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1.
Guatemala; OPS; 2021-09-09. (OPS/GTM/21-0001).
Não convencional em Espanhol | PAHO-IRIS | ID: phr2-54809

RESUMO

Establecida en 1902 como el organismo independiente especializado en salud del sistema interamericano, la Organización Panamericana de la Salud (OPS) ha desarrollado competencias y experiencia ampliamente reconocidas al brindar cooperación técnica a sus Estados Miembros para combatir las enfermedades transmisibles y no transmisibles y sus causas, fortalecer los sistemas de salud y responder a situaciones de emergencia y desastres en toda la Región de las Américas. Asimismo, en su calidad de oficina regional de la Organización Mundial de la Salud, la OPS participa activamente en los equipos de las Naciones Unidas en los países, colaborando con otros organismos, fondos y programas del sistema de las Naciones Unidas para contribuir al logro de los Objetivos de Desarrollo Sostenible (ODS) a nivel de país. En este informe anual se presenta la cooperación técnica de la OPS a nivel de país en el 2020, mediante la aplicación de la estrategia de cooperación con el país, la respuesta a las necesidades y prioridades nacionales, y el desarrollo de las actividades en el marco de los mandatos regionales y mundiales de la Organización y los ODS. En consonancia con el tema general de "la salud universal y la pandemia: sistemas de salud resilientes", se pone de relieve la respuesta de la OPS a la pandemia de COVID-19, así como sus esfuerzos continuos en esferas prioritarias como las enfermedades transmisibles, las enfermedades no transmisibles, la salud mental, la salud a lo largo del curso de vida y las emergencias de salud. También se presenta un resumen financiero del ejercicio examinado.


Assuntos
Cooperação Técnica , Sistemas de Saúde , Programas Nacionais de Saúde , Políticas, Planejamento e Administração em Saúde , Cobertura de Serviços de Saúde , Cobertura Universal de Saúde , Doenças não Transmissíveis , Doenças Transmissíveis , Fatores de Risco , Fatores Socioeconômicos , Saúde Mental , Administração Financeira , Administração em Saúde Pública , Sistemas de Informação em Saúde , América Central , Guatemala
2.
Artigo em Inglês | MEDLINE | ID: mdl-34206907

RESUMO

The population's behavioral responses to containment and precautionary measures during the COVID-19 pandemic have played a fundamental role in controlling the contagion. A comparative analysis of precautionary behaviors in the region was carried out. A total of 1184 people from Mexico, Colombia, Chile, Cuba, and Guatemala participated through an online survey containing a questionnaire on sociodemographic factors, precautionary behaviors, information about COVID-19, concerns, maintenance of confinement, and medical symptoms associated with COVID-19. Cubans reported the highest scores for information about COVID-19. Colombians reported less frequent usage of precautionary measures (e.g., use of masks), but greater adherence to confinement recommendations in general, in contrast to the low levels of these behaviors in Guatemalans. Chileans reported greater pandemic-related concerns and the highest number of medical symptoms associated with COVID-19. These findings allow a partial characterization of the Latin American population's responses during the second and third phases of the COVID-19 pandemic and highlight the importance of designing and managing public health policies according to the circumstances of each population when facing pandemics.


Assuntos
COVID-19 , Pandemias , Chile/epidemiologia , Colômbia , Guatemala/epidemiologia , Humanos , América Latina/epidemiologia , México , SARS-CoV-2
3.
Artigo em Inglês | MEDLINE | ID: mdl-34209792

RESUMO

This analysis of surveys from six low- and middle-income countries (LMICs) aimed to (i) estimate the prevalence of disability among older adults and (ii) compare experiences and participation in key life areas among older people with and without disabilities which may show vulnerability during the COVID-19 pandemic. Data were analysed from district-level or national surveys in Cameroon, Guatemala, Haiti, India, Nepal and the Maldives, which across the six databases totalled 3499 participants aged 60 years and above including 691 people with disabilities. Disability was common among adults 60+, ranging from 9.7% (8.0-11.8) in Nepal to 39.2% in India (95% CI 34.1-44.5%). Mobility was the most commonly reported functional difficulty. In each setting, older people with disabilities were significantly less likely to be working and reported greater participation restrictions and environmental barriers in key life areas compared to people in the same age categories without disabilities (p < 0.05). Disability is common in this population, and older people with disabilities may have greater difficulties participating in COVID-19 responses and have high economic vulnerabilities. It is imperative to prioritise the needs of older people with disabilities in the COVID-19 pandemic, including ensuring accessibility of both health services and the community in general.


