and Trinidad and Tobago. During this period, Aruba, Belize, Curaçao, Guadeloupe, and Trinidad and Tobago had a >90% relative increase in confirmed cases (range 94% to 97%).

Desde la confirmación de los primeros casos de COVID-19 hasta el 5 de octubre, se han notificado a nivel global 35.109.317 casos de COVID-19, incluidas 1.035.341 defunciones. La Región de las Américas concentra 49% del total de casos y 55% de las defunciones acumuladas a nivel mundial. El análisis de las tendencias de casos de COVID-19 a nivel global, según regiones de la OMS, muestra un nuevo incremento de casos en las regiones de Europa y del Pacifico Occidental. En las Américas, 10 de los 54 países y territorios de la región notificaron un incremento de casos y defunciones de COVID-19 en los últimos 60 días1, modificando su escenario de transmisión de casos de menor a mayor intensidad: Aruba, Belice, Curazao, Guadalupe, Islas Vírgenes Británicas, Jamaica, Martinica, San Bartolomé, San Martín y Trinidad y Tobago. En este período, Aruba, Belice, Curazao, Guadalupe y Trinidad y Tobago presentaron un incremento relativo de casos confirmados mayor a 90% (rango 94% a 97%).

Epidemiological Update: Coronavirus disease (COVID-19) (18 September 2020)

Since the 26 August PAHO/WHO Epidemiological Update on COVID-19 and as of 15 September 2020, the five countries/territories in the Americas for which there was a ≥200% relative increase in the number of cases are: Curacao (357%), Guadeloupe (299%), Trinidad and Tobago (254%), the British Virgin Islands (214%), and Jamaica (200%). Those with the greatest relative increase in the number of deaths were Trinidad and Tobago (331%), Belize (280%), and Aruba (233%). Between 22 August and 15 September 2020, the countries/territories that modified their COVID-19 transmission classifications based on increased intensity of COVID-19 transmission were: Curacao and Saint Martin (changing from sporadic cases to community transmission) and Guadeloupe, Jamaica, and Martinique (changing from clusters of cases to community transmission). [...]

En el periodo comprendido entre la última actualización epidemiológica publicada por la OPS/OMS el 26 de agosto y el 15 de septiembre de 2020, los cinco países/territorios en las Américas en los cuales se observa un incremento relativo ≥200% en el número de casos son: Curazao (357%), Guadalupe (299%), Trinidad y Tobago (254%), las Islas Vírgenes Británicas (214%) y Jamaica (200%); mientras que los que presentaron el mayor aumento relativo en el número de defunciones fueron Trinidad y Tobago (331%), Belice (280%) y Aruba (233%). Los países y territorios que modificaron el escenario de transmisión de COVID-19, en este mismo periodo (entre el 22 de agosto y el 15 de septiembre) observándose un incremento en la transmisión de casos de menor a mayor intensidad fueron: Curazao y San Martín (de casos esporádicos a transmisión comunitaria), Guadalupe, Jamaica y Martinica (de conglomerado de casos a transmisión comunitaria). [...]

COVID-19 Situation Report, n.22 (24 August 2020)

Regional. PAHO continued to collaborate with its partners within the Region and across the globe to deliver technical cooperation, evidence-based guidance, and recommendations, and to advocate for the Americas on the global stage. PAHO’s regional IMST also provided support and strategic guidance to countries’ IMSTs as they coordinate and monitor their national response activities. Regulatory frameworks and requirements Health technology assessments (HTAs) are invaluable in guiding health authorities in the use of technologies relevant to the COVID-19 pandemic. The Regional Database of HTA Reports of the Americas (BRISA) now has 213 reports available in its COVID-19 section. PAHO convened the 12th regulatory update with the national regulatory authorities (NRAs) of the Americas to facilitate the sharing of experiences and challenges from the COVID-19 pandemic (60 participants from Argentina, Bahamas, Brazil, British Virgin Islands, Canada, Colombia, Cuba, Chile, Ecuador, Honduras, Guyana, Mexico, and the USA. PAHO continued to work with its Member States to provide guidance on the use of in vitro diagnostics (IVDs) and other regulatory aspects, considering authorizations from WHO’s Emergency Use Listing procedure (EUL) and recommendations from eight NRAs from around the globe. PAHO maintains a list of 67 prioritized IVDs for proprietary and open platforms.