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Cuban mosquitoes are an important factor in the transmission of both viral and protozoal and helminthic diseases. Eighteen species which have transmitted or are potential transmissors of different agents causing diseases in man or in domestic animals are reported in this paper. Sixteen illustrations of the mosquito species with a highest significance in Cuba are enclosed to the paper for their better identification.
The results of screening for G-6-PD deficiency carried out in a sample of 3083 subjects of the central region of Cuba have been analysed in the present study. The frequency of G-6-PD deficiency in this population is high. The proportion of G-6-DP deficient subjects in the negroid group was higher than that encountered in the group of white. No association was found between the age and G-6-DP deficiency.
Poliomyelitis appeared in Cuba in the present century and acquired an endemo -epidemic character, with epidemic peaks every five to seven years. The first polio vaccination campaign, conducted in 1962, changed the trend of the disease by eliminating the morbidity and mortality peaks. Since that time there have been only isolated cases. There have been 21 mass vaccination campaigns, which have been preceded by serologic studies on a sample of the national population younger than 14 years of age. Since the eighth campaign, a trivalent vaccine candy has been administered in two doses to children from one month to three years of age. A booster dose at nine years of age was introduced in the ninth campaign. Since 1962, seven cases have been reported in infants younger than one year of age who, for various reasons, had not been vaccinated. The key to the success of the mass vaccination campaigns conducted over the last 20 years has been the use of the Committees for the Defense of the Revolution. The high vaccination coverage achieved in the various campaigns for each age group (greater than 80%) guarantees that no epidemics will break out in the country. Quality-control surveys following each vaccination operation have yielded an understanding of difficulties and have allowed measures to be taken to improve operations.
Studies were carried out on the occurrence of the Ixodic ticks in farm animals in the province of Camagüey, Cuba. Most spread proved to be the Boophilus microplus and Amblyomma cajennense species. As many as three waves of parasitic activity were seen with B. microplus: at the end of the winter season, in the months of May and June, and in the autumn (October and November). Only one wave was there with the activity of A. cajennense, covering the period of March-September.
Electrophoretic screening system is worked out, which combines a high resolving power in polyacrylamide gel and a principle of simultaneous treatment of a large number of examples. 24,000 blood examples from inhabitants of Havana province (Cuba) are analysed in order to check the efficiency of the method described, to find the hemoglobin S frequency and to use these results in further genetic consulting. The frequency of hemoglobin S carriers is found to be 3.0%, that of hemoglobin C--0.7%. 15 rare hemoglobin variants are detected, 9 variants of alpha-chain and 3 variants of beta-chain are detected. One case was a result of hemoglobin S and a variant of alpha-chain interaction. Frequencies of S, C and A alleles were 0.016, 0.0038 and 0.98 respectively.
Spontaneous embryonic lethality and the recessive lethal gene frequency in the gene pool of noninbred mice and rats of the bioteria of the National Research Center of the Cuba Republic Academy of Sciences were investigated. It was established that the level of spontaneous embryonic lethality among mice increased greatly as compared to that in 1977 and was 40% (versus 20% in 1977). Of this number, 30% falls within the postimplantation period. In noninbred rats, these values constituted 21.4 and 8.1%, respectively. High embryonic lethality among noninbred mice may be determined by genetic causes and the influence of ecological factors. The frequency of recessive lethals among noninbred mice was 28%, that among rats 20.8%. It is characteristic that in both categories, recessive lethals became apparent only in the postimplantation period of embryogenesis.
Thirty-six strains of ovicidal fungi were isolated from 122 investigated soil samples collected in Cuba. The isolated strains belong to 8 genera, 2 strains consist of sterile mycelium only. Most of the strains belong to the genus Fusarium (4 species, 1 undetermined strain), the remaining ones to Mortierella (3 species and 6 undetermined strains), Humicola (2 species), Paecilomyces (2 species) and Penicillium (2 species). The genera Verticillium, Gliocladium and Cunninghamella were represented by one species each. A majority of isolated strains exhibited a high to very high ovicidal activity immediately after isolation; strains with a lower initial activity occurred only exceptionally. The high ovicidal activity has been preserved till now in the following five strains: Paecilomyces marquandii (2 strains), Fusarium solani f. spec. radicicola (1 strain), Mortierella sp. (1 strain) and the sterile mycelium (1 strain).