Assuntos
COVID-19 , Pessoas com Deficiência , Idoso , Camarões , Países em Desenvolvimento , Guatemala , Haiti , Humanos , Índia/epidemiologia , Ilhas do Oceano Índico , Nepal/epidemiologia , Pandemias , SARS-CoV-2
4.
Int J Soc Psychiatry ; : 207640211028612, 2021 Jun 27.
Artigo em Inglês | MEDLINE | ID: mdl-34176356

RESUMO

BACKGROUND: The mental health impact of Covid-19 from the perspective of individuals experiencing psychological distress during lockdown period in marginalized, high-risk communities remains underinvestigated. AIMS: This study aims to identify key factors related to psychological distress resulting from the Covid-19 pandemic across highly vulnerable districts in Guatemala. METHODS: The Covid Care Calls (CCC) survey was administered to households in 11 districts in Guatemala to gather information about medical, mental health, and psychosocial status during the lockdown period; provide referral for care; and disseminate information on evidence-based protective measures to stem the spread of the virus. The 330 individuals participated the survey. Conventional content analysis was used to analyze survey data. RESULTS: Most commonly reported mental health issues since the start of the pandemic were anxiety (46%), stress (36%), and exacerbation of pre-Covid-19 mental health conditions (19%). Depression and burnout were equally reported by 12% of participants. Only 2% reported issues with safety in the home. Concerns about catching the virus and economic worries were the most commonly reported sources of psychological distress. CONCLUSION: Results of this study indicate a high prevalence of anxiety, stress, and increased prior mental health symptoms resulting from the onset of the Covid-19 pandemic in low-income, high-risk communities across Guatemala. Efforts focused on enhancing coping strategies as well as psychoeducation to address stigma and increase help-seeking for depression are particularly important.

5.
Soc Sci Med ; 281: 114040, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34144481

RESUMO

RATIONALE: Stress process theory considers that actual and perceived isolation, caused by mobility restrictions from attempted containment of the COVID-19 pandemic, deteriorates mental health. OBJECTIVE: We examine the relationship between the COVID-19 lockdowns and mental health-related Google searches in 11 Latin American countries. We include the following countries: Argentina, Bolivia, Chile, Colombia, Ecuador, Guatemala, Honduras, Mexico, Paraguay, Peru, and Uruguay. We also explore how changes in search patterns relate to income support policies and to COVID-19 death rates. METHOD: Using Google Trends data and an event-study design, as well as a difference-in-differences analysis, we investigate the association between country specific stay-at-home orders and internet searches including the following words: insomnia, stress, anxiety, sadness, depression, and suicide. RESULTS: We find three main patterns. First, searches for insomnia peak but then decline. Second, searches for stress, anxiety, and sadness increase and remain high throughout the lockdown. Third, there is no substantial change in depression-related or suicide-related searches after the lockdown. In terms of potential mechanisms, our results suggest that searches declined for suicide and insomnia following the passage of each country's income support, while in countries with higher COVID-19-related death rates, searches for insomnia, stress, and anxiety increased by more. CONCLUSIONS: Our results suggest that, in Latin America, Google searches for words associated with mild mental health disorders increased during the COVID-19 stay-at-home orders. Nonetheless, these conclusions should not be construed as a general population mental health deterioration, as we cannot verify that search indicators are accurately related to the users' current feelings and behaviors, and as internet users may not be representative of the population in this region.


Assuntos
COVID-19 , Saúde Mental , Ferramenta de Busca , Argentina , Bolívia , Chile , Colômbia , Controle de Doenças Transmissíveis , Equador , Guatemala , Honduras , Humanos , América Latina/epidemiologia , México , Pandemias , Peru , SARS-CoV-2 , Uruguai
6.
Int J Soc Psychiatry ; : 207640211027212, 2021 Jun 21.
Artigo em Inglês | MEDLINE | ID: mdl-34154427

