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PubMed2005

[The People's Health Movement: health for all now].

We are moving away from the year 2000, and the goal of "health for all" remains distant. Economic globalization, which many consider to be one of the most serious threats to health, moves ahead, along with globalization of international health policies. A small number of powerful actors are in charge of setting the agenda, and they relegate to an inferior position the World Health Organization, which has moved away from the goal of "health for all." All of this has helped to promote a neoliberal mentality in the field of health. The People's Health Movement was created with the objective of reestablishing the right to comprehensive health and to development with equity as principal priorities of health policies at the local, national, and international levels. The People's Health Movement uses as a strategy the People's Charter for Health, which was approved at the first People's Health Assembly, which was held in Bangladesh in 2000. The Charter expresses collective concerns and the belief in a better and healthier world as a meeting point in order to promote a world health movement and a call for radical action. In July 2005 the People's Health Movement will hold the People's Health Assembly 2, in the city of Cuenca, Ecuador. The slogan of that meeting will be "The voices of the earth are calling!--let's build a healthy world." Among the topics that will be examined at the meeting are: health as a fundamental human right; militarization and occupation; environmental degradation; emerging and reemerging pandemics; equity, poverty, and health; the importance of cultural diversity; social and political violence; health in the hands of the people; health at work; traditional medicine and bioenergetic medicine; gender; and health sector reform. The objective of the People's Health Movement is to help to reach the Millennium Development Goals and to smooth the path toward attaining health for all, in Latin America and the Caribbean as well as in the rest of the world.

Global Health↗
PubMedDate not supplied

[Norms and standards for radiofrequency electromagnetic fields in Latin America: guidelines for exposure limits and measurement protocols].

New technologies that use electromagnetic fields (EMF) have proved greatly beneficial to humankind. EMF are used in a variety of ways in the transmission of electrical energy and in telecommunications, industry, and medicine. However, some studies have shown that EMF could be detrimental to one's health, having found an association between exposure to EMF on the one hand, and the incidence of some types of cancer as well as behavioral changes on the other. Although so far there is no concrete proof that exposure to low-intensity EMF is hazardous, researchers continue to study the issue in an attempt to reach a consensus opinion and to establish safety standards. While developing and establishing such norms and standards have traditionally been the responsibility of international specialized agencies, national health authorities should take an active part in this process. Currently the Pan American Health Organization is promoting scientific research, often in the form of epidemiologic studies, in order to propose uniform norms and standards. Some Latin American countries, including Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Mexico, Peru, and Venezuela, have already enacted incomplete or partial legislation based on recommended international standards. This article describes the norms established in Latin America and the particular approach taken by each country.

Electromagnetic Fields↗
PubMed2005

Bartonelosis (Carrion's Disease) in the pediatric population of Peru: an overview and update.

Bartonellosis, or Carrion's Disease, is an endemic and reemerging disease in Peru and Ecuador. Carrion's Disease constitutes a health problem in Peru because its epidemiology has been changing, and it is affecting new areas between the highland and the jungle. During the latest outbreaks, and previously in endemic areas, the pediatric population has been the most commonly affected. In the pediatric population, the acute phase symptoms are fever, anorexia, malaise, nausea and/or vomiting. The main signs are pallor, hepatomegaly, lymphadenopathies, cardiac murmur, and jaundice. Arthralgias and weight loss have also commonly been described. The morbidity and mortality of the acute phase is variable, and it is due mainly to superimposed infections or associated respiratory, cardiovascular, neurological or gastrointestinal complications. The eruptive phase, also known as Peruvian Wart, is characterized by eruptive nodes (which commonly bleed) and arthralgias. The mortality of the eruptive phase is currently extremely low. The diagnosis is still based on blood culture and direct observation of the bacilli in a blood smear. In the chronic phase, the diagnosis is based on biopsy or serologic assays. There are nationally standardized treatments for the acute phase, which consist of ciprofloxacin, and alternatively chloramphenicol plus penicillin G. However, most of the treatments are based on evidence from reported cases. During the eruptive phase the recommended treatment is rifampin, and alternatively, azithromycin or erythromycin.