A practical method for sanitary control of travellers with a risk of introducing communicable diseases which are nonexistent or unusual in Cuba is presented. A classification and the procedure to follow according to the county of origin are included.
An extensively organized, centrally controlled system, aimed at equalizing and improving the distribution and quality of medical services according to population and geography, characterizes the modern Cuban health care complex. Facilities of increasing sophistication are located in urban areas while an expanding series of ambulatory, multipotential polyclinics attempts to provide most health services in both urban and rural settings. Maternal and child care, immunization programs and other forms of preventive medicine represent major priorities for expenditures. Occupational health is increasingly understood as a valuable resource, and medical professionals on all levels are being trained in significant numbers for Cuba and its allies.
A brief description is made of how acute diarrheal diseases, known as gastroenterites, were the cause of diseases and death since the beginning of the Republic. Different results of works carried out by different authors on the mortality due to such diseases is reported. Statistical data show the situation in Latina America according to the criteria of several authors and synthesis is made of the general picture of diarrheal diseases in Cuba, beginning on the decade of 1960. The different causes of these acute diarrheal diseases in our country are analyzed and all the plans and control programs that have been developed up to the presented with the idea of eradicating these diseases are pointed out.
About 300 years ago, admitting children in hospitals started to be done and the complicated problems derived from this fact started as well. Those who followed the school of the psychological and even organic benefit and the evolution of the pathological process of the small patient when he received the family warmth and particularly his mother's, found many opposers. In Cuba, before the Revolution triumph in 1959, due to the great amount of illiteracy, inculture and misery of most of the people, a great deal of our children, when they became ill, were delivered in to hands of babblers or ignorants who gave them decoctions of herbs, and witch treatments, all this accompanied by the lack of medical establishments and staff, especially in the provinces, as well as the low standard of life of most of the people who could not afford the stay in the few existing medical centers which did not offer sanitary education or preventive measures either. After the triumph of the Revolution, a deep change in the social, economical and cultural structures took place in the country giving priority to education and people's health. In this last field, health programs, including food and other material cares, were given to the mother in the hospital during the whole day. The advantages of the mother near the child while he was in the hospital are outlined in the present paper, in addition to the education for health that the Cuban mother receives when she is in the hospital with her child, as well as under other circumstances. Significant achievements reached with this program are equally outlined and thus we find the total eradication of severe diseases for childhood, and among the indicators, the fact of having the lowest children mortality rate in Latin America.
The incidence, prevalence, evolution, prognosis and prophylaxis of rheumatic fever in Cuba are explained. Some results relative to prophylaxis and relapses in two different periods are compared. In both periods, carditis became evident in almost one half of the patients, although its severeness has decreaed in recent years due to the lesser number of cases with congestive heart insufficiency at the initial break. In the last part of the paper, a report is made of the organization established for the management and control of rheumatic patients, according to the new model for medical care in the polyclinics of the community.
The author describes a series of important steps followed in Cuba for the rehabilitation of the diabetic child, like education of the patient and his relatives, active participation of the child in his treatment (self control), hospital attention advisable for a minimal period exclusively in severe cases, attention in office visits as ambulatory patient, participation in vocational, social and psychological orientation activities of the antidiabetic center, areas for sport and recreation, vocational camping for diabetic children, homes, education through press, television and radio of special programs on diabetes.