RESUMO

BACKGROUND: On March 5th, Guatemala declared a 'State of Calamity' in response to the COVID-19 pandemic and strict lockdown measures were initiated. The psychological consequences of these measures are yet to be fully understood. There is limited research on the psychological impact of the virus in the general population, and even less focused on Latin America and high-risk communities characterized by poverty, limited mental health resources, and high rates of stigma around mental illness. The goal of this study is to examine the psychological impact of COVID-19 across several highly vulnerable districts in Guatemala. METHODS: A semi-structured phone interview was conducted of 295 individuals in multiple districts in Guatemala City to assess self-perceived mental health consequences related to the pandemic. Sociodemographic, medical, and mental health data were collected. Chisquares and t-tests used for categorical and continuous variables, as appropriate, to describe the sample. Binary logistic regressions were estimated to examine associations between sociodemographic characteristics and mental health symptoms (anxiety, stress, depression, burnout, escalation of pre-existing mental health symptoms, and a sense of safety). RESULTS: The results indicate high levels of anxiety and stress in all target communities. Significant differences based on gender, age, and the number of children in the household were identified: women and older adults experience higher rates of stress and anxiety associated with the pandemic; while families with greater number of children experience higher levels of burnout. CONCLUSION: Contextualizing the current pandemic as a complex emergency can help inform further studies focusing on socioeconomic challenges and higher vulnerabilities as preconditions affecting the impact of the pandemic on mental health. Given the limited available resources for mental health care in Guatemala, informal networks of care may play an important role in meeting the needs of those individuals experiencing increased psychological distress resulting from the pandemic.

7.
Int J Infect Dis ; 108: 422-427, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34119676

RESUMO

OBJECTIVES: To describe the impact of the coronavirus disease 2019 (COVID-19) pandemic on the diagnosis of human immunodeficiency virus (HIV) and deaths from opportunistic infections in Guatemala. METHODS: A retrospective study was conducted to investigate the impact of the COVID-19 pandemic on people with HIV at a referral clinic (Clinica Familiar Luis Angel García, CFLAG), as well as the disruption of services at a diagnostic laboratory hub (DLH) which provides diagnosis for opportunistic infections to a network of 13 HIV healthcare facilities. Comparative analysis was undertaken using the months March-August from two different time periods: (i) pre-COVID-19 (2017-2019); and (ii) during the COVID-19 period (2020). RESULTS: During the COVID-19 period, 7360 HIV tests were performed at Clinica Familiar Luis Angel García, compared with an average of 16,218 tests in the pre-COVID-19 period; a reduction of 54.7% [95% confidence interval (CI) 53.8-55.4%],Deaths from opportunistic infections at 90 days were 10.7% higher in 2020 compared with 2019 (27.3% vs 16.6%; P = 0.05). Clinical samples sent to the DLH for diagnosis of opportunistic infections decreased by 43.7% in 2020 (95% CI 41.0-46.2%). CONCLUSION: The COVID-19 pandemic is having a substantial impact on HIV care in Guatemala. Diagnostic services for HIV have been severely affected and deaths from opportunistic infections have increased. The lessons learnt must guide the introduction of strategies to reduce the impact of the pandemic.


Assuntos
COVID-19 , Infecções por HIV , Instituições de Assistência Ambulatorial , Guatemala/epidemiologia , Infecções por HIV/diagnóstico , Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologia , Humanos , Pandemias , Estudos Retrospectivos , SARS-CoV-2
8.
JCO Glob Oncol ; 7: 577-584, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33891480

RESUMO

PURPOSE: The COVID-19 pandemic is a colossal challenge for global health; nonetheless, specific subgroups face considerably higher risks for infection and mortality. Among patients with malignant diseases, those with hematologic neoplasms are at a higher risk for poor outcomes. The objective of this study was to register treatment modifications associated with the COVID-19 pandemic and their short-term consequences in Latin America. METHODS: Multicenter, prospective, observational, cohort study including patients older than 14 years from 14 centers in four countries (Mexico, Peru, Guatemala, and Panama) who had a confirmed diagnosis of acute leukemia, and who were undergoing active treatment since the first COVID-19 case in each country until the cutoff on July 15, 2020. RESULTS: We recruited 635 patients. Treatment modifications because of the COVID-19 pandemic were reported in 40.8% of cases. The main reason for such modifications was logistic issues (55.0%) and the most frequent modification was chemotherapy delay (42.0%). A total of 13.1% patients developed COVID-19 disease, with a mortality of 37.7%. Several factors were identified as independently associated with mortality, including a diagnosis of acute myeloid leukemia (odds ratio 2.38 [95% CI, 1.47 to 3.84]; P < .001), while the use of telemedicine was identified as a protective factor (odds ratio 0.36 [95% CI, 0.18 to 0.82]; P = .014). CONCLUSION: These results highlight the collateral damage of COVID-19 in oncology patients.