Bartonella Infections↗
PubMed2003

In vivo and in vitro rearing of Pediculus humanus capitis (Anoplura: Pediculidae).

Four geographically distinct colonies of the human head louse, Pediculus humanus capitis De Geer (Anoplura: Pediculidae) were reared on a live host and exhibited significantly different life history patterns. Florida head lice exhibited approximately 10% slower development and approximately 15% reduced longevity relative to California or Ecuador head lice. Fecundity (4.9 +/- 0.2 eggs/female/d) and fertility (76.4 +/- 2.9% mean hatching rate) declined over the lifetime of female lice, especially when separated from males (i.e., unmated recently). All four colonies (above plus one from Panama) were similar in their ability to tolerate starvation, although older stages tended to die sooner. An in vitro feeding apparatus was developed to rear head lice. Teneral first instar lice were placed on human hair tufts on the upper side of membrane-covered feeders, which were immersed bottom-side down within a vessel containing warmed human blood. Relative to lice reared on a human host, in vitro-reared lice required a significantly longer time (10-20%) to molt and survived a significantly shorter time as adults (30-50%); the addition of antibiotics did not adversely affect louse development. Teneral first instars were more likely than any other stage to feed through the membrane. Lice spent a significantly greater proportion of time searching in the in vitro apparatus than on a host, but the proportion of time spent feeding did not differ. This research is the first to demonstrate that head lice can be reared successfully in vitro through a complete life cycle.

Animals↗
PubMedDate not supplied

Molecular characterization of infectious bursal disease virus from commercial poultry in the United States and Latin America.

From June 1999 to September 2001, 216 bursal samples from broiler farms in the United States and from countries of Latin America were submitted to the Poultry Diagnostic and Research Center at the University of Georgia for the purpose of genotyping field infectious bursal disease viruses (IBDVs). The reverse transcriptase-polymerase chain reaction (RT-PCR) was used to amplify a 248-bp product, encompassing the hypervariable region of VP2 gene. The genotyping was conducted by restriction fragment length polymorphism (RFLP) analysis with six restriction endonucleases, DraI, SacI, TaqI, Sty, BstNI, and SspI. For the 150 samples received from the United States, 125 samples (83.3%) were RT-PCR positive for the presence of IBDV. One hundred positive samples (80%) had RFLP identical to the variant Delaware E strain, whereas 10 samples (8.0%) exhibited a RFLP pattern similar to this antigenic variant. Other IBDV strains such as Grayson Laboratory strain (GLS), Lukert, PBG-98, Delaware A, and the vaccine strains Sal-1 and D-78 were also detected. Two samples exhibited a pattern similar to the standard challenge (STC) strain, and seven strains (5.6%) were not classified by RFLP. Sixty-six bursal samples previously inactivated with phenol were received from Latin American countries. IBDV strains with analyzed genotypes similar to the Lukert strain were predominantly detected in Mexico. IBDV strains similar to variant E were detected in Colombia and Ecuador. Peru and Venezuela exhibited a higher heterogeneity of IBDV strains due to the detection of classic Delaware type as well as GLS variant strains. IBDV strains detected from Brazil and Dominican Republic exhibited RFLP patterns identical to very virulent IBDV strains prevalent in several countries in Europe, Asia, and Africa.

Animals↗
PubMed1996

Epizootiology, distribution and the impact on international trade of two penaeid shrimp viruses in the Americas.

Marine penaeid shrimp are effected by approximately twenty viruses, the majority of which were discovered as a result of their negative effects on aquaculture. In the Americas, infectious hypodermal and haematopoietic necrosis (IHHN) virus and Taura syndrome (TS) virus have had a significant negative impact on aquaculture industries and, in one instance, on a commercial fishery. Both viruses have become widely distributed as a consequence of the movement of host stocks for aquaculture. IHHN virus (IHHNV) causes catastrophic losses in cultured and wild Penaeus stylirostris. In marked contrast, P. vannamei is relatively resistant to IHHN but infection results, nonetheless, in poor culture performance. TS virus (TSV) is the 'mirror image' of IHHNV in its effect on P. stylirostris and P. vannamei. TSV causes catastrophic losses in P. vannamei, whereas P. stylirostris is highly resistant to TS. In the less than three years since the discovery of TSV in Ecuador in 1992, the virus has spread rapidly and caused massive production losses in most shrimp-growing countries in the Americas.

