Prevalence of nutritional wasting in populations: building explanatory models using secondary data.
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OBJECTIVE: To understand how social context affects the nutritional status of populations, as reflected by the prevalence of wasting in children under 5 years of age from Africa, Latin America, and Asia; to present a systematic way of building models for wasting prevalence, using a conceptual framework for the determinants of malnutrition; and to examine the feasibility of using readily available data collected over time to build models of wasting prevalence in populations. METHODS: Associations between prevalence of wasting and environmental variables were examined in the three regions. General linear mixed models were fitted using anthropometric survey data for countries within each region. FINDINGS: Low birth weight (LBW), measles incidence, and access to a safe water supply explained 64% of wasting variability in Asia. In Latin America, LBW and survey year explained 38%; in Africa, LBW, survey year, and adult literacy explained 7%. CONCLUSION: LBW emerged as a predictor of wasting prevalence in all three regions. Actions regarding women's rights may have an effect on the nutritional status of children since LBW seems to reflect several aspects of the conditions of women in society. Databases have to be made compatible with each other to facilitate integrated analysis for nutritional research and policy decision-making. In addition, the validity of the variables representing the conceptual framework should be improved. (+info)
Long-term follow-up of chronic hepatitis B virus infection in children of different ethnic origins.
(50/746)
The natural history of chronic hepatitis B in children is influenced by mode of transmission and varies with regional endemicity. Seroconversion rates were studied in 174 hepatitis B e antigen (HBeAg)-positive children who were of different ethnic origins and living in Canada. Overall, 40.2% became anti-HBeAg positive, and 8.6% were hepatitis B surface-antigen positive during a mean follow-up of 4.5 years. Spontaneous seroconversion rates were lower in Asian-born, mainly vertically infected, children, versus those born either in Canada or where horizontal transmission predominates (24% vs. 44%, P=.015). Kaplan-Meier analysis showed that the cumulative persistence of HBeAg after 13 years was 25% in Asian-born children, versus 6% in all others (P<.05). Treatment of 27 children accelerated seroconversion by 3 years, without influencing the proportion seroconverting over time. Thus, although Asian-born children seroconvert more slowly, a large proportion will seroconvert before adulthood. Because treatment appears to accelerate anti-HBe seroconversion, longitudinal studies are required in order to assess the long-term benefits of early treatment. (+info)
Occupational risks in Latin America and the Caribbean: economic and health dimensions.
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This study analyzes health and economic aspects of occupational safety in Latin America and the Caribbean. Work-related injuries and illnesses represent a primary health risk in the region. Specific factors negatively affect work safety in the region: the structure of the labour market, the lack of adequate resources for enforcement, prevention and research, the hazard profile, as well as the presence of vulnerable groups in the workforce. This study estimates that between 27,270 and 73,500 occupational fatal accidents occur in the region each year. It also calculates that the economic costs of these hazards represent between 2 and 4% of regional Gross Domestic Product. The paper concludes by discussing public policies that could address this problem and improve compliance with appropriate safety standards in the region. (+info)
Multicenter assessment of the linezolid spectrum and activity using the disk diffusion and Etest methods: report of the Zyvox(R) antimicrobial potency study in Latin America (LA-ZAPS).
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Linezolid was the first clinically applied member of the new antimicrobial class called the oxazolidinones. These agents have a powerful spectrum of activity focussed against Gram-positive organisms including strains with documented resistances to other antimicrobial classes. We conducted a multicenter surveillance (Zyvox Antimicrobial Potency Study; ZAPS) trial of qualifying Gram-positive isolates from 24 medical centers in eight countries in Latin America. The activity and spectrum of linezolid was compared to numerous agents including glycopeptides, quinupristin/dalfopristin, beta-lactams and fluoroquinolones when testing 2,640 strains by the standardized disk diffusion method or Etest (AB BIODISK, Solna, Sweden). The linezolid spectrum was complete against staphylococci (median zone diameter, 29 - 32 mm), as was the spectrum of vancomycin and quinupristin/dalfopristin. Among the enterococci, no linezolid resistance was detected, and the susceptibility rate was 93.1 - 96.4%. Only the vancomycin-susceptible Enterococcus faecium strains remained susceptible (92.8%) to quinupristin/dalfopristin. Marked differences in the glycopeptide resistance patterns (van A versus van B) were noted for the 22 isolates of VRE, thus requiring local susceptibility testing to direct therapy. Streptococcus pneumoniae and other species were very susceptible (100.0%) to linezolid, MIC(90) at 0.75 microg/ml. Penicillin non-susceptible rate was 27.7% and erythromycin resistance was at 17.4%. Other streptococci were also completely susceptible to linezolid (MIC(90), 1 microg/ml). These results provide the initial benchmark of potency and spectrum for linezolid in Latin American medical centers. Future comparisons should recognize that the oxazolidinones possess essentially a complete spectrum coverage of the monitored staphylococci, enterococci and streptococcal isolates in 2000-2001. This positions linezolid as the widest spectrum empiric choice against multi-resistant Gram-positive cocci, a spectrum of activity greater than available glycopeptides and the streptogramin combination. (+info)
Sildenafil citrate (Viagra) in the treatment of men with erectile dysfunction in southern Latin America: a double-blind, randomized, placebo-controlled, parallel-group, multicenter, flexible-dose escalation study.