Assuntos
COVID-19/prevenção & controle , Leucemia Mieloide/terapia , Oncologia/métodos , SARS-CoV-2/isolamento & purificação , Doença Aguda , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , COVID-19/epidemiologia , COVID-19/virologia , Comorbidade , Epidemias , Feminino , Guatemala/epidemiologia , Humanos , Leucemia Mieloide/diagnóstico , Leucemia Mieloide/epidemiologia , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Panamá/epidemiologia , Peru/epidemiologia , Estudos Prospectivos , SARS-CoV-2/fisiologia , Adulto Jovem
9.
Guatemala; MSPAS; 3 feb. 2021. 28 p. graf.
Não convencional em Espanhol | LILACS, LIGCSA | ID: biblio-1224546

RESUMO

En los antecedentes, brinda detalles técnicos de enfermedades previas al COVID-19 y sigue esta consigna internacional: "Sin embargo, a la luz de la posible introducción de un caso sospechoso relacionado con el 2019-nCoV en la Región de las Américas, la Organización Panamericana de la Salud / Organización Mundial de la Salud (OPS / OMS) recomienda a los Estados Miembros garantizar su identificación oportuna, el envío de las muestras a laboratorios Nacionales o de referencia y la implementación del protocolo de detección molecular para 2019-nCoV, según la capacidad del laboratorio." Aborda las tres mutaciones del virus conocidas hasta la fecha del documento y las tres variantes conocidas: Reino Unido e Irlanda del Norte, República de Sudáfrica y Brasil, siendo la de mayor transmisibilidad, según el documento, la del Reino Unido. El primero de los objetivos del documento es: "Brindar los lineamientos generales para la toma de muestra, conservación, transporte y diagnóstico del SARS-Cov-2 en los laboratorios descentralizados bajo la técnica de Reacción en Cadena de la Polimerasa (PCR) en tiempo Real, en atención a pacientes que cumplen con la definición de caso y se tipifica como "sospechoso inusitado"." Incluye como anexo 2 el documento: "Lineamientos para el abordaje de casos positivos para SARS-COV-2 de viajeros que ingresan al país por el aeropuerto internacional "La Aurora" (AILA)"


Assuntos
Humanos , Masculino , Feminino , Pneumonia Viral/diagnóstico , Manejo de Espécimes/normas , Infecções por Coronavirus/diagnóstico , Betacoronavirus , Contenção de Riscos Biológicos/métodos , Monitoramento Epidemiológico , Equipamento de Proteção Individual/normas , Guatemala , Indicadores e Reagentes/administração & dosagem , Laboratórios/normas
10.
Ciudad de Guatemala; s.n; 5 feb. 2021. 35 p. tab, ilus.
Não convencional em Espanhol | LILACS, LIGCSA | ID: biblio-1179867

RESUMO

Para facilitar la introducción de la vacuna contra la COVID-19 el Ministerio de Salud Pblica y Asistencia Social (MSPAS) estableció el Comité Nacional de Coordinación para Vacunación contra COVID-19 (CNVCOVID) a través del Acuerdo Ministerial No 0262-2020, con la finalidad de desarrollar e implementar el plan estratégico nacional de vacunación contra la COVID-19. Este documento representa ese producto, en el cual se integran y describen los componentes esenciales para el despliegue de la vacunación contra la COVID-19 el cual se actualizará periódicamente, a medida que se obtenga información actualizada, científica, legal y técnico-operativa para fortalecer la estrategia de vacunación contra la COVID-19 en Guatemala


Assuntos
Pneumonia Viral/imunologia , Vacinas Virais/provisão & distribuição , Infecções por Coronavirus/imunologia , Vírus da SARS/imunologia , Pandemias/prevenção & controle , Política de Saúde , Vacinas Virais/normas , Guatemala
12.
Kidney Int Rep ; 2021 Jan 29.
Artigo em Inglês | MEDLINE | ID: mdl-33532670

RESUMO

Introduction: COVID-19 is public health concern across the world. Data on the epidemiology among patients on hemodialysis in Latin America and low and middle-income countries is limited. Methods: Using electronic medical records from the second largest dialysis network in Guatemala, we performed a retrospective analysis of all adult patients on hemodialysis with the diagnosis of COVID-19 to estimate incidence of infection, and describe the demographics, comorbidities, and outcomes. We stratified incidence rate by region. We reviewed data from May 1 to July 31, 2020, with outcome data ascertained up to August 28, 2020. Results: Of 3201 patients undergoing hemodialysis, 325 patients were diagnosed with COVID-19 (incidence rate: 102 per 1,000 patients on hemodialysis, compared with 3 per 1,000 in the general population). Incidence was higher in the Central region (207 per 1,000) and lowest in the Southeast region with 33 per 1,000, and unlike in the general population, incidence was lower in Guatemalan city. Mean age of the COVID-19 diagnosed patients was 51.1 (SD 14.8) years, and 84 (25.8%) were female. The median length of hospital stay was 12 days [IQR 10-16]. 229 (69.8%) of the patients recovered, 90 patients died (27.7%), and 6 (1.8%) patients were still in the hospital at the time of last follow-up. Conclusion: In summary, incidence of diagnosed COVID-19 in Guatemalan patients on hemodialysis was much higher than reported in the general population, with outcomes similar to those described in high income countries. Rural regions had higher incidence rates than the major metropolitan area.