Animals↗
PubMed2003

Research on health inequalities in Latin America and the Caribbean: bibliometric analysis (1971-2000) and descriptive content analysis (1971-1995).

We conducted a bibliometric and content analysis of research on health inequalities produced in Latin American and Caribbean countries. In our bibliometric analysis (n = 576), we used indexed material published between 1971 and 2000. The content analysis (n = 269) covered the period 1971 to 1995 and included unpublished material. We found recent rapid growth in overall output. Brazil, Chile, and Mexico contributed mostly empirical research, while Ecuador and Argentina produced more conceptual studies. We found, in the literature reviewed, a relative neglect of gender, race, and ethnicity issues. We also found remarkable diversity in research designs, however, along with strong consideration of ecological and ethnographic methods absent in other research traditions.

Bibliometrics↗
PubMed1977

The epidemiology of drug promotion.

A survey was conducted on the promotion of 28 prescription drugs in the form of 40 different products marketed in the United States and Latin America by 23 multinational pharmaceutical companies. Striking differences were found in the manner in which the identical drug, marketed by the identical company or its foreign affiliate, was described to physicians in the United States and to physicians in Latin America. In the United States, the listed indications were usually few in number, while the contraindications, warnings, and potential adverse reactions were given in extensive detail. In Latin America, the listed indications were far more numerous, while the hazards were usually minimized, glossed over, or totally ignored. The differences were not simply between the United States on the one hand and all the Latin American countries on the other. There were substantial differences within Latin America, with the same global company telling one story in Mexico, another in Central America, a third in Ecuador and Colombia, and yet another in Brazil. The companies have sought to defend these practices by contending that they are not breaking any Latin American laws. In some countries, however, such promotion is in clear violation of the law. The corporate ethics and social responsibilities concerned here call for examination and action.

Adrenal Cortex Hormones↗
PubMed2002

[Obesity prevalence in Latin America].

Obesity is a public health problem that affects both the developed and the developing countries. Its aetiology includes genetic factors and lifestyle (diet and physical activity). The studies of its prevalence in different strata and localisations of the Latin American countries varied between 22-26% in Brazil, 21% in Mexico, 10% in Ecuador, 3-22% in Peru, 22-35% in Paraguay and 24-27% in Argentina, although these data should not be extrapolated to the general population. The comparative national studies made it possible to establish that: 1.- The prevalence of preobesity plus obesity was above 20% in 17 of the 20 countries. 2.- There is a trend to increase in the prevalence of obesity. 3.- The relation of obesity between women/men is significantly higher in females in the majority of countries. In any case, although the validity of these rates must be examined with care, since the goals of evaluation and comparison with the corresponding patterns might differ, it can be observed that the epidemiological transition in these countries leads to a growing number of persons with obesity.

English Abstract↗
PubMed1998

Sequence analysis of the rDNA internal transcribed spacer 2 of five species of South American human malaria mosquitoes.

The rDNA internal transcribed spacer 2 (ITS2) was sequenced for 5 species of mosquitoes that may be important vectors of human malaria in certain regions of South America and are difficult to distinguish by morphology: Anopheles evansae, An. nuneztovari, An. rangeli, An. strodei and An. trinkae. ITS2 sequences from samples collected in Ecuador, Bolivia, Venezuela and Brazil were aligned and compared in order to determine the usefulness of this spacer for the elaboration of species specific primers and DNA probes. The ITS2 was found to be different in size (ranging from 333 to 397 bp) and sequence between all pairs of species. Highly variable regions were found primarily at the 3' end of the spacer and were interspersed with relatively conserved sites. Instraspecific sequence variation was limited to a single transversion between specimens of An. rangeli from distant geographic locations suggesting concerted evolution and homogenization of the ITS2.

Animals↗
PubMed2005

The importance of low serum levels of high-density lipoprotein cholesterol (HDL-C) as a cardiovascular risk factor.