The purpose of this study was to identify the risk factors for epidemic optic neuropathy, which occurred in Cuba in 1992 and 1993, as well as to formulate a hypothesis about its etiology. The study sample consisted of 551 pairs of cases and controls matched for age, sex, and area of residence. The cases were patients aged 15 years and over who were diagnosed in April 1993. Diagnosis was made in accordance with major criteria (diminished visual acuity, alteration in color vision, scotomata, and changes in the papillo-macular tract) and minor criteria (pallor of the optic disk, photophobia, and others). Cases were selected through systematic sampling of all the country's provinces. The controls were selected from the population registers of the primary care districts. By means of a 52-section questionnaire, information was obtained from the cases and controls about their sociodemographic characteristics, drug and food habits, and exposure to toxic environmental substances. The population group most affected was that of persons 25 to 64 years of age who lived in urban areas. No evidence was found to support biological transmission of the disease, nor were any environmental toxins discovered to be causal agents. Construction of logistic models showed an irregular diet (95% confidence interval of the odds ratio [95%CI OR]: 2.43-3.63), smoking (95% CI OR: 2.60-3.13), and elevated ingestion of sugar (95% CI OR: 1.74-2.52) to be risk factors for the disease. Despite the study's limitations, it supports the hypothesis that the epidemic's pathogenesis is toxic-nutritional. According to this hypothesis, nutritional deficiencies could be responsible for a marked alteration in metabolic detoxification mechanisms, which would increase susceptibility to a noxious agent.
This article describes the basic strategies employed by Cuba's Diarrheal Disease Control Program (DDCP) to reduce acute diarrheal disease (ADD) mortality among infants and young children from 1962 through 1993, together with the diarrheal disease trends recorded in these years. An initial control effort, the Program to Combat Gastroenteritis, began operating in 1963. Since then, in one form or another, increasingly effective efforts have consistently lessened ADD mortality. Among other things, these efforts have concentrated on providing improved sanitation, effective health education, proper nutrition (including promotion of breast-feeding and food hygiene), and adequate health care (which in recent times has placed increasing emphasis on oral rehydration therapy and primary care). Largely as a result, recorded infant ADD mortality fell from 12.9 deaths per 1,000 live births in 1962 to 0.3 in 1993, while recorded mortality from this cause among children 1-4 years old dropped from 6.4 deaths per 10,000 children in this age group in 1962 to 0.1 in 1993. Besides describing the work performed through 1993, the author also outlines plans for the period through 1999 that are directed at maintaining and perhaps augmenting these gains.
This article describes the major activities carried out since 1959 in the field of pediatrics and child care in Cuba. In particular, it notes the improvements made through establishment of a national health system and through the participation of community organizations (the Federation of Cuban Women, Committees for the Defense of the Revolution, associations of small farmers, and trade unions) and shows how perinatal, infant, and childhood mortality have been significantly reduced. As of 1973 perinatal mortality had fallen to 27.9 deaths per 1,000 live births, infant mortality to 27.4 deaths per 1,000 live births, preschool mortality to 1.2 per 1,000 children, and school-age mortality, to 0.4 per 1,000 children. This report also cites data on available physical and manpower resources, and outlines a large range of activities linked to a Comprehensive Child Care Program undertaken in 1967. This program, in which newborns are enrolled upon leaving the maternity, seeks to encourage breast-feeding, to promote the activities of well-baby clinics, to provide special examinations for malnourished infants, to provide health care for preschool and school-age children, to promote pediatric medical visits to the home, to assist with camps for asthmatic and diabetic children, to provide pediatric services at pioneer and other camps for schoolchildren, to carry out health education activities, and to combat communicable disease. In particular, activites to prevent communicable disease appear responsible for a good part of the progress achieved to date. As a result of these activities malaria and diphtheria have been eradicated, poliomyelitis has been overcome, and the incidences of tuberculosis, tuberculous meningitis, tetanus (among both newborns and children under 15), and acute diarrheal disease have been substantially reduced.
A brief account is provided on the main characteristics of the stages in the historical evolution of struggle against tuberculosis in Cuba. The foundations and the steps taken in tuberculosis control are noted. A synthesis of therapeutic schemes used in the last 20 years is provided and the tendency of notification of new cases in 1979-1988 is discussed. During that ten-year period there was a 38.8% reduction.
A description in made about the methodology and outcome of screening conducted on foreing students arriving in Cuba from 1987-1990 to reside for several years. During that period, a total number of 13,025 foreing travellers coming from 36 countries were controlled; of them, 1,100 were positive to some kind of infectious disease. The majority were positive to malaria (838), 220 cases were diagnosed as having epidemic hemorrhagic conjunctivitis and 58 were seropositive to HIV. All positive cases were controlled and treated by the Department of Medical Services of the Institute of Tropical Medicine "Pedro Kouri".