13.
Guatemala; MSPAS; 26 ene. 2021. 7 p.
Não convencional em Espanhol | LILACS, LIGCSA | ID: biblio-1224547

RESUMO

En los antecedentes se presentan estadísticas del COVID-19 a la fecha en la que se elaboró el documento (enero 2021) y aborda las tres mutaciones del virus conocidas hasta la fecha del documento: Reino Unido e Irlanda del Norte, República de Sudáfrica y Brasil, siendo la de mayor transmisibilidad, según el documento, la del Reino Unido Destaca la importancia de los protocolos, puesto que ellos han sido parte primordial en la lucha contra la pandemia: "Asimismo, la secuenciación genómica del SARS-CoV-2 y la liberación oportuna de la información no solo permitió la caracterización del agente etiológico involucrado en el brote inicial, sino también el desarrollo oportuno de protocolos de diagnóstico y seguimiento a la evolución de la pandemia de COVID-19. Así, la secuenciación genómica se ha convertido en una herramienta esencial para generar datos virológicos de SARS-CoV-2, para impulsar la respuesta de laboratorio, y entender mejor los patrones de dispersión y evolución de SARS-CoV-2 " Por ello, el objetivo general del documento es: "Contribuir a la generación de datos de las variantes genómicas del virus SARS-CoV-2 para establecer patrones de dispersión y evolución." Así como: "Establecer y actualizar protocolos de detección y tratamiento de COVID-19 utilizando la información generada a partir de la secuenciación de las muestras" (objetivo específico 1).


Assuntos
Humanos , Masculino , Feminino , Controle de Doenças Transmissíveis/métodos , Infecções por Coronavirus , Infecções por Coronavirus/diagnóstico , Pandemias/prevenção & controle , Monitoramento Epidemiológico , Estudos Epidemiológicos , Epidemiologia/classificação , Controle Sanitário de Viajantes , Vigilância em Saúde Pública/métodos , Guatemala
14.
Guatemala; MSPAS; 29 ene. 2021. 6 p.
Não convencional em Espanhol | LILACS, LIGCSA | ID: biblio-1224473

RESUMO

En los antecedentes se presentan estadísticas del COVID-19 a la fecha en la que se elaboró el documento (enero 2021) y aborda las tres mutaciones del virus conocidas hasta la fecha del documento. "La caracterización genética de patógenos virales es la base para el desarrollo de protocolos de diagnóstico, vacunas y medicamentos antivirales. Esta estrategia también es una herramienta útil en salud pública para el seguimiento a brotes y control de enfermedades mediante estudios de epidemiología molecular." "…la secuenciación genómica del SARS-CoV-2 y la liberación oportuna de la información no solo permitió la caracterización del agente etiológico involucrado en el brote inicial, sino también el desarrollo oportuno de protocolos de diagnóstico y seguimiento a la evolución de la pandemia de COVID-19. Así, la secuenciación genómica se ha convertido en una herramienta esencial para generar datos virológicos de SARS-CoV-2, para impulsar la respuesta de laboratorio, y entender mejor los patrones de dispersión y evolución de SARS-CoV-2" De manera que el objetivo del documento es: "Generar información genética mediante la vigilancia genómica de casos confirmados de COVID-19 de pacientes que asisten a los servicios de salud públicos y privados del país, así como del Instituto Guatemalteco de Seguridad Social ­IGSS-."


Assuntos
Humanos , Masculino , Feminino , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/prevenção & controle , Betacoronavirus , Laboratórios/normas , Controle de Infecções/normas , Gestão da Segurança/estatística & dados numéricos , Genômica/tendências , Pandemias/prevenção & controle , Vigilância em Saúde Pública/métodos
16.
J Med Virol ; 93(4): 2099-2114, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33049069