In order to discuss and establish a joint position on the treatment of low serum levels of high-density lipoprotein cholesterol (HDL-C), a group of experts involved in the care of people with dyslipidaemia and at risk of cardiovascular disease met in Miami, Florida, U.S., on 5th and 6th March 2005. The experts came from the Latin American countries Argentina, Brazil, Chile, Colombia, Ecuador, Guatemala, Mexico and Venezuela and had at least five years of experience in the care of patients with dyslipidaemia and low HDL-C. The main objective of the meeting was to discuss and propose a treatment for low serum HDL-C levels as a cardiovascular risk factor in patients and to create a group of useful recommendations in this regard, applicable to the daily clinical practice of physicians dealing with patients with dyslipidaemia and cardiovascular disease. This document describes the methodology developed to obtain these recommendations and presents the results of this academic meeting.

Biomarkers↗
PubMed2005

Primary screening of relatively less allergenic wheat varieties.

Since the number of wheat-allergic patients has been increasing in recent years, less allergenic wheat varieties are socially demanded. The aim of this study was to primarily screen 324 varieties of wheat picked up from various parts of the world. Prior to the screening, the inhibition ELISA (enzyme-linked immunosorbent assay) was examined with major wheat allergens (glutenin, gliadin and alpha-amylase inhibitor). As a result, the patient's IgE antibodies used in this assay reacted to these three allergens, and thereby turned out to be suitable for the primary screening for the less allergenic wheat varieties. Thus, the allergenicity of each wheat sample was measured by direct ELISA using the sole patient's serum as an IgE source and 'Aoba Komugi' as a control (a value of 1.0). The mean +/- SD of all kinds was 1.14 +/- 0.37. Among them, 'CM32859' (Mexico) gave the lowest value (0.38). Several other varieties, such as 'Einkorn' (Unknown), 'Iliniaza' (Ecuador), 'Hsin Mai 2' (China), 'Italy 1' (Italy) and so on, also serve as candidates for the less allergenic varieties. More detailed secondary screening will lead to a finding of the less allergenic wheat varieties for wheat-allergic patients, because these varieties are expected to become mother plants for breeding.

Allergens↗
PubMedDate not supplied

DDT, global strategies, and a malaria control crisis in South America.

Malaria is reemerging in endemic-disease countries of South America. We examined the rate of real growth in annual parasite indexes (API) by adjusting APIs for all years to the annual blood examination rate of 1965 for each country. The standardized APIs calculated for Brazil, Peru, Guyana, and for 18 other malaria-endemic countries of the Americas presented a consistent pattern of low rates up through the late 1970s, followed by geometric growth in malaria incidence in subsequent years. True growth in malaria incidence corresponds temporally with changes in global strategies for malaria control. Underlying the concordance of these events is a causal link between decreased spraying of homes with DDT and increased malaria; two regression models defining this link showed statistically significant negative relationships between APIs and house-spray rates. Separate analyses of data from 1993 to 1995 showed that countries that have recently discontinued their spray programs are reporting large increases in malaria incidence. Ecuador, which has increased use of DDT since 1993, is the only country reporting a large reduction (61%) in malaria rates since 1993. DDT use for malaria control and application of the Global Malaria Control Strategy to the Americas should be subjects of urgent national and international debate. We discuss the recent actions to ban DDT, the health costs of such a ban, perspectives on DDT use in agriculture versus malaria control, and costs versus benefits of DDT and alternative insecticides.

Agriculture↗
PubMedDate not supplied

First case of yellow fever in French Guiana since 1902.

The first case of yellow fever in French Guiana since 1902 was reported in March 1998. The yellow fever virus genome was detected in postmortem liver biopsies by seminested polymerase chain reaction. Sequence analysis showed that this strain was most closely related to strains from Brazil and Ecuador.

DNA, Viral↗
PubMedDate not supplied

Dengue reemergence in Argentina.

Aedes aegypti, eradicated from Argentina in 1963, has now reinfested the country as far south as Buenos Aires. In 1997, four persons with travel histories to Brazil, Ecuador, or Venezuela had confirmed dengue, and surveillance for indigenous transmission allowed the detection of 19 dengue cases in Salta Province. These cases of dengue are the first in Argentina since 1916 and represent a new southern extension of dengue virus.