(53/746)
Our objectives were: (1) to determine the efficacy, safety, and tolerability of sildenafil citrate (Viagra) administered to men with broad-spectrum erectile dysfunction (ED) in southern Latin America; and (2) to correlate Rigiscan measurements assessing ED etiology with the investigator's assessment. A total of 141 men with broad-spectrum ED (mean age 57) were enrolled in a randomized, 12-week, double-blind, placebo-controlled, flexible-dose escalation study of sildenafil. After the 12-week treatment period, the mean score for the primary efficacy variables had risen significantly: for the sildenafil group, 66.2% from baseline for question 3 of the International Index of Erectile Function and 77.6% for question 4, vs 15.1% and 21.2% for the placebo group, respectively (P<0.0001). Rigiscan data confirmed investigator assessments of etiology. Headache and flushing, usually mild and transient, were the most common adverse events. Sildenafil was an effective, well-tolerated treatment for men in southern Latin America with broad-spectrum ED. (+info)
Tolerability and safety profile of sildenafil citrate (Viagra) in Latin American patient populations.
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Safety data from 546 men with erectile dysfunction (ED) enrolled in three double-blind, placebo-controlled studies conducted in distinct regions of Latin America were pooled and analyzed. The most commonly reported adverse events of all causalities associated with sildenafil treatment were headache (19%), flushing (14%), dyspepsia (6%), and nasal congestion (4%), reflecting the inhibitory effects of sildenafil on cyclic guanosine monophosphate (cGMP)-specific phosphodiesterase type 5 (PDE5) in the peripheral vasculature, gastroesophageal sphincter, and nasal mucosa. Visual symptoms were reported in 5.5%, reflecting sildenafil's minor inhibitory effects on cGMP-specific PDE6 in the retina. These adverse events were generally transient and mild, and rarely resulted in discontinuation of sildenafil therapy. Thus, in this representative sample of Latin American men with ED, including those with concomitant stable cardiovascular disease, sildenafil treatment was well tolerated with an incident rate of adverse events similar to reports from other patient populations. (+info)
Determination of deforestation rates of the world's humid tropical forests.
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A recently completed research program (TREES) employing the global imaging capabilities of Earth-observing satellites provides updated information on the status of the world's humid tropical forest cover. Between 1990 and 1997, 5.8 +/- 1.4 million hectares of humid tropical forest were lost each year, with a further 2.3 +/- 0.7 million hectares of forest visibly degraded. These figures indicate that the global net rate of change in forest cover for the humid tropics is 23% lower than the generally accepted rate. This result affects the calculation of carbon fluxes in the global budget and means that the terrestrial sink is smaller than previously inferred. (+info)
HIV infection among people of foreign origin voluntarily tested in Spain. A comparison with national subjects.
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OBJECTIVES: To describe exposure categories and HIV prevalence among subjects voluntarily tested in Spain by country of origin. METHODS: HIV prevalence and exposure categories were compared between national and non-Spanish subjects voluntarily tested in 18 sexually transmitted disease/HIV testing clinics from 16 Spanish cities in 2000. RESULTS: Of 8861 testers, 2810 (31.7%) came from foreign countries; 73.1% from Latin America, 9.1% from western Europe, 6.2% from central/eastern Europe, 4.4% from northern Africa, and 4.2% from sub-Sahara Africa. Among women from Latin America, 78% were sex workers compared to 5.5% Spanish women. HIV infection was diagnosed in 170 persons, 34.7% from foreign countries. HIV prevalence for Spanish subjects (23% for men and 1.0% for women) was significantly different from men and women from Latin America (11.3% and 0.3% respectively), Sub-Saharan Africa (9.1% and 7.5% respectively), and women from the north of Africa (11.8%). Compared with Spaniards, analyses of persons of the same exposure category showed higher HIV prevalence in men who had sex with men from Latin America (odds ratio: 4.1; 95% CI: 2.4-6.9), heterosexual men from sub-Sahara Africa (OR: 19.3; 95% CI: 6.4-58.0), and Latin America (OR: 9.4; 95% CI: 3.4-25.9), heterosexual women from sub-Sahara Africa (OR: 16.9; 95% CI: 3.5-82.4) and from northern Africa (OR: 15.3; 95% CI: 3.2-73.2). CONCLUSIONS: An important proportion of HIV testers from these clinics came from foreign countries and some groups showed a high prevalence of HIV infection. Specific prevention and testing programmes adapted to the needs of migrants in Spain should be developed. (+info)