RESUMO

The genomic sequences of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) worldwide are publicly available and are derived from studies due to the increase in the number of cases. The importance of study of mutations is related to the possible virulence and diagnosis of SARS-CoV-2. To identify circulating mutations present in SARS-CoV-2 genomic sequences in Mexico, Belize, and Guatemala to find out if the same strain spread to the south, and analyze the specificity of the primers used for diagnosis in these samples. Twenty three complete SARS-CoV-2 genomic sequences, available in the GISAID database from May 8 to September 11, 2020 were analyzed and aligned versus the genomic sequence reported in Wuhan, China (NC_045512.2), using Clustal Omega. Open reading frames were translated using the ExPASy Translate Tool and UCSF Chimera (v.1.12) for amino acid substitutions analysis. Finally, the sequences were aligned versus primers used in the diagnosis of COVID-19. One hundred and eighty seven distinct variants were identified, of which 102 are missense, 66 synonymous and 19 noncoding. P4715L and P5828L substitutions in replicase polyprotein were found, as well as D614G in spike protein and L84S in ORF8 in Mexico, Belize, and Guatemala. The primers design by CDC of United States showed a positive E value. The genomic sequences of SARS-CoV-2 in Mexico, Belize, and Guatemala present similar mutations related to a virulent strain of greater infectivity, which could mean a greater capacity for inclusion in the host genome and be related to an increased spread of the virus in these countries, furthermore, its diagnosis would be affected.


Assuntos
COVID-19/virologia , Genoma Viral , Mutação , SARS-CoV-2/genética , Belize , COVID-19/diagnóstico , Primers do DNA , Guatemala , Humanos , México , Fases de Leitura Aberta , Reação em Cadeia da Polimerase
17.
Rev Panam Salud Publica ; 44, dec. 2020https://doi.org/10.26633/RPSP.2020.174.
Artigo em Inglês | PAHO-IRIS | ID: phr-53144

RESUMO

[ABSTRACT]. Objectives. To measure protocol adherence and antigen-based detection tests (AgDT) negative predictive value after 3 months of massive use as a diagnostic tool for COVID-19 in Guatemala. Methods. The study period included nasopharyngeal swabs taken between March 12 and August 31, 2020, which results were entered in the national COVID-19 information system. Proportional increase in testing between one month before and one month after the introduction of AgDT (May 9–June 8 vs. June 9–July 8) was measured. Results. After AgDT introduction, there was a 139% increase in SARS-CoV-2 testing. Between June 9 and August 31, 7.8% of 110 657 AgDT-negative patients had follow-up RT-PCR testing. Of them, 30% were RT-PCR positive. Conclusions. While introducing AgDT improved access to diagnostics, ensuring the availability of timely RT-PCR capacities to confirm diagnosis is also key.


[RESUMEN]. Objetivos. Evaluar la adherencia al protocolo y el valor predictivo negativo de las pruebas de detección basadas en antígeno (AgDT) después de 3 meses de uso masivo como método diagnóstico para la COVID-19 en Guatemala. Métodos. Se estudiaron hisopados nasofaríngeos tomados entre el 12 de marzo y el 31 de agosto de 2020, cuyos resultados constaban en el sistema de información nacional de COVID-19. Se midió el aumento proporcional del número de pruebas entre un mes antes y un mes después de la introducción de las AgDT (9 de mayo a 8 de junio, frente a 9 de junio a 8 de julio). Resultados. Después de la introducción de AgDT hubo un aumento del 139% en el número de pruebas de SARS-CoV-2. Entre el 9 de junio y el 31 de agosto, el 7,8% de 110 657 pacientes negativos según una AgDT se sometieron a una prueba de seguimiento con RT-PCR. De ellos, el 30% presentó una RT-PCR positiva. Conclusiones. Aunque la introducción de AgDT mejoró el acceso al diagnóstico, también es clave asegurar la disponibilidad oportuna de RT-PCR para confirmar el diagnóstico.


Assuntos
Testes Laboratoriais , Técnicas de Laboratório Clínico , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Infecções por Coronavirus , Guatemala , COVID-19 , Testes Laboratoriais , Técnicas de Laboratório Clínico , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Infecções por Coronavirus
18.
Artigo em Espanhol | PAHO-IRIS | ID: phr-53115

RESUMO

[RESUMEN]. Objetivos. Presentar una metodología para la formulación simultánea de metas cuantitativas que reflejen tanto la mejoría del promedio nacional de un indicador del tercer Objetivo de Desarrollo Sostenible (ODS3) como la reducción de su desigualdad geográfica. Métodos. Se definió un algoritmo en cinco pasos: a) cálculo del cambio porcentual anual promedio (CPAP) nacional para un indicador del ODS3; b) definición normativa de estratos geográficos a partir de la distribución subnacional del indicador en un año base; c) aplicación de un criterio de progresividad proporcional del CPAP para proyectar el indicador estrato-específico al año meta; d) establecimiento de la meta nacional como el promedio ponderado del indicador en las unidades territoriales subnacionales al año meta; y e) formulación de metas de reducción de desigualdad mediante el cálculo de las brechas absoluta y relativa entre los estratos extremos al año meta. Resultados. Se aplicó el algoritmo al indicador ODS 3.1.1 (razón de mortalidad materna, RMM), desagregado por los 22 departamentos de Guatemala para el año base 2014 (RMM = 113 por 100 000 nacidos vivos). Sosteniendo la intensidad promedio de CPAP observada entre 2009 y 2014 (−4,3%) y focalizando sus acciones con progresividad territorial, el país reduciría al 2030 su RMM a 53 por 100 000 nacidos vivos y sus brechas absoluta y relativa en 72% y 48%, respectivamente. Conclusiones. La metodología propuesta permite formular simultáneamente metas de reducción de las desigualdades geográficas en salud y hacer explícita la primacía del principio de equidad expresado en el compromiso de no dejar a nadie atrás que identifica a los ODS, cuya urgencia cobra renovada relevancia en el escenario pospandémico actual.