Aedes↗
PubMedDate not supplied

Epidemiology and molecular pathology of gallbladder cancer.

Gallbladder cancer is usually associated with gallstone disease, late diagnosis, unsatisfactory treatment, and poor prognosis. We report here the worldwide geographical distribution of gallbladder cancer, review the main etiologic hypotheses, and provide some comments on perspectives for prevention. The highest incidence rate of gallbladder cancer is found among populations of the Andean area, North American Indians, and Mexican Americans. Gallbladder cancer is up to three times higher among women than men in all populations. The highest incidence rates in Europe are found in Poland, the Czech Republic, and Slovakia. Incidence rates in other regions of the world are relatively low. The highest mortality rates are also reported from South America, 3.5-15.5 per 100,000 among Chilean Mapuche Indians, Bolivians, and Chilean Hispanics. Intermediate rates, 3.7 to 9.1 per 100,000, are reported from Peru, Ecuador, Colombia, and Brazil. Mortality rates are low in North America, with the exception of high rates among American Indians in New Mexico (11.3 per 100,000) and among Mexican Americans. The main associated risk factors identified so far include cholelithiasis (especially untreated chronic symptomatic gallstones), obesity, reproductive factors, chronic infections of the gallbladder, and environmental exposure to specific chemicals. These suspected factors likely represent promoters of carcinogenesis. The main limitations of epidemiologic studies on gallbladder cancer are the small sample sizes and specific problems in quantifying exposure to putative risk factors. The natural history of gallbladder disease should be characterized to support the allocation of more resources for early treatment of symptomatic gallbladder disease in high-risk populations. Secondary prevention of gallbladder cancer could be effective if supported by cost-effective studies of prophylactic cholecystectomy among asymptomatic gallstone patients in high-risk areas.

Cholelithiasis↗
PubMedDate not supplied

Intersterility, morphology and taxonomy of Ceratocystis fimbriata on sweet potato, cacao and sycamore.

Ceratocystis fimbriata is a large, diverse complex of species that cause wilt-type diseases of many economically important plants. Previous studies have shown that isolates in three monophyletic lineages within the Latin American clade of C. fimbriata are host-specialized to cacao (Theobroma cacao), sweet potato (Ipomoea batatas) and sycamore (Platanus spp.), respectively. We paired testers of opposite mating type from isolates of these lineages to find intersterility groups. Two intersterility groups corresponded to the sweet potato and sycamore lineages, respectively. The cacao lineage contained two intersterility groups, corresponding to two genetic sublineages centered in western Ecuador and Brazil/Costa Rica/Colombia. Six isolates from cacao that were not members of the cacao lineage and were not pathogenic to cacao in an earlier study also were intersterile with members of the two cacao intersterility groups. Some pairings between testers from different lineages or sublineages yielded perithecia from which a few abnormal progeny could be recovered, typical of interspecific hybrids. These progeny showed abnormal segregation of the MAT-2 gene and mycelial morphology, showing that they were indeed the result of crosses. Isolates of the sweet potato, cacao, and sycamore lineages were indistinguishable morphologically except for the presence or absence of a doliform (barrel-shaped) conidial state and minor differences in size of perithecial bases and necks and ascospores. C. fimbriata originally was described from sweet potato. We describe the cacao pathogen as a new species, Ceratocystis cacaofunesta and we raise the sycamore pathogen from a form to species Ceratocystis platani.

Ascomycota↗
PubMed2006

[Malaria: report of 12 non autochthonous cases].

Malaria is a protozoan infection caused by four Plasmodia species transmitted by female Anopheles mosquito. Nearly 40% of the world population is at risk of acquiring the disease because of increasing resistance to treatment, climate changes and travels to endemic zones. We report twelve patients with diagnosis of malaria, supported by the identification of parasites on blood smear. All cases had traveled to endemic zones (Peru, Ecuador, Central America, Africa), but only three used chemoprophylaxis. Seven cases were infected with Plasmodium vivax and five cases with P. falciparum. Three of latter required intensive care. All patients were treated with standard drugs according to the severity and Plasmodium specie, with excellent results and no mortality.

Adolescent↗