[ABSTRACT]. Objectives. Present methodology for the concurrent development of quantitative targets that reflect improvement in the national average of an indicator for Sustainable Development Goal 3 (SDG3), as well as a reduction in geographic inequality. Methods. A five-step algorithm was developed: a) calculate the national average annual percentage change (AAPC) for an SDG3 indicator; b) standardize the definition of geographic strata based on subnational distribution of the indicator in a base year; c) apply a criterion for proportional progress in the AAPC in order to project the stratum-specific indicator to the target year; d) set the national target as the weighted average of the indicator in the subnational territorial units for the target year; and e) develop inequality reduction targets by calculating absolute and relative gaps between the top and bottom strata for the target year. Results. The algorithm was applied to SDG indicator 3.1.1 (maternal mortality ratio, MMR), disaggregated by Guatemala’s 22 departments for base year 2014 (MMR = 113/100,000 live births). By sustaining the average AAPC rate attained from 2009 to 2014 (-4.3%) and targeting its actions to territorial progress, the country would reduce its MMR to 53/100,000 by 2030 and its absolute and relative gaps by 72% and 48%, respectively. Conclusions. The proposed methodology makes it possible to concurrently develop targets for the reduction of geographic inequalities in health and improvements in the national average, with explicit reference to the primacy of the principle of equity expressed in the SDGs’ commitment to leaving no one behind, whose urgency is newly important in the current post-pandemic scenario.


[RESUMO]. Objetivos. Apresentar uma metodologia para a formulação simultânea de metas quantitativas que reflitam tanto a melhoria da média nacional de um indicador do terceiro Objetivo de Desenvolvimento Sustentável (ODS3) quanto a redução das desigualdades geográfica nesse indicador. Métodos. Estabelecemos um algoritmo em cinco etapas: (a) cálculo da variação percentual anual média (VPAM) em um país para um indicador do ODS3, (b) definição normativa de estratos geográficos a partir da distribuição subnacional do indicador em um ano base, (c) aplicação de um critério de progressividade proporcional da VPAM para projetar o indicador específico do estrato para o ano base, (d) estabelecimento da meta nacional como a média ponderada do indicador nas unidades territoriais subnacionais para o ano alvo e (e) estabelecimento de metas para a redução das desigualdades calculando a disparidade absoluta e relativa entre os estratos extremos para o ano alvo. Resultados. Aplicamos o algoritmo ao indicador ODS 3.1.1 (razão de mortalidade materna, RMM), desagregado pelos 22 departamentos da Guatemala para o ano base de 2014 (RMM = 113 por 100.000 nascidos vivos). Se mantiver a intensidade média da VPAM observada entre 2009 e 2014 (-4,3%) e concentrar as suas ações com progressividade territorial, o país reduzirá, até 2030, a sua RMM para 53 por 100.000 e sua disparidade absoluta e relativa em 72% e 48%, respectivamente. Conclusões. A metodologia proposta permite formular simultaneamente metas para a redução das desigualdades geográficas em saúde e explicitar a primazia do princípio da equidade expresso no compromisso de não deixar ninguém para trás consagrado nos ODS, cuja urgência assume uma relevância renovada no atual cenário pós-pandêmico.


Assuntos
Desenvolvimento Sustentável , Equidade em Saúde , Indicadores Básicos de Saúde , Mortalidade Materna , Guatemala , COVID-19 , Desenvolvimento Sustentável , Equidade em Saúde , Indicadores Básicos de Saúde , Mortalidade Materna , Desenvolvimento Sustentável , Equidade em Saúde , Indicadores Básicos de Saúde , Mortalidade Materna
19.
PLoS One ; 15(11): e0240526, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33141833

RESUMO

In-person (face-to-face) data collection methods offer many advantages but can also be time-consuming and expensive, particularly in areas of difficult access. We take advantage of the increasing mobile phone penetration rate in rural areas to evaluate the feasibility of using cell phones to monitor the provision of key health and nutrition interventions linked to the first 1,000 days of life, a critical period of growth and development. We examine response rates to calendarized text messages (SMS) and phone calls sent to 1,542 households over a period of four months. These households have children under two years old and pregnant women and are located across randomly selected communities in Quiche, Guatemala. We find that the overall (valid) response rate to phone calls is over 5 times higher than to text messages (75.8% versus 14.4%). We also test whether simple SMS reminders improve the timely reception of health services but do not find any effects in this regard. Language, education, and age appear to be major barriers to respond to text messages as opposed to phone calls, and the rate of response is not correlated with a household's geographic location (accessibility). Moreover, response veracity is high, with an 84-91% match between household responses and administrative records. The costs per monitored intervention are around 1.12 US dollars using text messages and 85 cents making phone calls, with the costs per effective answer showing a starker contrast, at 7.76 and 1.12 US dollars, respectively. Our findings indicate that mobile phone calls can be an effective, low-cost tool to collect reliable information remotely and in real time. In the current context, where in-person contact with households is not possible due to the COVID-19 crisis, phone calls can be a valuable instrument for collecting information, monitoring development interventions, or implementing brief surveys.


Assuntos
Telefone Celular/estatística & dados numéricos , Infecções por Coronavirus/epidemiologia , Monitorização Fisiológica/estatística & dados numéricos , Estado Nutricional/fisiologia , Pandemias , Pneumonia Viral/epidemiologia , População Rural/estatística & dados numéricos , Adulto , COVID-19 , Telefone Celular/economia , Pré-Escolar , Feminino , Guatemala/epidemiologia , Humanos , Lactente , Recém-Nascido , Masculino , Monitorização Fisiológica/economia , Gravidez , Sistemas de Alerta/economia , Sistemas de Alerta/estatística & dados numéricos , Inquéritos e Questionários , Telemedicina/economia , Telemedicina/estatística & dados numéricos , Envio de Mensagens de Texto/economia , Envio de Mensagens de Texto/estatística & dados numéricos
20.
PLoS One ; 15(10): e0240309, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33075098

RESUMO

INTRODUCTION: Etiology studies of severe acute respiratory infections (SARI) in adults are limited. We studied potential etiologies of SARI among adults in six countries using multi-pathogen diagnostics. METHODS: We enrolled both adults with SARI (acute respiratory illness onset with fever and cough requiring hospitalization) and asymptomatic adults (adults hospitalized with non-infectious illnesses, non-household members accompanying SARI patients, adults enrolled from outpatient departments, and community members) in each country. Demographics, clinical data, and nasopharyngeal and oropharyngeal specimens were collected from both SARI patients and asymptomatic adults. Specimens were tested for presence of 29 pathogens utilizing the Taqman® Array Card platform. We applied a non-parametric Bayesian regression extension of a partially latent class model approach to estimate proportions of SARI caused by specific pathogens. RESULTS: We enrolled 2,388 SARI patients and 1,135 asymptomatic adults from October 2013 through October 2015. We detected ≥1 pathogen in 76% of SARI patients and 67% of asymptomatic adults. Haemophilus influenzae and Streptococcus pneumoniae were most commonly detected (≥23% of SARI patients and asymptomatic adults). Through modeling, etiology was attributed to a pathogen in most SARI patients (range among countries: 57.3-93.2%); pathogens commonly attributed to SARI etiology included influenza A (14.4-54.4%), influenza B (1.9-19.1%), rhino/enterovirus (1.8-42.6%), and RSV (3.6-14.6%). CONCLUSIONS: Use of multi-pathogen diagnostics and modeling enabled attribution of etiology in most adult SARI patients, despite frequent detection of multiple pathogens in the upper respiratory tract. Seasonal flu vaccination and development of RSV vaccine would likely reduce the burden of SARI in these populations.


Assuntos
Bactérias/classificação , Infecções Respiratórias/epidemiologia , Infecções Respiratórias/microbiologia , Vírus/classificação , Adulto , Idoso , Doenças Assintomáticas/epidemiologia , Bactérias/genética , Bactérias/isolamento & purificação , Bangladesh , Teorema de Bayes , Feminino , Guatemala , Humanos , Masculino , Pessoa de Meia-Idade , Modelos Teóricos , Epidemiologia Molecular , Nasofaringe/microbiologia , Orofaringe/microbiologia , Reação em Cadeia da Polimerase , Vírus/genética , Vírus/isolamento & purificação , Adulto Jovem
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